This is a five min rounds overview of health psychology treatment for IBS. It explores skills, mental health interventions and medications used to manage IBS.

1. Health Psych IBS Tx.
Irritable Bowl Syndrome (IBS): Has a wide range of symptoms that impact a
person’s functioning. There are three kinds of IBS. IBS-C (Constipation), IBS-D
(Diarrhea), IBS-M (Mixed Diarrhea and Constipation).
Biopsychosocial Model of IBS
76% Patients w IBS
Report Impairment
in 5 Life Domains
Work
SocialActivities
Appearance
House HoldIntimacy
Leisure
Travel
Eating
Early Life Experiences
Social Support/ Stress
Traumas/ACEs
Infection/Inflammation
Prematurity/perinatal
Genetics
CNS/Brain: Mental Health Dx (Depression/Anxiety),
Health Anxiety, Cognitive distortions (Catastrophization),
GI Anxiety, Fear Conditioning, Emotional & Cog.
Modulation of Gut Motility, HPA-Axis Response.
Gut Physiology: Motility, Inflammation, Gut Sensation,
Micro-biome, gut-brain axis, intestinal barrier
permeability
IBS
Sympt.
Psychosocial Stressors
Major Events, Social,
Cultural, Daily Stress
Treatment Utilization and Outcomes: Symptom Severity, Treatment Response, Health Care Adherence,
Health Care Utilization, Health Related Quality of Life
IBS Treatments
CBT and
ACT
Relaxation &
Meditation
MedicationsDiet ExerciseMicrobiome

2. IBS Medications
1. Fiber supplements
2. Probiotics and Gut Flora
3. Laxatives
4. Anti-diarrheal medications
5. Anticholinergic medications
6. SSRI antidepressants
7. Pain medications (Lyrica)
Alosetron (Lotronex). Alosetron is designed
to relax the colon and slow the movement of
waste through the lower bowel.
Eluxadoline (Viberzi). Eluxadoline can ease
diarrhea by reducing muscle contractions and
fluid secretion in the intestine, and increasing
muscle tone in the rectum.
Rifaximin (Xifaxan). This antibiotic can
decrease bacterial overgrowth and diarrhea.
Lubiprostone (Amitiza). Lubiprostone can
increase fluid secretion in your small intestine
to help with the passage of stool.
Linaclotide (Linzess). Linaclotide also can
increase fluid secretion in your small intestine
to help you pass stool.
IBS Behavioral Health Interventions
Exposure techniques: Patients with IBS often
have safety behaviors that increase IBS symptoms
and anxiety. These can limit life like not going
places where they know where the bathroom is,
restrict eating, eating alone, safety meds during
travel.
Problem-solving skills: IBS requires problem-
solving for many life challenges. Developing
flexible problems solving and acceptance
strategies can improve some one’s quality of life.
This is true for both problems of life and
emotional coping.
Cognitive restructuring: Cognitive restructuring
is highly helpful for IBS. Addressing symptom
related anxiety, hypervigilance of IBS events can
impact life significantly. Education around
cognitive distortions related to digestion and
symptoms.. Providing examples of symptom
catastrophization helps patients make effective
cognitive appraisal. Example: fear of passing gas
at a party increases anxiety, which leads to
hyperarousal and stress reaction, which intern
changes peristalsis and gut motility driving IBS
symptoms.
Relaxation strategies: Relaxation strategies are
important even early in care. These skills are
aimed at teaching regulating the autonomic
nervous system. Patients should learn skills to
evoke parasympathetic response through
diaphragmatic breathing and how this impacts
peristalsis and gut motility.
Psychoeducation: Psychoeducation is a vital
aspect of IBS care. Education should focus on
dispelling myths, understanding brain gut axis,
stress and digestion and reasons for behavioral
health interventions.
Kinsinger, S. W. (2017). Cognitive-behavioral therapy for patients
with irritable bowel syndrome: current insights. Psychology research
and behavior management, 10, 231.
IBS Exercise
 Daily Exercise: Exercise at the same
time each day, and choose a time that
is easy for you to stick to.
 Exercise and Eating; Avoid
exercising within an hour before or
after eating.
 Exercise and Sleepiness: Exercise
when you’re alert, rather than when
you’re sleepy.
 Exercise you Enjoy! Choose an
exercise that you enjoy and that fits in
with your way of life.
 Types of Exercise: Cardiovascular
exercise, yoga, martial arts/Thai
Chi/Chi gong.
https://www.everydayhealth.com/ibs/ibs-and-exercise.aspx
IBS Interventions for Health Psychologists