Psychological treatment of irritable bowel syndrome

Psychosocial research in gastroenterology is primarily focused on functional bowel disorders, the most common and costly of which is irritable bowel syndrome (IBS). Advances in functional neuroimaging and neuroimmunology have shifted the etiological paradigm of IBS from a psychosomatic framework to a biopsychosocial framework. The purpose of this chapter is to (i) provide a rationale for the use of psychological therapies in IBS based on what is now known about the pathophysiology of IBS, and (ii) describe the structure, focus, and efficacy of the primary psychological interventions used to treat IBS. Discussions include diagnosis and burden of IBS, its management and psychological treatment. While there are any number of psychological interventions for medical and psychiatric illness, randomized controlled trials that have demonstrated efficacy in the treatment of IBS are limited to three broad classes of psychotherapy: brief psychodynamic therapy, gut-directed hypnotherapy, and cognitive behavioral therapy (CBT).