The cause of irritable bowel syndrome (IBS) is not completely understood. For various reasons, the symptoms appear to result from altered patterns of muscle contraction in the gut and increased sensitivity to distension and movement of food, gas, or fecal material through the gastrointestinal tract. There also appears to be a predilection for the bowel to be overly reactive to various triggers: eating, stress, emotional arousal, gastrointestinal infections, menstrual period, or gaseous distension, which can exaggerate or perpetuate the symptoms. Learn More About Stress in IBS
Referral for psychological treatment can be recommended as part of a multi-component treatment program to help the patient better manage the symptoms, or to address psychosocial difficulties (e.g., abuse, loss) that may be interfering with daily function and ability to manage their illness. In general, these treatments are reserved for patients with moderate to severe symptoms, particularly if they experience psychological distress. However, the patient must be motivated and see this type of treatment as relevant to their personal needs.
Psychological treatments used to treat IBS include psychotherapy (dynamic and cognitive-behavioral therapy), relaxation therapy, hypnotherapy, and biofeedback therapy. Psychological treatments can also be combined. Review of well-designed treatment studies of IBS supports the use of psychological treatment. Follow-up studies (duration 9–40 months), have demonstrated that psychological treatment maintained superiority over placebo, indicating that these methods have lasting value. The choice of treatment will depend on patient requirements, available resources, and the experience of the therapist.