[Rocki]

FYI, here's an evidence-based report on mind-body modalities and the GI (IBS). The quality of research is poor which doesn't mean these techniques don't work, just that the science behind them is lacking

Gayle http://www.ahrq.gov/clinic/epcsums/mindsum.htm

 

[trbell]

Thanks for theinfo, Rocki. I think there's some underestimation of the evidence because they took a medical view of the research but it still shows they all work. Actuslly I think some of these techniques, such as hypnosis, CBT, biofeedback, and writing, for example can be seen as 'mainstream' treatments these days rather than dismised as 'mind-body' techniques.I realize this may be confusing to many but I think it is important.tom

 

[eric]

I agree with Tom as to that being confusing and with his comments.With that said should I get into this or not. LOLShould I go into the science in how just basic breathing techniques can help IBS or just basic relaxation can help IBS?

 

[trbell]

I think it would help people to see some kind of list of things that might help?tom

 

[anxiolytics]

Yes Tom, I agree. I don't know whether such a list has been posted her before (most likely it has) or if it even exists in a concise format, but eric, if you had a link to relaxation methods and their implementations, that would be great.

 

[eric]

Caroline, this is a good start for this. http://www.med.unc.edu/medicine/fgidc/relax.htm

 

[Kathleen M.]

For CBT a large-scale clinical trial that should provide numbers good enough for anyone (based on size and design of study) may be out soon.The trial is just now wrapping up (some people still in the one-year follow up period).Study had 4 groups. Antidepressant, Placebo, CBT, Sham Therapy (get attention, come in once a week , get info, but no CBT).Tests were run pre and post (ballon in the rectum for how well you tolerate expansion of the rectum--which tends to be abnormal in IBSers) Symptoms were tracked both during the study and every 3 months in follow up.The CBT will be compared to the drug treatment to see how it faired against it.Now I did the study (CBT part) in 1998, and they just finshed up. With therapy studies it can take a long time because of limited # of hours/week you have the therapist you can only do so many concurrently .One other comment. Most of the DRUGS used for treating IBS also tend to fair badly in these kinds of "what good research do we have" review studies as well. So the evidence for ANY IBS treatment tends to be less then stellar, mostly because most drugs used for IBS are "off-label" uses and they were never initially developed for IBS, and "off-label" uses of pretty much all drugs are really spotty when it comes to how good the data really is.K.

 

[trbell]

Interesting K - any idea where it will be published. By the way, Blanchard's book is really quite good on this whole area of IBS research even though it's probablymuch more than people want to read (I don't have the details right here, but I'm sure I posted info in the book forum and APA published it)tom

 

[Kathleen M.]

I am hoping soon.When I saw Dr. Drossman in November I think they were just starting the write up on the pre-post therapy work and may publish that before the year follow up stuff is ready to be analyzed (i.e. code broken as to who was a what).It can take 6 months (sometimes longer, but sometimes less) time to get through the review/revision/check the galley proofs/finally in press kinda thing....so I'm kinda expecting by the end of this year.....ish (heavy on the ish)K.

 

[Rocki]

Hi all. Actually I wasn't surprised at this being a medical librarian. It doesn't mean that there haven't been studies done (and good ones!). "Evidence-based" medicine is when they want all studies to fit a perfect mold based on scientific "principles." No, I'm not knocking clinical studies just the fact that we seem to need more and more before the "medical establishment" (don't get me started)determines that something is sound. I don't agree with the paper (not sure if they did a meta-analysis as i didn't read the whole thing) and I think the National Center for Complimentary and Alternative Medicine has a long way to go (too many politics). I've certainly benefitted from clinical hypnotherapy, guided imagery, and a whole host of other therapies for almost 20 years now that used to be considered "alternative" but as you say Tom they are more "mainstream." If you think people still think of clinical hypnotherapy as side-show hypnosis then almost 20 years ago you didn't mention it when someone asked you what you did for treatment. Unfortunately in evidence-based medicine it's not based on one or two excellent study outcomes. When i worked at the APA (sorry Tom, the "other" APA)the whole "decade of the brain" was based on drug interventions and was driven by managed-care. Well,I'll stop rambling. Gayle

 

[trbell]

you're not rambling, Gayle. I think people need to have some awareness of the issues involved so they don't just rely on snippets they read in the news and on the web.tom