CBT for Gastrointestinal Problems

Gastrointestinal disorders are a group of chronic medical conditions of the gastrointestinal tract that are hard to treat effectively. In a survey of 1658 patients with gastrointestinal disorders, the patients who reported that their symptoms were better after six months of usual medical management were only 49% for irritable bowel syndrome (IBS), 63% for functional diarrhea, and 56% for functional constipation and functional abdominal pain. This demonstrates that many gastrointestinal disorder patients remain highly symptomatic despite all that medical care approaches can offer. Cognitive Behavioral Therapy (CBT) has shown the best promise to date and is gradually becoming a recommended option for gastrointestinal disorders. Cognitive Behavioral Therapy is given a "strong recommendation" rating for improving global IBS in the American College of Gastroenterology. The American Gastroenterological Association recommends CBT treatment for moderate and severe IBS patients.

CBT is helpful for gastrointestinal disorders for the following reasons:

  • Stress triggers exacerbations of GI symptoms in patients and is associated with an increased prevalence of GI disorders.

  • Emotional disorders such as anxiety and clinical depression are highly prevalent in gastrointestinal disorder patients (for example, found in 50%–94% of IBS patients), and have been identified as associated with poorer outcomes for GI patients.

  • The brain exerts a powerful influence over gastrointestinal pain perception, motility, and secretion. Anxiety is correlated with lowered threshold for gastric discomfort/pain and reduced gastric accommodation, and depression is associated with increased postprandial distress, nausea, and vomiting. Stress lowers pain thresholds and stimulates colonic and ileal motility.

  • CBT works. A large number of randomized controlled trials (RCTs) show that short courses of CBT can markedly improve the symptoms of several gastrointestinal disorders while simultaneously enhancing emotional well-being and quality of life and reducing healthcare needs.

Click for more information about What CBT is and How it Works. 

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