Psychological Treatments in Functional Gastrointestinal Disorders

A Primer for the Gastroenterologist

Olafur S. Palsson; William E. Whitehead

Disclosures

Clin Gastroenterol Hepatol. 2012;11(3):208-216. 

In This Article

Relaxation Training

This category of psychological treatment describes a heterogeneous group of interventions that principally aim to reduce sympathetic nervous system arousal and lessen physiological stress reactivity. Relaxation training is often included as a component of other interventions (such as CBT) and has also been used as control treatment for other psychological treatment. However, we identified 7 randomized studies where such treatment was tested as a monotherapy for FGDs, all of them in IBS (Supplementary Table 3). One sizable trial by Boyce et al[32] compared outcomes for relaxation training with those of cognitive therapy and standard medical care and found no outcome differences between the treatment arms. In contrast, the other 6 RCTs all found some significant benefits of relaxation training not seen in the comparison groups. Therefore, it seems that interventions that aim at reducing autonomic arousal and stress reactivity are helpful in IBS. As few as 5 sessions are needed.[33] However, the treatment methods tested in this group of studies have been so varied that they could be considered different forms of treatment. Only progressive relaxation has been tested in more than one of the positive trials. This is a form of physiological relaxation achieved by systematically alternating tensing and relaxing muscles in different muscle groups of the body and noticing the contrast between the feeling of tension and relaxation. Over time, patients learn in this way to more effectively release muscle tension and relax their body more thoroughly.

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