Managing Gastrointestinal Symptoms With An IBS Therapist

If you have an irritable bowel syndrome (IBS) diagnosis, you are likely very familiar with how uncomfortable the symptoms can sometimes be. You might look forward to your daily plans but suddenly feel overcome with cramps, abdominal pain, and bloating. IBS symptoms can affect all aspects of your everyday life, taking a toll on your physical and mental well-being.

While living with IBS, you might have also found that your mental and physical health can be strongly connected. For example, having IBS may cause emotional stress, worsening IBS symptoms. Although different treatment options are available to help treat IBS, including medication and lifestyle changes, one approach that may be effective and is often overlooked is cognitive behavioral therapy (CBT).

Read on to learn more about how an IBS therapist can help you learn coping strategies and manage the symptoms of IBS. 

IBS and the connection between the brain and gut

Understanding the connection between the brain and gut can be important for understanding irritable bowel syndrome (IBS) and its available treatment options. This connection is often referred to as the gut-brain axis, a communication pathway that moves in both directions between the central nervous system and the enteric nervous system. The two systems work together and can affect conditions like IBS, which researchers have pointed to as an example of disrupting these relationships between the gut and brain. 

IBS symptoms and causes

People with IBS can experience various symptoms, including abdominal pain, cramps, constipation, diarrhea, excess gas, and bloating. Stress or certain foods can often act like a switch, triggering or worsening these symptoms. 

The exact causes of IBS are unknown, but researchers think various factors may play a role. These include problems with how your gastrointestinal muscles contract, hypersensitive nerves in the GI tract, miscommunication between nerves in the brain and gut, and early life stress.  

IBS diagnosis and treatment

To diagnose IBS, your doctor may conduct a physical exam and perform tests, such as a colonoscopy, upper endoscopy, or CT scan, to rule out other causes of gastrointestinal symptoms. After ruling out other conditions, your doctor may use diagnostic criteria for IBS. There are four main types of IBS: constipation-predominant, diarrhea-predominant, mixed, or unclassified.

Treatment for IBS often focuses on managing the causes and triggers of the condition through various methods, such as stress management, dietary changes, and psychological therapies like counseling. Sometimes, medicines may help keep specific symptoms in check. Therapy that can help improve the brain-gut connection, such as cognitive behavioral or mindfulness-based therapies, may also benefit some individuals with IBS.

Cognitive behavioral therapy for IBS 

When experiencing IBS, you may experience stress and uncertainty because of how unpredictable and uncomfortable GI symptoms can be. This may take a toll on your relationships at home and work. It may feel like people don't understand what you're going through, making you feel isolated. Research has found that individuals with IBS may be more likely to experience mental health conditions like anxiety and depression.

This same study also notes that studies have consistently shown that psychological treatments—including CBT—effectively reduce actual GI symptoms, such as pain and bowel functioning, rather than just improving psychological factors. 

Several components of CBT may be used to treat IBS. There are cognitive techniques that can help you identify what triggers your symptoms. You might learn to tackle specific triggers through exposure. Stress management and relaxation strategies can help keep stress levels low. You might also learn more effective coping strategies by improving problem-solving skills.

The exact approaches used in therapy may vary by therapist and individual, but these are some techniques. It may be important for individuals with IBS to work with a qualified therapist with experience treating IBS through CBT. 

Other treatment options for IBS

Besides seeking help from an IBS therapist, several other treatment options are available to help manage IBS symptoms. Below, we’ll discuss dietary changes, medications, lifestyle modifications, and hypnotherapy as potential ways to improve one's quality of life with IBS.

Dietary changes

Adjusting your diet may help ease IBS symptoms. A gastroenterologist or dietitian may recommend changes such as:

• Increasing fiber intake
• Avoiding gluten
• Keeping a food diary to identify triggers, and developing a personalized meal plan
• Trying the low FODMAP diet involves avoiding or reducing certain foods that contain carbohydrates that are hard to digest. 

Medications

For some individuals, various medications may be recommended to help manage specific symptoms, such as:

• Laxatives for constipation
• Lubiprostone (Amitiza), linaclotide (Linzess), and plecanatide (Trulance) for constipation-predominant IBS
• Rifaximin (Xifaxan), eluxadoline (Viberzi), alosetron (Lotronex), and loperamide to treat IBS with diarrhea
• Tricyclic antidepressants or selective serotonin reuptake inhibitors (SSRIs) may help relieve pain or discomfort in the abdomen and depression.

You may want to work closely with a healthcare provider to determine the most appropriate medications for managing IBS symptoms.

Lifestyle modifications

Incorporating lifestyle changes may also help improve IBS symptoms, such as:

• Regular exercise to promote bowel movement and reduce stress
• Consistent sleep patterns to help control digestion
• Stress management techniques, such as deep breathing exercises, mindfulness, and yoga, reduce and relieve stress.
• Drinking more fluids
• Reducing or eliminating the consumption of tobacco and alcohol 

Adopting these habits may help improve overall health and IBS symptom management in the short and long term.

Hypnotherapy

Hypnotherapy has also been shown to help manage IBS symptoms effectively. During hypnotherapy, a trained mental health professional guides patients through relaxation techniques, helping them reduce anxiety and alter their pain perception. This treatment option can be a helpful complementary therapy alongside other management strategies.

Finding an IBS therapist

If you're looking for an IBS therapist, you can look for in-person therapists locally or connect with a therapist online. If you prefer meeting with someone in person, you might want to talk with your healthcare provider first. They may recommend therapists in your area who specialize in CBT for IBS.

If you want to connect with a licensed therapist virtually, online platforms like BetterHelp can be helpful. For some people, such as individuals in rural areas or those with severe IBS symptoms, finding a suitable therapist near you or making it to an in-person appointment may be challenging. When you use online therapy, you can work with a licensed therapist from your own home or wherever you have an internet connection. 

Research has also shown the effectiveness of online therapy for individuals with IBS. For instance, one such study examined the effectiveness of CBT based on exposure and mindfulness exercises delivered through the internet for treating patients with IBS. The study concluded that “CBT based on exposure and mindfulness delivered via the Internet can effectively treat IBS patients, alleviating the total burden of symptoms and increasing quality of life.”