IBS: It’s Not In Your Head, But Working On Your Head Might Help.

January 18, 2019
written by:Claire Brandon, M.D.

What is IBS?

Irritable bowel syndrome (IBS) is becoming increasingly common in the United States, resulting in a major impact on productivity and well-being. While gastroenterologists struggle to try to understand why exactly someone would struggle with IBS symptoms, psychiatrists might look at the symptoms from a different perspective.

A hot new term in GI psychiatry is “the brain-gut axis,” or the idea that the nervous system is interconnected between the gut and the brain, in a way that our thoughts, emotions, and personalities have a significant impact on our gut symptoms.

In the United States, there are approximately 2.4-3.5 million doctor visits for symptoms of IBS every year, incurring thousands of dollars in health care costs.

Mechanisms of IBS

Throughout extensively studying IBS, we are still not sure of the exact mechanisms of the disorder, but there is promising data related to changes in serotonin functioning in the intestines that may explain symptoms for at least some patients that suffer from irritable bowel syndrome. Having depression and anxiety has been found to have a 2x increased risk of developing IBS in some studies. Having a history of trauma or abuse is also thought to result in a higher risk of developing irritable bowel syndrome. 

Although there are different types of psychotherapy suggested for irritable bowel syndrome, any psychotherapy is better than none. Cognitive-behavioral therapy can be especially useful with 1 out of every 3 patients finding benefit. Medications might also be able to help, depending on your most prominent symptoms.

A GI psychiatrist, such as myself, can tailor a medication and therapy regimen to assist with both depression and anxiety symptoms that may interfere with and worsen your IBS as well as potentially provide some benefit to your IBS symptoms. 

Claire Brandon, M.D.

Dr. Brandon is a dual board-certified psychiatrist in both adult psychiatry and consultation-liaison psychiatry (treatment of psychiatric illness in medically ill adults). She completed her residency and fellowship training at Mount Sinai Hospital in New York City and did a second fellowship in public psychiatry at New York University in New York City

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