Patient - Irritable Bowel Syndrome (IBS) Meditation/Relaxation

• Gaylord S, Palsson OS, Garland E, et al. The University of North Carolina at Chapel Hill. Therapeutic impact of mindfulness meditation on Irritable Bowel Syndrome (IBS): Results of a randomized controlled trial. Program and abstracts of Digestive Disease Week 2011; May 7-10, 2011; Chicago, Illinois. Abstract 219.

  Seventy-five women with IBS were randomly assigned to either a course of mindfulness training or a support group for 8 weekly group sessions plus a half-day retreat. There were significantly greater reductions in overall IBS symptom severity after treatment and at 3 month follow-up in the meditation group. Changes in quality-of-life, anxiety and psychological distress also improved more in the meditation group than the support group at 3 month follow-up. Mindfulness training as an intervention for IBS has a substantial therapeutic effect on bowel symptom severity and also results in improved health-related quality of life and reduced psychological symptoms.

• Keefer L and Blanchard EB. "A one year follow-up of relaxation response meditation as a treatment for irritable bowel syndrome. Behaviour Research & Therapy. 40(5): 541-546, 2002.

  Ten of thirteen original participants of a study of IBS participated in a one year follow-up study to determine whether the effects of Relaxation Response Meditation (RRM) on IBS symptom reduction were maintained over the long-term. From pre-treatment to one-year follow-up, significant reductions were noted for the symptoms of abdominal pain, diarrhea, flatulence, and bloating. When changes from the original three month follow-up point to the one year follow-up were examined, significant additional reductions in pain and bloating were noted, which tended to be the most distressing symptoms of IBS. It appears that: (1) continued use of meditation is particularly effective in reducing the symptoms of pain and bloating and (2) Relaxation Response Meditation is a beneficial treatment for IBS in the both short- and the long-term.

• Keefer L and Blanchard EB. "The effects of relaxation response meditation on the symptoms of irritable bowel syndrome: Results of a controlled treatment study." Behaviour Research & Therapy. 39(7): 801-811, 2001.

  In this study, Herbert Benson’s (1975) Relaxation Response Meditation program was tested as a possible treatment for Irritable Bowel Syndrome (IBS). Sixteen participants were randomized to either a six week meditation condition or a six week wait list symptom monitoring condition. Thirteen participants completed treatment and follow-up. Patients in the treatment condition were taught the meditation technique and asked to practice it twice a day for 15 minutes. Symptom Reduction scores were calculated for each patient from end of baseline to two weeks post-treatment (or to post wait list). Meditation was found to be superior to the symptom-monitoring control. Significant improvements were noted for flatulence and belching by post-treatment. By three month follow-up, significant improvements in flatulence, belching, bloating, and diarrhea were shown on symptom diary. Constipation approached significance. Benson’s Relaxation Response Meditation appears to be a viable treatment for IBS.

• Lahmann C, Röhricht F, Sauer N, et al. Functional relaxation as complementary therapy in irritable bowel syndrome: a randomized, controlled clinical trial. J Altern Complement Med. 16(1):47-52, 2010.

  Seventy-eight patients were randomly assigned either to functional relaxation or to enhanced medical care (treatment as usual plus two counseling interviews) as control intervention with 2 weekly sessions over the 5-week trial each. Results suggest that functional relaxation training has positive effects on subjective functional impairment in IBS, if provided in addition to treatment as usual, and that there is thus a clinically relevant long-term benefit of functional relaxation as a nonpharmacological and complementary therapy approach in IBS.

• Ljótsson B, Hedman E, Lindfors P, et al. Long-term follow-up of internet-delivered exposure and mindfulness based treatment for irritable bowel syndrome. Behav Res Ther. 49(1):58-61, 2011.

  This article presents a follow-up of a previously reported study of internet-delivered cognitive behavior therapy (CBT) for IBS, based on exposure and mindfulness exercises. Seventy-five participants from the original sample of 85 (88%) reported follow-up data at 15-18 months after completing treatment. Fifty participants (59% of the total original sample) reported adequate relief of symptoms. Results suggest that internet-delivered CBT has long-term beneficial effects for IBS-patients including IBS symptoms, quality of life, and anxiety related to gastrointestinal symptoms.

• Ljótsson B, Andréewitch S, Hedman E, et al. Exposure and mindfulness based therapy for irritable bowel syndrome--an open pilot study. J Behav Ther Exp Psychiatry. 41(3):185-90, 2010.

  Thirty-four patients with IBS received a 10-week group therapy based on exposure and mindfulness. A gastrointestinal symptom diary, self-report questionnaires covering quality of life, gastrointestinal specific anxiety, general functioning, and a psychiatric interview were used to assess patients. Results suggest that exposure and mindfulness interventions are effective in improving symptoms of IBS (mean reduction in symptoms was 41% and 50% of patients), but further randomized studies are needed to confirm the efficacy of the treatment.

• van der Veek PP, van Rood YR, Masclee AA. Clinical trial: short- and long-term benefit of relaxation training for irritable bowel syndrome. Aliment Pharmacol Ther. 26(6):943-52, 2007.

  Ninety-eight irritable bowel syndrome patients were included in this randomized controlled trial. Forty-six patients received standard medical care and 52 received four 90-min sessions of relaxation training in small groups in addition to standard medical care. Results suggest that relaxation training is a brief group intervention that significantly improves symptom severity, general health perception and medical consumption in irritable bowel syndrome patients immediately after, as well as 6 and 12 months after intervention.