The current goal of treatments in irritable bowel syndrome focus primarily on symptom management and attempts to improve quality of life. Several treatments are at the disposal of physicians, with lifestyle and dietary management, pharmacological treatments, and psychological interventions as the most used and recommended. Psychological treatments have been proposed as viable alternatives or compliments to existing models of care. Most forms of psychological therapies studied have been shown to be helpful in reducing symptoms and in improving psychological components of anxiety/depression, and health-related quality of life. According to current NICE/NHS guidelines, physicians should consider referral for psychological treatment in patients who do not respond to pharmacotherapy for a period of 12 months and develop a continuing symptom profile (described as refractory irritable bowel syndrome). So far, Cognitive Behavioural Therapy has been the most well-studied and has been presented as the most promising treatment. However, some studies have challenged the effectiveness of Cognitive Behavioural Therapy for irritable bowel syndrome, with one study highlighting Cognitive Behavioural Therapy as not being more effective than an attention control placebo and another showing effects to wane at 6 months follow-up. A review of mind/body approaches to irritable bowel syndrome has therefore suggested that approaches that target mechanisms other than thought content change might be helpful, specifically mindfulness and acceptance based approaches. In this article, we intend to review these new psychological treatment approaches in an attempt to raise awareness of these alternative treatments to gastroenterologists that work with this clinical syndrome.
- irritable bowel syndrome
- acceptance and commitment therapy
- mental disorders
- cognitive therapy