[Medical Q&A] How to conduct psychological assessment and treatment of irritable bowel syndrome?

Author: Zhang Zhengyong University Town Hospital Affiliated to Chongqing Medical University

Reviewer: Wang Wo, deputy chief physician, University City Hospital affiliated to Chongqing Medical University

Irritable bowel syndrome (IBS) is a group of diseases with persistent or intermittent onset, with abdominal pain, bloating, changes in bowel habits and/or stool characteristics as the main clinical manifestations.

The purpose of intervention for IBS patients is to improve symptoms, enhance their quality of life, and restore their social function. Treatment strategies should follow the principle of individualization. The main harm of IBS to patients is subjective painful feelings such as abdominal pain, bloating, abdominal discomfort, and defecation disorders, as well as the impact on quality of life (including social function).

(1) General treatment: Understand the factors that trigger the disease and find ways to improve or eliminate them. In addition, you should establish good living habits and dietary structure and avoid eating foods that trigger symptoms.

(2) Drug treatment: There are antispasmodics, antidiarrheal drugs, prokinetic drugs, intestinal proecological preparations, antidepressants, etc. Patients need to choose the appropriate drugs according to different symptoms.

(3) Cognitive therapy: Cognitive therapy is an essential part of IBS treatment. To a certain extent, IBS patients’ inappropriate cognition of the causes and hazards of the disease is the main reason for them to seek medical treatment, sometimes more than the symptoms themselves, so cognitive therapy is very important. If some patients can overcome their doubts, their symptoms can be significantly alleviated to the point where they do not affect their daily lives. Studies have shown that cognitive therapy, as well as good communication on treatment strategies, can significantly improve the short-term and long-term efficacy of placebo in IBS patients.