Management of Stress in Inflammatory Bowel Disease: A Therapeutic Option?

James R Goodhand; Mahmood Wahed; David S Rampton

Disclosures

Expert Rev Gastroenterol Hepatol. 2009;3(6):661-79. 

In This Article

Abstract and Introduction

Abstract

There is increasing evidence that psychological stress and associated mood disorders are linked with, and can adversely affect the course of, inflammatory bowel disease (IBD). Unfortunately, owing to methodological difficulties inherent in undertaking appropriately targeted and blinded trials, there are limited high-quality data regarding the effects on IBD of interventions aimed to ameliorate stress and mood disorders. Nevertheless, patients want psychological intervention as well as conventional medical strategies. Emerging trial evidence supports the suggestion that psychologically orientated therapy may ameliorate IBD-associated mood disorders, but there are no strong data as of yet to indicate that stress management has a beneficial effect on the activity or course of IBD. As yet, which, when and how interventions targeted at psychological stress and mood disturbances should be offered to individual patients with IBD is not clear.

Introduction

Chronic psychological stress is associated with adverse effects on health.[1–3] The inflammatory bowel diseases (IBDs) – Crohn's disease (CD) and ulcerative colitis (UC) – were classified as psychosomatic disorders, with early studies reporting a close association between IBD and psychiatric diagnoses. Recent well-designed studies have confirmed the anecdotal suggestion that psychological stress can trigger relapse in IBD. Here, we outline these topics and review the evidence assessing psychotherapy and related modalities as therapeutic options in patients with IBD.

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