26 June 2008 The University at Buffalo, The State University of New York, issued a
news release: “Home-Based Cognitive Behavioral Therapy Relieves IBS
Symptoms; Improvement is comparable to office-based therapy, study shows.”

Here’s their statement:

Research by Jeffrey Lackner has shown that an at-home cognitive
behavioral program can be effective in treating irritable bowel syndrome.

Persons with irritable bowel syndrome (IBS) can relieve their symptoms
as effectively by following a self-administered, at-home cognitive
behavioral program as they can by undergoing a 10-week in-office program
administered by a trained therapist, a new pilot study has shown.

The findings are important because there are no reliable medicines
available to treat successfully the full range of symptoms of this
chronic, often debilitating, disorder that affects an estimated 14-24
percent of women and 5-19 percent of men in the U.S.

The study is posted online on the Clinical Gastroenterology and
Hepatology’s Web site and will be published in the journal’s July 2008 issue.

Jeffrey M. Lackner, Psy.D., assistant professor in the Division of
Gastroenterology in the University at Buffalo School of Medicine and
Biomedical Sciences and director of its Behavioral Medicine Clinic at
the Erie County Medical Center, is first author.

“The value of this study is that it shows that patients can learn
relatively simple self-care skills to take control of symptoms that are
resistant to existing medical treatments,” said Lackner. “This is a
dramatic example of the complexity of brain-gut interactions.”

IBS is characterized by chronic abdominal pain and discomfort, diarrhea
and/or constipation. Cognitive behavioral therapy (CBT) has been shown
to improve symptoms, quality of life and psychological stress, but there
is a shortage of trained CBT therapists, which has created long waiting lists.

The treatment also is expensive and time consuming, requiring 10-12 in-
office sessions, a schedule many patients are unable or unwilling to
maintain. In addition, IBS specialty clinics are rare, so patients are
deprived of the state-of-the-art treatment available at UB.

To help solve these problems, Lackner and colleagues designed a
primarily self-administered treatment program that patients can learn at
home, using self-study materials, supplemented by four in-office
counseling sessions.

“Patients can follow a program like this at their own pace and on their
own time,” Lackner noted, “and perhaps most important, they can learn
these skills in the environment where symptoms are most likely to occur.
It also requires less travel, which makes it convenient for patients
with busy lifestyles and for those in underserved and rural areas.”

The researchers tested the program’s effectiveness in a pilot study
involving 75 IBS-diagnosed patients who were randomized to one of three
groups: a standard 10-session therapist-administered cognitive therapy
group (CBT); a “minimal-contact” CBT group (MC-CBT) that included the
home-based program and a wait-list group (WL). This last group simply
monitored their gastrointestinal symptoms daily.

All participants were interviewed two weeks after the end of the 10-week
treatment period to gather information on overall relief of symptoms and
improved quality of life.

Patients in both therapy groups reported clinically significant relief
of symptoms: 60.9 percent in the CBT group and 72 percent for MC-CBT.
Only 7.4 percent of the wait-list group reported improvement. Patients
in both treatment groups also reported significant improvement in
quality of life.

“The finding that a self-administered approach can be successful in
reducing IBS symptoms is important at this point in time, when few
validated therapies are available for patients,” said Lackner.

“Further research is needed to establish the therapeutic potential of
this novel approach to managing IBS, as well as to understand how these
treatments work and the conditions under which they are most likely to
achieve the desired effects.”

Additional contributors to the study were James Jaccard, Ph.D., from
Florida International University; Susan S. Krasner, Ph.D., Leonard A.
Katz, M.D., and Gregory D. Gudleski, Ph.D., from UB, and Kenneth A.
Holroyd, Ph.D., from Ohio University.

The study was supported by a grant to Lackner from the National
Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).