Meditation Can Calm Irritable Bowel Syndrome--By John Gever, Senior Editor, MedPage Today

CHICAGO -- A form of meditation known as mindfulness training reduced symptoms of irritable bowel syndrome (IBS) in a randomized trial, a researcher said here.

Three months after completing an eight-week course of mindfulness training, patients had a mean 38.2% reduction in IBS severity scores, compared with 11.8% among patients assigned to participate in support groups, reported Olafur Palsson, PsyD, of the University of North Carolina in Chapel Hill.

The meditation group also had significant reductions in specific symptoms, including severity of abdominal pain and bloating, and significant improvements in quality of life, Palsson told attendees at Digestive Disease Week.

The training was adapted from the Kabat-Zinn mindfulness training program, with IBS-specific content included, Palsson said.

Mindfulness training seeks to divert patients' attention away from past problems and anxieties about the future by having them focus on immediate experiences.

For example, Palsson said at a press briefing on the study, participants are told to simply think about their own breathing.

Other meditation programs and psychological interventions have previously been found to reduce IBS symptoms, although the studies have seldom been very rigorous.

The current trial is the first randomized, controlled study of mindfulness training to be reported, Palsson said.

There were 75 participants -- all women, with a mean age 43 -- all of whom met Rome II criteria for IBS confirmed by a physician.

Baseline IBS severity scores averaged 276.

Both treatment groups met weekly for eight weeks. Evaluations were conducted two weeks after the last session and again three months later.

At both follow-up visits, overall IBS severity scores had declined only slightly in patients attending the support group sessions, but they dropped to just over 200 among those receiving the mindfulness training two weeks after training ended and to about 180 after three months.

Relative to baseline, these declines with mindfulness training were significant at the P<0.0001 level, Palsson said.

The pattern was similar for severity scores for abdominal pain and bloating. The differences from the support-group patients were less notable for psychological distress and visceral sensitivity.

Both groups had increases in quality of life scores, but these were statistically significant only for the patients receiving mindfulness training at the three-month follow-up (77 points at follow-up versus 65 at baseline, P=0.027).

The absolute differences in scores between groups were often modest, and Palsson acknowledged that it was reasonable to suspect a placebo effect in the unblinded trial.

But he said that that was unlikely, because control patients perceived the support groups to be an active intervention. At the press briefing and in his formal presentation, he said participants were very enthusiastic about the support group sessions and had to be discouraged from meeting independently of the scheduled sessions.

But he did cite other limitations to the analysis: it included only women and the study design shed no light on what it was about the mindfulness training that was effective. In particular, whether the IBS-specific content was helpful remained unclear.

Press briefing moderator Robynne Chutkan, MD, of Georgetown University in Washington, D.C., said the mind-body interaction in IBS can definitely be used to patients' advantage.

She said that one exercise she uses with patients is to point out the immediate physical responses that occur in fearful situations, such as an unexpected confrontation with a snake.

"As Dr. Palsson said, all the anxiety about what happened in the past and what could happen in the future, and people sort of readying themselves for action [may contribute to their symptoms.] So that detached observation that he described is so useful and is a huge part of biofeedback."

She added that the mindfulness training seems especially attractive because "it's something patients can learn and take away on their own. This concept of self-determination for patients is so important."

Primary source: Digestive Disease Week
Source reference:
Gaylord S, et al "Therapeutic impact of mindfulness meditation on irritable bowel syndrome (IBS): results of a randomized controlled trial" DDW 2011; Abstract 219.