DDW 2011: Mindfulness Meditation Training Reduces IBS Severity

The first randomized controlled trial of mindfulness training as an intervention for irritable bowel syndrome (IBS) revealed a substantial therapeutic impact on bowel symptom severity as compared with a support group. During a Digestive Disease Week 2011 oral presentation, Olafur S. Palsson, PsyD, University of North Carolina, said “By three months after the end of mindfulness training, overall IBS severity was reduced by 38%.”

Palsson noted that mindfulness is a behavioral technique that has been gaining popularity in recent years, but has not been previously tested for IBS. It involves intentional focus on present-moment experience and nonjudgmental awareness of body sensations and emotions, as well as letting go of fixation of thoughts of the past and the future. The structured eight-week mindfulness-based stress reduction (MBSR) program used in this study, developed by Jon Kabat-Zinn in 1979, is now used in more than 250 US hospitals. It has been reported to improve symptoms in chronic medical conditions such as fibromyalgia and depression.

The randomized controlled study included 75 female patients between the ages of 19 and 71, with an average age of 42.7 years. Patients participated in either mindfulness meditation training (n=36) or a support group (n=39) offering mutual support for IBS and life problems. Each eight‐week course held weekly sessions plus a half‐day retreat. Palsson noted that participants’ ratings of the credibility of their assigned intervention as therapy for IBS, measured after the first group session, were not different between the two treatment groups.

At the end of the eight‐week session, overall IBS severity was reduced significantly more (p<0.0001) in the mindfulness group than in the support group, by 26.4% as compared with 6.2 %, respectively. At the three‐month follow‐up period, the difference improved further in favor of the mindfulness group, after patients ended their group participation. Reductions in severity of IBS symptoms were reported at 38.2% for the mindfulness group and 11.8% for support group patients. While changes in quality of life impairment, visceral anxiety and psychological distress were not significantly different immediately after the eight‐week period, they were significantly improved (p=0.027) at the three‐month follow‐up period in the mindfulness meditation group.

Thirty-four women completed the meditation group and 32 completed the support group. The overall dropout rate was 12%.

Lead investigator on the study Susan Gaylord, PhD, who directs the University of North Carolina program on integrative medicine, stated, “Mainstream medicine doesn’t offer a cure for IBS, and as many as half of patients do not see adequate improvement in their symptoms with conventional treatment. We observed significant improvements in patients’ bowel symptoms and quality of life with mindfulness meditation. It is a widely available and inexpensive method that can provide individuals with skills they can use for the rest of their lives.”

Palsson noted further that mindfulness appears to be a very useful self-management technique for reducing symptom morbidity and enhancing well-being among IBS patients. Also, he said, the method can be taught in educational classes without the need for long-term clinical therapists and leading to long‐term and independent use by individuals.

Among study limitations, Palsson cited the inclusion of women only, and the lack of a mechanism for IBS improvements observed in the study.