David July 5th, 2006

When a disease is poorly understood, when it’s of a distinctly personal nature and when medication doesn’t help, there’s often little left to do but to suffer in silence.

That’s the case for the 15 percent of Americans – about 25 million people – who have irritable bowel syndrome. Although television commercials and magazine advertisements promise easy relief for a chronically misbehaving gut, many people with the condition know better. The constipation, bloating, diarrhea and gas make their lives miserable, limiting some to short excursions when they leave home at all.Although the pharmaceutical industry is eagerly pursuing new drug treatments for irritable bowel syndrome, these potentially more effective medications are several years away. Now researchers say the best hope may be the most basic of treatments: lifestyle changes.

Experts meeting recently in Los Angeles for Digestive Disease Week, the world’s largest gathering of gastrointestinal health professionals, reported that behavior modification and dietary alterations can significantly ease symptoms of the still little-understood condition.

For example, even a brief, self-help course of cognitive behavior therapy – in which people identify their symptoms’ triggers and learn techniques, such as relaxation and thought processes, that can alter the response – significantly helped most patients in one study presented at the meeting. Another study found that 12 sessions of hypnotherapy reduced symptoms in many patients for at least one year.

The findings support recent theories that irritable bowel syndrome involves a communication glitch between the brain and gut. But experts disagree on whether drugs that act on the gastrointestinal tract or psychological therapies that alter thoughts and emotions will ultimately prove most beneficial.

“There is a camp totally focused on the GI tract. But there is also a lot of talk about how we’re beginning to understand the mind-body connection,” said Dr. Emeran Mayer, director of the Center for Neurovisceral Sciences and Women’s Health at the University of California, Los Angeles.

Dissatisfaction with the two medications currently approved for IBS – Lotronex and Zelnorm – has led to a resurgence of interest in how patients can help themselves, said Jeffrey M. Lackner, an assistant professor of medicine at University at Buffalo, State University of New York.

“At this point, there are no drugs that seem to be satisfactory for the full range of symptoms,” he said. “The real burden of IBS rests on the shoulders of patients on a day-to-day basis.”

By Shari Roan - Los Angeles Times

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