Mindfulness-based stress reduction in patients with irritable bowel syndrome: authors’ reply

Abstract

Sirs, We would like to thank Drs Asarel and Simren for their comments regarding our work.1 We certainly agree that studies of mindfulness interventions for irritable bowel syndrome (IBS) are of potentially great clinical importance. Given the high prevalence of multiple overlapping somatic syndromes,2 psychiatric conditions3 and trauma among IBS patients, interventions that emphasise learning broadly applicable strategies to work with difficult conditions and to improve quality of life, rather than alleviating specific symptoms, hold the potential to play a key role in improving the health status of these patients. Our hope is that the following comments will add to the discussion of the role of mindfulness programmes in the clinical management of patients with IBS. A limitation of our study is the lack of a control group. We agree that controlled trials are needed. Recently, support for teaching mindfulness to patients with IBS has come from a randomised controlled trial of mindfulness-based stress reduction (MBSR) (modified slightly for IBS) for women with IBS.4 As compared to a support group, Gaylord et al. found significant improvements in IBS symptoms, quality of life, and GI-specific anxiety at 3-month follow-up among women randomised to MBSR. The results of Gaylord et al. were limited to women, and we feel they complement our results (based on a predominantly male sample), and together the two studies provide support for MBSR for IBS in both genders, although randomised controlled trials that include men are still needed. Of note, although IBS is more common among women, approximately one-third of persons with this condition are men.5 In the Veteran population, which has a high prevalence of trauma, IBS is a common clinical condition in both men and women. Mindfulness-based stress reduction, in the format employed in our study, is already widely available, and our findings support utilisation of MBSR as an additional resource for persons with IBS. We wish to thank the Veterans who participated in this research. Declaration of personal interests: This work was supported by resources from VA Puget Sound Health Care System. Declaration of funding interests: None.