Counselling Conquers Constipation

"People often pigeonhole diseases as being biological or psychological, but in fact they're often a complex mixture of both," Professor Rona Moss-Morriss of the University of Southampton told the BA Festival of Science on September 10.

She and her colleagues studied 1000 people who contracted either glandular fever or food poisoning. They wanted to see who would go on to develop irritable bowel syndrome (IBS).

The symptoms of IBS are severe stomach pain, with diarrhoea or constipation or both.  The people with food poisoning were more likely to develop IBS, perhaps because both conditions affect the stomach.  But psychological factors were important, too.

The researchers asked the patients how they felt when they had food poisoning, what they did and what they believed.  They found that those who were more stressed, and who had very high expectations of themselves, were more likely to develop IBS.

Having high expectations manifested itself in an "all-or-nothing" pattern of behaviour, in which people would try to ignore the symptoms to fulfil their normal obligations, only to collapse in bed, try to get up too quickly, and collapse again.

The researchers have submitted a study for publication in which they used the psychological intervention called cognitive behavioural therapy (CBT) to help people with IBS. "It appears to be a promising approach," they said.

Their new study follows one in which some IBS patients were given CBT along with an anti-spasmodic drug, mebeverine, while others received mebeverine alone.  Those who received CBT as well saw their symptoms improve.

Professor Trudie Chalder of Kings College London said a study of patients with type 1 diabetes would give "good news" when it is published shortly. Her results were, she said, "extremely promising."

She used CBT to address people's beliefs about their diabetes.  For example, some people will say: "There's nothing I can do to control my diabetes because it's a biological disease which I have no control over."  Having used CBT to challenge such beliefs, Professor Chalder aimed to improve people's blood sugar levels by encouraging them to exercise regularly and eat a healthy diet. 

The researchers are also aiming to use CBT to help people adjust to having multiple sclerosis.