Irritable Bowel Syndrome (IBS)
Stress associated with early life adverse events is implicated in the etiology of IBS (Bradford 2012); about 50% of individuals who seek IBS treatment have depression or anxiety (Spiller 2007). This relationship appears to be bidirectional, meaning that IBS may cause stress, and stress may contribute to IBS symptoms. This cycle may be partially attributed to enhanced sympathetic nervous system (“fight or flight”) signaling in IBS patients relative to healthy controls (Berman 2009).
IBS symptoms appear to respond positively to stress reduction. In one study, a meditation-based intervention known as mindfulness-based stress reduction (MBSR) reduced the severity of IBS and stress symptoms in IBS patients, although improvements in mood and quality of life were similar to those of a control group of IBS patients who were placed on a waiting list for MBSR (Zernicke 2012). Furthermore, psychological therapies — including cognitive therapy, dynamic psychotherapy, and hypnotherapy — have been deemed highly effective in relieving global symptoms of IBS by the American College of Gastroenterology Task Force on IBS (Brandt 2009).
Exercise also appears to be beneficial for IBS patients. In one study, subjects who engaged in 20–60 minutes of moderate to vigorous physical activity 3 to 5 days per week experienced a marked improvement in quality of life that was associated with reduced IBS severity (Johannesson 2011).
Some clinical trials suggest that acupuncture may alleviate IBS symptoms (Stuardi 2012; Macpherson 2012; Shi 2011), but a 2012 comprehensive review found that evidence remains inconclusive (Manheimer 2012). Although more trials are needed, acupuncture may be a useful adjunct to conventional IBS treatment and is not likely to cause significant side effects.