Irritable colon and psychotherapy

Disorders of gastrointestinal functions are a group of psychosomatic disorders characterized by an unknown etiology, unclear diagnostic criteria, prolonged periods of illness and poor responsiveness to drugs.

Among the more than 25 known disorders of intestinal function, the syndrome Irritable Colon ( Irritable Bowel Syndrome-IBS ) is the most common disorder, the most expensive in terms of treatments and the most debilitating. This disorder is characterized by changes in bowel function, abdominal pain and swelling, and associated discomfort with no detectable structural abnormality.

The prevalence is high, in Italy it is 18% of the population, while in the United States it reaches 22%, and the most affected gender is female.

Those who suffer from this disorder usually tend to turn to specialist doctors in the first instance, underestimating the prevalent psychological cause of this condition. It is well established that there is a significant relationship between IBS symptoms, anxiety levels, and early traumatic experiences.

These symptoms, in fact, are the clinical manifestation of a dysregulation of the two-way gut-brain system, which links the gastrointestinal functions to the cognitive and emotional centers of our brain. The amygdala, the prefrontal cortex and the hippocampus mediate the functions of the intestine, as well as regulate emotional states and behaviors. In addition, more than half of IBS patients also report other disorders such as depression , panic , agoraphobia and specific phobias .

Finally, this physically and emotionally debilitating condition leads to a drastic reduction in the quality of life with important complications in professional, relational and personal life, influencing performance and limiting the perception of pleasure in activities.

It is clear how helpful a not only medical but also a psychotherapeutic approach can be in dealing with this condition. The model CBT ( Cognitive-Behavioral Therapy – Cognitive Behavioral Therapy ) addresses the IBS on different levels, arguing that the symptoms are sons of the interaction of psychological, physiological and social.

Cognitive behavioral treatment includes various components, such as psychoeducation on IBS, nutrition and the sleep-wake cycle, learning relaxation techniques, anxiety management strategies and assertiveness education.

Action is taken on the negative automatic thoughts, which accompany IBS symptoms and which, by increasing the anxiety component (“something dangerous is about to happen”), perpetuate and aggravate the perception of body pain and emotional discomfort. Furthermore, learning to recognize the mechanisms of selective attention and acting on them defuse maladaptive behaviors and feelings of not mastering one’s reactions, which open the way to avoidance.

In addition, if it is found, a work objective is also to reduce the tendency to catastrophize, the frequent duties and the high personal and social standards that in patients with IBS can aggravate and maintain the problem.

Research studies show us that CBT tools are already effective in the treatment of IBS, but that some approaches strengthen the results obtained over time. Much research has explored the effects, both in the short and long term, of mindfulness-based approaches , noting their great benefits.

With Mindfulness techniques, an attitude of non-reaction and acceptance of negative emotions and sensations develops, automatically attenuating the activation of the cognitive mechanisms that we have seen to influence intestinal hyper reactivity.

mindful attitude allows emotions to take their natural course and return to baseline , rather than being held back and intensified by brooding. Furthermore, selective attention to the sensory components of pain is reduced, making the perception of pain more bearable and reducing its catastrophization.

The application of Mindfulness induces an improvement in the quality of life as well as effects on coping strategies, alleviates depressive symptoms and anxiety levels.

Ultimately, therefore, cognitive-behavioral therapy helps us to deal with physical discomfort by facing and managing the emotional, cognitive and behavioral implications that it brings with it, increasing awareness of these mechanisms and encouraging the learning of new more functional strategies. their physical and emotional well-being.


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