Digestion: Soothing a Sensitive Gut

Digestion: Soothing a Sensitive Gut

By Kathleen Cahill Allison and Lawrence S. Friedman, M.D.
Newsweek, September 27, 2004

It's probably happened to you. You're driving to work and suddenly remember that a neglected assignment is due today. Your gut clenches, your intestines twist and before you know it you're feeling downright ill. One person in four ends up seeking medical attention for a gastrointestinal problem such as heartburn or irritable bowel syndrome (IBS). When doctors examine these patients, their blood tests and abdominal X-rays are usually normal. But the absence of ulcers or tumors doesn't mean that nothing is wrong. The brain and gut communicate through an impressive network of hormones, peptides and neurotransmitters. When emotional distress disrupts this dialogue, the effects can be seen on a brain scan. An area known as the midcingulate cortex goes into overdrive—and the gut suffers potentially devastating consequences.

Stress-related digestive problems often defy conventional treatments, such as antacids and anti-diarrhea medications. But mind-body techniques such as relaxation, hypnosis or cognitive behavioral therapy can provide a safe, effective alternative. Last year, for example, researchers at the University of North Carolina showed that cognitive behavioral therapy was effective in treating IBS. When the brain perceives pain, it tends to fret over the sensation and amplify it. In cognitive behavioral therapy, a trained therapist helps patients quell that amplification by reorienting negative ways of thinking. Instead of tensing up at the first sign of abdominal pain, a patient might learn to tell herself, "I can manage this pain and still live my life." In the North Carolina study, 70 percent of IBS patients reported less pain, bloating and diarrhea after 12 weeks of cognitive behavioral therapy, compared with just 37 percent who received only educational information about the condition. And when cognitive behavioral therapy was compared with the antidepressant desipramine, the two treatments were equally effective.

Studies are still lacking on other mind-body treatments for digestive problems, but several techniques are likely to help. Here are some remedies worth trying:

Relaxation therapy: Stress stimulates the autonomic nervous system, a part of the nervous system that controls such involuntary functions as heartbeat and intestinal contractions. Meditation and other relaxation techniques can calm the autonomic nervous system by tuning out stress-inducing thoughts, feelings and sensations. One common technique, known as progressive muscle relaxation, can be done alone or with a therapist. Simply lie or sit quietly, and then flex and relax each set of muscles, starting with your feet and progressing slowly upward to your neck and shoulders.

Hypnotherapy: This technique can help create a long-lasting state of relaxation and may help calm painful muscular motion in the intestine. A trained therapist can teach you the steps to enter a hypnotic state. You focus on your breathing and imagine what it feels like to be completely relaxed. Once you know the steps, you can use this technique to lower your tension and pain perception whenever symptoms strike.

Biofeedback: Using an electronic monitor at the office of a trained specialist, you learn to sense, and control, muscular activity in the bowel. No one knows exactly how biofeedback works, but the technique is widely accepted and many insurance plans will cover at least part of the cost of treatment.

Adapted from "The Sensitive Gut," a Special Health Report from Harvard Medical School. For more information go to health.harvard.edu/NEWSWEEK.

Read article at original source