Gut Pain? There’s an App for That!
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By Luisa Scott, PhD
Living with chronic pain is hard. Disorders characterized by chronic pain, like IBS, do not just affect us physically. Pain affects our emotions, our outlook, and how we interact with others. We change our behavioral patterns to try to guard against our symptoms occurring or worsening. It is common for those living with chronic pain to withdraw. But this isolation from others reduces our quality of life. It can feel like your symptoms control you.
“Psychological stress influences gut function through the same gut-brain system of communication as physiological stress.”
Our thoughts and responses to life events and our symptoms can influence how we feel. Our perceptions and actions can either exacerbate our symptoms and make us feel worse or help us cope with our symptoms and feel a bit better. Why do our thoughts have so much impact on our body, and particularly our gut?
Our brain is responsible for regulating our body’s movement and functions so that our body can meet our needs. Usually, we are not even aware this communication is happening. If we need to run away from a predator, or just go on a jog around our neighborhood, it is not a good time for a bowel movement. Our brain regulates this response to physiological stress without us even thinking about it. It communicates the need to our gut through the gut-brain axis, a robust network of signaling pathways.
Psychological stress influences gut function through this same gut-brain system of communication as physiological stress. The shared signaling pathways allows chronic stress, which is so common in our modern lives, to influence our bowel function. Our emotional and behavioral reactions to our symptoms can make things even worse by piling on the stress. Gastrointestinal symptom-related anxiety is quite common, and the stress response provoked by these feelings can increase bowel discomfort and exacerbate bowel dysfunction.
But we can reverse this process by targeting how we respond to symptoms and take control.
“By employing these techniques to reduce distress from internal and external factors, we can break the cycle of stress, reduce our symptom severity and increase our quality of life.”
Cognitive Behavioral Therapy (CBT) is a goal-oriented, structured treatment that can be effective in treating or supporting a variety of health conditions (not just mental health!). It focuses on problem solving in the present and encouraging the behavioral and outlook changes. Moreover, these positive effects last long after the end of treatment.
Symptom-directed CBT can help patients manage chronic pain disorders, like irritable bowel syndrome (IBS), by changing how we respond to the events in our lives and our symptoms themselves. CBT can be tailored to address how our own thoughts and behavioral patterns might be worsening our specific symptoms and setting up a barrier to our improved well-being. Through CBT we learn tools to reduce the impact of stressful life events on our health. We can also learn to identify and alter unhelpful perceptions and behaviors related to our health condition. By employing these techniques to reduce distress from internal and external factors, we can break the cycle of stress, reduce our symptom severity, and increase our quality of life.
In fact, the American College of Gastroenterology and the American Gastroenterology Association both currently recommend interventions like gut-directed CBT as a treatment option for IBS. A recent study combined over 40 clinical trials of CBT for IBS and found consistent improvement in IBS symptoms and pain, and that these improvements even lasted well beyond the treatment time.
Unfortunately, even though CBT is a well-validated treatment for chronic pain disorders, traditional therapist-directed CBT has substantial barriers for use by many patients. There are too few therapists who can provide symptom-directed CBT. Even if one can find a provider, the appointments typically require a time commitment including travel during working hours, which can preclude access for many already struggling with health-related burdens on their time.
“Digitally delivered CBT helps you get the care you need from the convenience of a mobile app.”
Digital CBT makes this important treatment much more widely available for people suffering from chronic pain. Digitally delivered CBT helps you get the care you need from the convenience of a mobile app. You can open the app and work through the content when your schedule has an opening; and the mobile device can provide helpful reminders. With digital CBT, individuals can get the tailored personalized model they need to address their own symptoms and experiences.
And clinical studies show that digital CBT works! Research demonstrates that whether CBT is delivered in-person, over the phone, in group sessions, at home, or digitally, it is all more effective than routine care. In fact, two out of three patients see improvement in their IBS symptoms after going through a digitally delivered treatment of gut-directed CBT. Digital CBT may not only be more accessible, but also preferable: in a study of IBD patients, 3 out of 4 patients chose online CBT over face-to-face CBT.
If you are interested in learning more about whether CBT is right for you, start a discussion with your health care provider.
Luisa Scott, PhD is a neuroscientist and science communicator who is passionate about innovative solutions that help people with chronic conditions achieve greater well-being. As a Medical Engagement Manager at Mahana Therapeutics, Luisa Scott shares clinical and scientific information about prescription digital therapeutics with the healthcare community and the patients they serve.