University at Buffalo

Behavioral Medicine Clinic

 
 

IBS Resources for Doctors

Many irritable bowel syndrome (IBS) patients are reluctant to seek treatment or have been frustrated by previous encounters with health care professionals. You can play a crucial role in guiding these people to seek evidence-based treatment for symptoms that have not adequately responded to drugs or dietary changes. Here are some suggestions for communicating with an IBS patient for whom conventional medical treatments are not enough:

Acknowledge Seriousness
As recently described in the New England Journal of Medicine (Mayer 2008), behavioral self-management treatment for IBS is one of the few empirically supported treatments for IBS. Behavioral treatments combine a variety of behavioral change strategies based on a biopsychosocial approach. Behavioral approaches emphasize teaching patients evidence-based tools and strategies for controlling IBS symptoms and reducing their day-to-day burden. Often, IBS sufferers find that others trivialize this condition. As a trusted health care professional to whom your patients are looking for expert guidance, your recognition that IBS is real and serious can persuade patients to seek treatment and begin returning their lives to normal. Your advice can go a long way in helping them, and you, manage their symptoms more effectively.

In offering reassurance to your patients, it is important to avoid statements that may be interpreted as dismissive: “It’s nothing to worry about,” or “It’s just stress,” for example. Patients need to hear words that reflect an understanding of the legitimacy of the disorder regardless of the lack of underlying organicity. Many professionals who have treated IBS have found patients receptive to the following explanation. “You have a condition called irritable bowel syndrome that can improve with proper treatment. Without addressing the IBS or the way it affects your life and it can take a toll on you. This would be unfortunate because there are professionals trained to help IBS sufferers gain control over symptoms using state-of-the-art, non-drug treatments.”

Also, some people feel their condition is too embarrassing to bring to a health care professional’s attention and have heard some health care providers and family and friends tell them that it is “all in their heads.” By telling them that the disorder has both behavioral and biological components, you can reassure your patients that there are facets of IBS and its symptoms that can be helped.

Educate
Knowing more about their IBS disorder can help people overcome their fear, embarrassment, or skepticism about treatment. For example, your patients may benefit from hearing that millions of people have IBS disorder — in fact, one out of five people has had or will have it. Point out that treatment can make a significant difference in their lives in just weeks or months. Make the patient an active, fully informed participant in the treatment planning process.

Encourage
Finally, encourage your patients to seek help about IBS from the Behavioral Medicine Clinic. If they qualify for one of our research studies, they need not suspend ongoing medical treatment during trial participation. For help managing more complex IBS patients, contact the BMC at (716) 898-4458. 

Reference

Mayer EA. Clinical practice. Irritable bowel syndrome. N Engl J Med 2008;358:1692-9.