Stress Management Could Help Treat Abdominal Pain in IBD Patients, British Study Suggests

Stress Management Could Help Treat Abdominal Pain in IBD Patients, British Study Suggests
Managing stress and changing the diets of patients with inflammatory bowel disease (IBD) may help mitigate abdominal pain, a British study suggests. The systematic review, “Interventions for abdominal pain management in inflammatory bowel disease,” appeared in the journal Alimentary Pharmacology and Therapeutics. IBD patients, including those with ulcerative colitis and Crohn's disease as well as those in remission, frequently complain of chronic abdominal pain. However, pain in IBD is under-recognized, under-treated and under-researched, says the study. Factors contributing to IBD pain include inflammation, post-inflammatory sensitization, bacterial overgrowth in the intestine, food intolerances and disease-induced morphological alterations. Psychological symptoms such as stress, anxiety or depression, sleep disturbance and medications also influence the perception of pain. The use of analgesics, including opioids, to manage IBD pain may exacerbate symptoms, cause side effects or mask a relapse. Moreover, opioids’ benefits may not be significantly strong or long-lasting, and their use might also stigmatize patients as addicts. Yet relaxation and psychotherapy — along with dietary changes — are promising approaches. Christine Norton, a professor at King's College London, led a team that reviewed interventions for abdominal pain management in IBD patients. Their analysis of 15 studies revealed a variety of psychological interventions such as individualized and group-based relaxation; in fact, stress management reduced pain in four of six studies. Moreover, both psychologist-led and self-
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