The effects of relaxation response meditation on the symptoms of irritable bowel syndrome: results of a controlled treatment study
Practice
- Yoga
- Meditation
- Mindfulness
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Abstract
In this study, Herbert Benson's (1975) Relaxation Response Meditation program was tested as a possible treatment for Irritable Bowel Syndrome (IBS).
Participants were 16 adults who were matched into pairs based on presence of Axis I disorder, primary IBS symptoms and demographic features and randomized to either a six week meditation condition or a six week wait list symptom monitoring condition. Thirteen participants completed treatment and follow-up. All subjects assigned to the Wait List were subsequently treated.
Patients in the treatment condition were taught the meditation technique and asked to practice it twice a day for 15 minutes. Composite Primary IBS Symptom Reduction (CPSR) scores were calculated for each patient from end of baseline to two weeks post-treatment (or to post wait list).
One tailed independent sample t-tests revealed that Meditation was superior to the control (P=0.04). Significant within-subject improvements were noted for flatulence (P=0.03) and belching (P=0.02) by post-treatment. By three month follow-up, significant improvements in flatulence (P<0.01), belching (P=0.02), bloating (P=0.05), and diarrhea (P=0.03) were shown by symptom diary. Constipation approached significance (P=0.07).
Benson's Relaxation Response Meditation appears to be a viable treatment for IBS.
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Authors
Laurie Keefer
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Edward B Blanchard
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Journal
Behaviour Research and Therapy
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Volume / Issue
1.6298611111
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Author's primary institution
The University at Albany, State University of New York, Center for Stress and Anxiety Disorders, Albany, USA
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A randomized trial of yoga for adolescents with irritable bowel syndrome
Practice
- Yoga
- Meditation
- Mindfulness
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Abstract
BACKGROUND:
Adolescents with irritable bowel syndrome (IBS) frequently experience interference with everyday activities. Mind-body approaches such as yoga have been recommended as interventions for patients with IBS. Despite promising results among adult samples, there have been limited studies exploring the efficacy of yoga with pediatric patients.
OBJECTIVE:
To conduct a preliminary randomized study of yoga as treatment for adolescents with IBS.
METHODS:
Twenty-five adolescents aged 11 to 18 years with IBS were randomly assigned to either a yoga or wait list control group. Before the intervention, both groups completed questionnaires assessing gastrointestinal symptoms, pain, functional disability, coping, anxiety and depression. The yoga intervention consisted of a 1 h instructional session, demonstration and practice, followed by four weeks of daily home practice guided by a video. After four weeks, adolescents repeated the baseline questionnaires. The wait list control group then received the yoga intervention and four weeks later completed an additional set of questionnaires.
RESULTS:
Adolescents in the yoga group reported lower levels of functional disability, less use of emotion-focused avoidance and lower anxiety following the intervention than adolescents in the control group. When the pre- and post intervention data for the two groups were combined, adolescents had significantly lower scores for gastrointestinal symptoms and emotion-focused avoidance following the yoga intervention. Adolescents found the yoga to be helpful and indicated they would continue to use it to manage their IBS.
CONCLUSIONS:
Yoga holds promise as an intervention for adolescents with IBS.
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Authors
Leora Kuttner
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Chritine T Chambers
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Janine Hardial
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David M Israel
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Kevan Jacobson
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Kathy Evans
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Journal
Pain Research and Management
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Author's primary institution
University of British Columbia, Vancouver, British Colombia
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Mindfulness Training Reduces the Severity of Irritable Bowel Syndrome in Women: Results of a Randomized Controlled Trial
Practice
- Yoga
- Meditation
- Mindfulness
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Abstract
OBJECTIVES:
This prospective, randomized controlled trial explored the feasibility and efficacy of a group program of mindfulness training, a cognitive-behavioral technique, for women with irritable bowel syndrome (IBS). The technique involves training in intentionally attending to present-moment experience and non-judgmental awareness of body sensations and emotions.
METHODS:
Seventy-five female IBS patients were randomly assigned to eight weekly and one half-day intensive sessions of either mindfulness group (MG) training or a support group (SG). Participants completed the IBS severity scale (primary outcome), IBS-quality of life, brief symptom inventory-18, visceral sensitivity index, treatment credibility scale, and five-facet mindfulness questionnaire before and after treatment and at 3-month follow-up.
RESULTS:
Women in the MG showed greater reductions in IBS symptom severity immediately after training (26.4% vs. 6.2% reduction; P=0.006) and at 3-month follow-up (38.2% vs. 11.8%; P=0.001) relative to SG. Changes in quality of life, psychological distress, and visceral anxiety were not significantly different between groups immediately after treatment, but evidenced significantly greater improvements in the MG than in the SG at the 3-month follow-up. Mindfulness scores increased significantly more in the MG after treatment, confirming effective learning of mindfulness skills. Participants’ ratings of the credibility of their assigned interventions, measured after the first group session, were not different between groups.
CONCLUSIONS:
This randomized controlled trial demonstrated that mindfulness training has a substantial therapeutic effect on bowel symptom severity, improves health-related quality of life, and reduces distress. The beneficial effects persist for at least 3 months after group training.
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Authors
Susan A Gaylord
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Olafur S Palsson
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Eric L Garland
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Keturah R Faurot
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Rebecca S Coble
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J Douglas Mann
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William Frey
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Karyn Leniek
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William E Whitehead
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Journal
The American Journal of Gastroenterology
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Author's primary institution
Program on Integrative Medicine, Department of Physical Medicine and Rehabilitation, School of Medicine, The University of North Carolina, USA
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A one year follow-up of relaxation response meditation as a treatment for irritable bowel syndrome
Practice
- Yoga
- Meditation
- Mindfulness
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Abstract
Ten of thirteen original participants with Irritable Bowel Syndrome (IBS) participated in a one year follow-up study to determine whether the effects of Relaxation Response Meditation (RRM) on IBS symptom reduction were maintained over the long-term.
From pre-treatment to one-year follow-up, significant reductions were noted for the symptoms of abdominal pain (p=0.017), diarrhea (p=0.045), flatulence (p=0.030), and bloating (p=0.018). When we examined changes from the original three month follow-up point to the one year follow-up, we noted significant additional reductions in pain (p=0.03) and bloating (p=0.04), which tended to be the most distressing symptoms of IBS.
It appears that: (1) continued use of meditation is particularly effective in reducing the symptoms of pain and bloating; and (2) RRM is a beneficial treatment for IBS in the both short- and the long-term.
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Authors
L Keefer
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E. B Blanchard
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Journal
Behaviour Research and Therapy
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Author's primary institution
Center for Stress and Anxiety Disorders, University at Albany, State University of New York, USA
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Internet-delivered exposure and mindfulness based therapy for irritable bowel syndrome – A randomized controlled trial
Practice
- Yoga
- Meditation
- Mindfulness
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Abstract
The aim of this study was to investigate if cognitive behavior therapy (CBT) based on exposure and mindfulness exercises delivered via the Internet would be effective in treating participants with irritable bowel syndrome (IBS).
Participants were recruited through self-referral. Eighty-six participants were included in the study and randomized to treatment or control condition (an online discussion forum). One participant was excluded after randomization.
The main outcome measure was IBS-symptom severity and secondary measures included IBS-related quality of life, GI-specific anxiety, depression and general functioning. Participants were assessed at pre-treatment, post-treatment and 3 month follow-up (treatment condition only). Four participants (5% of total sample) in the treatment condition did not participate in post-treatment assessment.
Participants in the treatment condition reported a 42% decrease and participants in the control group reported a 12% increase in primary IBS-symptoms. Compared to the control condition, participants in the treatment group improved on all secondary outcome measures with a large between group effect size on quality of life (Cohen’s d = 1.21).
We conclude that CBT-based on exposure and mindfulness delivered via the Internet can be effective in treating IBS-patients, alleviating the total burden of symptoms and increasing quality of life.
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Authors
Brjánn Ljótssona
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Lisa Falka
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Amanda Wibron Vesterlundb
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Erik Hedmana
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Perjohan Lindforsc
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Christian Rücka
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Timo Hurstib
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Sergej Andréewitcha
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Liselotte Janssona
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Nils Lindeforsa
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Gerhard Anderssona
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Journal
Behaviour Research and Therapy
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Author's primary institution
Center for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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Exposure and mindfulness based therapy for irritable bowel syndrome- An open pilot
Practice
- Yoga
- Meditation
- Mindfulness
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Abstract
We conducted a study of a group therapy based on exposure and mindfulness in the treatment of irritable bowel syndrome (IBS).
Out of 49 outpatients, most of whom were referred from gastroenterological clinics, 34 entered into the 10-week treatment. Patients were assessed before, immediately after and 6 months after treatment. The assessments consisted of a gastrointestinal symptom diary, self-report questionnaires covering quality of life, gastrointestinal specific anxiety, general functioning, and a psychiatric interview.
At post-treatment, the mean reduction in symptoms was 41% and 50% of patients showed clinically significant improvement in symptom level. Patients also showed marked improvement on other outcome measures. Treatment gains were maintained at follow-up.
The results support the use of exposure and mindfulness based strategies in the treatment of IBS, but further randomised studies are needed to confirm the efficacy of the treatment.
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Authors
Brjann Ljotsson
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Sergej Andreewitch
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Erik Hedman
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Christian Ruck
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Gerhard Andersson
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Nils Lindefors
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Journal
Journal of Behavior Therapy and Experimental Psychiatry
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Author's primary institution
Center for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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Yogic Versus Conventional Treatment in Diarrhea-Predominant Irritable Bowel Syndrome: A Randomized Control Study
Practice
- Yoga
- Meditation
- Mindfulness
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Abstract
This study was conducted to evaluate the comparative effect of yogic and conventional treatment in diarrhea-predominant irritable bowel syndrome (IBS) in a randomized control design.
The patients were 22 males, aged 20–50 years, with confirmed diagnosis of diarrhea-predominant IBS. The conventional group (n=12, 1 dropout) was given symptomatic treatment with loperamide 2–6 mg/day for 2 months, and the yogic intervention group (n=9) consisted of a set of 12 asanas (yogic poses, i.e., Vajrasana, Shashankasana, Ushtrasana, Marjariasana, Padhastasana, Dhanurasana, Trikonasana in two variations, Pawanmuktasana, and Paschimottanasana) along with Surya Nadi pranayama (right-nostril breathing) two times a day for 2 months.
All participants were tested at three regular intervals, at the start of study—0 month, 1 month, and 2 months of receiving the intervention—and were investigated for bowel symptoms, autonomic symptoms, autonomic reactivity (battery of five standard tests), surface electrogastrography, anxiety profile by Spielberger's Self Evaluation Questionnaire, which evaluated trait and state anxiety.
Two months of both conventional and yogic intervention showed a significant decrease of bowel symptoms and state anxiety. This was accompanied by an increase in electrophysiologically recorded gastric activity in the conventional intervention group and enhanced parasympathetic reactivity, as measured by heart rate parameters, in yogic intervention group.
The study indicates a beneficial effect of yogic intervention over conventional treatment in diarrhea-predominant IBS.
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Authors
K. K. Indu Taneja
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G. Poojary Deepak
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I. N. Acharya
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R. M. Pandey
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M. P. Sharma
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Journal
Applied Psychophysiology and Biofeedback
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Author's primary institution
Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
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A pilot study of yoga treatment in children with functional abdominal pain and irritable bowel syndrome
Practice
- Yoga
- Meditation
- Mindfulness
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Abstract
Objectives:
The aim of this pilot study was to evaluate the effect of yoga exercises on pain frequency and intensity and on quality of life in children with functional abdominal pain.
Design:
20 children, aged 8–18 years, with irritable bowel syndrome (IBS) or functional abdominal pain (FAP) were enrolled and received 10 yoga lessons. Pain intensity and pain frequency were scored in a pain diary and quality of life was measured with the Kidscreen quality of life questionnaire (KQoL).
Results:
In the 8–11 year old group and the 11–18 year old group pain frequency was significantly decreased at the end of therapy (p = 0.031 and p = 0.004) compared to baseline. In the 8–11 year group pain intensity was also significantly decreased at this time point (p = 0.015). After 3 months there still was a significant decrease in pain frequency in the younger patient group (p = 0.04) and a borderline significant decrease in pain frequency in the total group (p = 0.052). Parents reported a significantly higher KQoL-score after yoga treatment.
Conclusion:
This pilot study suggests that yoga exercises are effective for children aged 8–18 years with FAP, resulting in significant reduction of pain intensity and frequency, especially in children of 8–11 years old.
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Authors
Marion M. M. G. Brands
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Helen Purperhart
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Judith M. Deckers0Kocken
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Journal
Complementary Therapies in Medicine
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Author's primary institution
Department of Pediatrics, Flevo Hospital Almere, The Netherlands
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Iyengar yoga for adolescents and young adults with irritable bowel syndrome
Practice
- Yoga
- Meditation
- Mindfulness
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Abstract
Objectives:
Irritable bowel syndrome (IBS) is a chronic, disabling condition that greatly compromises patient functioning. The aim of this study was to assess the impact of a 6-week twice per week Iyengar yoga (IY) program on IBS symptoms in adolescents and young adults (YA) with IBS compared with a usual-care waitlist control group.
Methods:
Assessments of symptoms, global improvement, pain, health-related quality of life, psychological distress, functional disability, fatigue, and sleep were collected pre- and posttreatment. Weekly ratings of pain, IBS symptoms, and global improvement were also recorded until 2-month follow-up. A total of 51 participants completed the intervention (yoga=29; usual-care waitlist=22).
Results:
Baseline attrition was 24%. On average, the yoga group attended 75% of classes. Analyses were divided by age group. Relative to controls, adolescents (14–17 years) assigned to yoga reported significantly improved physical functioning, whereas YA (18–26 years) assigned to yoga reported significantly improved IBS symptoms, global improvement, disability, psychological distress, sleep quality, and fatigue. Although abdominal pain intensity was statistically unchanged, 44% of adolescents and 46% of YA reported a minimally clinically significant reduction in pain following yoga, and one-third of YA reported clinically significant levels of global symptom improvement. Analysis of the uncontrolled effects and maintenance of treatment effects for adolescents revealed global improvement immediately post-yoga that was not maintained at follow-up. For YA, global improvement, worst pain, constipation, and nausea were significantly improved postyoga, but only global improvement, worst pain, and nausea maintained at the 2-month follow-up.
Conclusions:
The findings suggest that a brief IY intervention is a feasible and safe adjunctive treatment for young people with IBS, leading to benefits in a number of IBS-specific and general functioning domains for YA. The age-specific results suggest that yoga interventions may be most fruitful when developmentally tailored.
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Authors
Subhadra Evans, Kirsten C Lung, Beth Sternlieb, Lonnie K Zeltzer, Jennie Tsao
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Journal
Journal of Pediatric Gastroenterology & Nutrition
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Author's primary institution
David Geffen School of Medicine, University of California, Los Angeles
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