Mind Over Gut?
Depression treatments seem to help irritable bowel

(HealthDay News) -- Depression treatments, even for those not feeling blue, just might ease irritable bowel symptoms.

Researchers believe that there's a mind-body connection between the brain and the intestines and that medicines that work on one area could also work well on the other.

"People who have irritable bowel syndrome don't necessarily have a clinical disorder in terms of psychology, but have certain behavior patterns that make them vulnerable to symptoms," Dr. Bu'Hussain Hayee, a clinical research fellow from the University College Hospital in London, told HealthDay .

Though people with irritable bowel, or IBS, "are not depressed," he said, "in part, the symptoms of irritable bowel syndrome are similar to those you find in depression, so things that work for depression work for it." Hayee co-authored a review of medical literature on IBS and mind-centered treatments that appeared in the British medical journal BMJ .

As many as 20 percent of all Americans will have IBS symptoms at some point in their life, according to the National Institute of Diabetes and Digestive and Kidney Diseases. Symptoms -- which include bloating, gas, mucus in the stool, diarrhea, constipation, strong urges to have bowel movements, abdominal pain and cramping -- often begin in early adulthood, around age 20, according to the American Academy of Family Physicians. A healthy diet and stress management frequently help alleviate the worst symptoms, the academy reports.

Hayee found that an effective stress management technique known as cognitive behavioral therapy, or CBT, often used by people with depression, proved beneficial for IBS as well. CBT helps people rethink their beliefs about a condition, which has been shown to help, even if the condition doesn't change.

And CBT can be as effective for irritable bowel as antidepressant medication, Hayee found.

"It has proven to be effective," Hayee said of CBT. "It focuses on the patient's perception of symptoms rather than on the symptoms themselves."

Hypnotherapy also appears to have some promise, though the authors said that too few people had been studied to recommend the use of hypnotherapy for IBS. However, they noted that hypnotherapy had been shown effective in some small studies.

"In general, people who are more open to the idea of therapy will do better," Hayee said.

Dr. Sita Chokhavatia described IBS as an example of "brain-gut interaction." Chokhavatia, an associate professor of medicine in the gastroenterology department of Mount Sinai Medical Center in New York City , specializes in treating IBS.

"There is a 'big brain' in the skull and a 'little brain' in the enteric [intestinal] tract," she said. "Either you have too much information going up or too much information going down."

She said it's important for someone with irritable bowel to understand that IBS isn't a psychological disorder but a "brain-gut reaction." By controlling that reaction with treatments such as antidepressants, some IBS symptoms can be alleviated, she said.

On the Web

Learn more about treating IBS at the International Foundation for Functional Gastrointestinal Disorders.

SOURCES: HealthDay News ; Bu'Hussain Hayee, B.Sc., clinical research fellow, University Hospital London, England; Sita Chokhavatia, M.D., associate professor of medicine, Mount Sinai Medical Center, New York City; May 26, 2007, BMJ ; American Academy of Family Physicians (www.familydoctor.org)
Author: Serena Gordon
Publication Date: May 31, 2008
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