Antidepressants and psychological treatments such as hypnotherapy have the potential to help patients with severe irritable bowel syndrome (IBS).
IBS is a very common disorder, but conventional ‘physical' treatments often do not work very well.
Patients with IBS are more likely to suffer from depression and have ‘abnormal' behaviour patterns including anxiety and somatisation.
Patients can feel that their symptoms are being ignored, downplayed or misunderstood.
Dr Ian Forgacs and colleagues from England assessed this conversion of an emotional, mental, or psychosocial problem to a physical complaint.
|Hypnotherapy may help those patients whose IBS is severe|
|British Medical Journal|
The research team evaluated the idea that IBS has a psychological and a biological basis.
The researchers reviewed the growing body of evidence that supports the use of antidepressants for IBS.
The team commented that many doctors are reluctant to prescribe such agents to patients who are clearly not depressed.
The researchers found that other ‘psychological' therapies exist that patients with IBS should be made aware of.
For example, ‘talking therapy', also known as cognitive behavioural therapy, is as effective as antidepressant treatment, and its benefits last longer.
The researchers noted that hypnotherapy has also been reported to be an effective intervention for IBS in small trials.
However, a recent review of hypnotherapy trials found insufficient evidence to recommend its widespread use.
The team observed that suggestions were made that this treatment option should be restricted to specialist centres dealing with more severe cases of the syndrome.
The team noted that hypnotherapy has the potential to help those patients whose IBS is severe.
Dr Forgacs' team concluded, "The choice of treatment will depend on the individual patient and, inevitably, will be limited by local availability."
"However, IBS is undeniably very common, and many patients are probably denied help by lack of access to therapists with the appropriate psychological skills."
"Increasing provision of primary care services for patients with IBS will provide an avenue for effective and early psychological treatment for a condition in which real improvement can be achieved."