title: Aspects of the non-pharmacological treatment of irritable bowel syndrome.
abstract: Irritable bowel syndrome (IBS) is one of the most commonly diagnosed gastrointestinal conditions. It represents a significant healthcare burden and remains a clinical challenge. Over the years IBS has been described from a variety of different perspectives; from a strict illness of the gastrointestinal tract (medical model) to a more complex multi-symptomatic disorder of the brain-gut axis (biopsychosocial/psychosomatic model). In this article we present aspects of the pathophysiology and the non-pharmacological treatment of IBS based on current knowledge. Effects of conditioned stress and/or traumatic influences on the emotional system (top-down) as well as effects on the intestine through stressors, infection, inflammation, food and dysbiosis (bottom-up) can affect brain-gut communication and result in dysregulation of the autonomic nervous system (ANS), playing an important role in the pathophysiology of IBS. Conditioned stress together with dysregulation of the autonomic nervous system and the emotional system may involve reactions in which the distress inside the body is not recognized due to low body awareness. This may explain why patients have difficulty identifying their symptoms despite dysfunction in muscle tension, movement patterns, and posture and biochemical functions in addition to gastrointestinal symptoms. IBS shares many features with other idiopathic conditions, such as fibromyalgia, chronic fatigue syndrome and somatoform disorders. The key to effective treatment is a thorough examination, including a gastroenterological examination to exclude other diseases along with an assessment of body awareness by a body-mind therapist. The literature suggests that early interdisciplinary diagnostic co-operation between gastroenterologists and body-mind therapists is necessary. Re-establishing balance in the ANS is an important component of IBS treatment. This article discusses the current knowledge of body-mind treatment, addressing the topic from a practical point of view.
authors.affiliation: Elsa Maria Eriksson, Kristina Ingrid Andrén, Göran Karl Kurlberg, Henry Ture Eriksson, Department of Functional Gastroenterology, Pavilion 2, Sahlgrenska University Hospital/Östra, SE-416 78 Göteborg, Sweden.
authors.forename: Elsa Maria
authors.initials: EM
authors.lastname: Eriksson
authors.affiliation: Elsa Maria Eriksson, Kristina Ingrid Andrén, Göran Karl Kurlberg, Henry Ture Eriksson, Department of Functional Gastroenterology, Pavilion 2, Sahlgrenska University Hospital/Östra, SE-416 78 Göteborg, Sweden.
authors.forename: Kristina Ingrid
authors.initials: KI
authors.lastname: Andrén
authors.affiliation: Elsa Maria Eriksson, Kristina Ingrid Andrén, Göran Karl Kurlberg, Henry Ture Eriksson, Department of Functional Gastroenterology, Pavilion 2, Sahlgrenska University Hospital/Östra, SE-416 78 Göteborg, Sweden.
authors.forename: Göran Karl
authors.initials: GK
authors.lastname: Kurlberg
authors.affiliation: Elsa Maria Eriksson, Kristina Ingrid Andrén, Göran Karl Kurlberg, Henry Ture Eriksson, Department of Functional Gastroenterology, Pavilion 2, Sahlgrenska University Hospital/Östra, SE-416 78 Göteborg, Sweden.
authors.forename: Henry Ture
authors.initials: HT
authors.lastname: Eriksson
mesh_terms: D004644:Emotions; D017615:Enteric Nervous System / Q000503:physiopathology*; D026241:Exercise Movement Techniques; D006801:Humans; D006990:Hypnosis; D007422:Intestines / Q000294:innervation*; D043183:Irritable Bowel Syndrome / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D026441:Mind-Body Therapies; D012307:Risk Factors; D013315:Stress, Psychological / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D016896:Treatment Outcome
keywords: Assessment; Body awareness therapy; Body-mind; Hypnotherapy; Irritable bowel syndrome; Pathophysiology; Psychosomatics; Stress; Treatment