Reviewed by: HU Medical Review Board | Last reviewed: March 2023

Counseling and psychological therapy have proven to be helpful in the treatment of irritable bowel syndrome (IBS) because they elevate overall well-being.1 Many studies demonstrate an increase in negative moods in people suffering from gastrointestinal and pain conditions, such as IBS, but it is unknown whether the psychological factors influence IBS or if they are a result of dealing with disrupted life activities and frequently painful and distressing symptoms.2

People with IBS may also experience anxiety specific to their gastrointestinal events or symptoms, for example, fear and anxiety around meals or when experiencing abdominal pain or diarrhea. This is called GI symptom-specific anxiety. These people can benefit from psychological treatment, including cognitive behavioral therapy and biofeedback.2

Cognitive behavioral therapy (CBT)

Cognitive behavioral therapy is a form of talk therapy in which a mental health professional helps the person identify thought patterns that are negative or erroneous and create more effective ways to view challenging situations. It generally requires fewer sessions than other types of therapy. CBT can be an effective tool for anyone to learn how to better manage stress and address emotional challenges. It can help a person in a variety of ways, including:

  • Learning techniques for coping with stressful life situations
  • Identifying ways to manage emotions
  • Resolving conflicts in relationships
  • Coping with grief or loss
  • Learning better ways to communicate
  • Managing chronic physical symptoms3

CBT is a structured therapy that usually includes a step-wise approach:

  • Identifying troubling situations or conditions
  • Becoming aware of thoughts, emotions and behaviors
  • Identifying negative or inaccurate thinking
  • Reshaping negative or inaccurate thinking 3

Biofeedback therapy

Another form of therapy that has proven beneficial in helping people with IBS is biofeedback therapy. In biofeedback therapy, sensors are placed on the person and connected to a computer. The sensors measure bodily functions that are generally unconscious to the person, such as heart rate, blood pressure, muscle tension, and skin temperature. By learning how the body responds, the person can then learn how to change their heart rate or blood pressure, reducing the stress load on the body.2,4

There are three common forms of biofeedback:

  • Electromyography, which measures muscle tension
  • Thermal biofeedback, which measures skin tension
  • Neurofeedback or electroencephalography, which measures brain wave activity.4

Bowel control has been proven as a bodily function that can be shaped by biofeedback. In people with IBS, the bowel functions too quickly, in cases of diarrhea, or too slowly, in cases of constipation. Biofeedback therapy can help reestablish a more normal function and may restore a sense of personal control.2

In a study that used computer-aided gut-directed biofeedback, 80 percent of people with IBS learned to achieve deeper levels of relaxation. In 50 percent of the people, the technique was helpful in controlling their bowel symptoms. Other studies have shown improvement in abdominal pain, the urgency to defecate, and global well-being.5

Other treatment approaches for IBS

Counseling or therapy is often used in combination with other treatment approaches for the management of IBS symptoms. Additional treatment options include dietary changes, adding fiber or probiotics to the diet, medications, and alternative or complementary medicine.

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