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Mindfulness-Based Stress Reduction for the Treatment of Irritable Bowel Syndrome Symptoms: A Randomized Wait-list Controlled Trial

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Abstract

Background

Irritable bowel syndrome (IBS) is a functional disorder of the lower gastrointestinal (GI) tract affected by stress, which may benefit from a biopsychosocial treatment approach such as mindfulness-based stress reduction (MBSR).

Purpose

A treatment as usual (TAU) wait-list controlled trial was conducted in Calgary, Canada to investigate the impact of MBSR on IBS symptoms. It was hypothesized that MBSR patients would experience greater reduction in overall IBS symptom severity and self-reported symptoms of stress relative to control patients.

Method

Ninety patients diagnosed with IBS using the Rome III criteria were randomized to either an immediate MBSR program (n = 43) or to wait for the next available program (n = 47). Patients completed IBS symptom severity, stress, mood, quality of life (QOL), and spirituality scales pre- and post-intervention or waiting period and at 6-month follow-up. Intent-to-treat linear mixed model analyses for repeated measures were conducted, followed by completers analyses.

Results

While both groups exhibited a decrease in IBS symptom severity scores over time, the improvement in the MBSR group was greater than the controls and was clinically meaningful, with symptom severity decreasing from constantly to occasionally present. Pre- to post-intervention dropout rates of 44 and 23 % for the MBSR and control groups, respectively, were observed. At 6-month follow-up, the MBSR group maintained a clinically meaningful improvement in overall IBS symptoms compared to the wait-list group, who also improved marginally, resulting in no statistically significant differences between groups at follow-up. Improvements in overall mood, QOL, and spirituality were observed for both groups over time.

Conclusions

The results of this trial provide preliminary evidence for the feasibility and efficacy of a mindfulness intervention for the reduction of IBS symptom severity and symptoms of stress and the maintenance of these improvements at 6 months post-intervention. Attention and self-monitoring and/or anticipation of MBSR participation may account for smaller improvements observed in TAU patients.

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Acknowledgments

Dr. Linda E. Carlson holds the Enbridge Research Chair in Psychosocial Oncology, co-funded by the Alberta Cancer Foundation and the Canadian Cancer Society Alberta/NWT Division. She is also an Alberta Heritage Foundation for Medical Research Health Scholar. This research was supported by a Calgary Health Region/Centre for the Advancement of Health Research Grant awarded to Dr. Carlson. Kristin Zernicke holds a Canadian Institute of Health Research—Frederick Banting and Charles Best Canada Graduate Scholarship, an Alberta Innovates—Health Solutions Studentship, and a Psychosocial Oncology Research Training Fellowship. We would like to thank our dedicated MBSR instructors, research assistants, and the patients who participated in this research. Without them, this research would not be possible.

Conflict of interest

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Authors and Affiliations

  1. Department of Psychology, University of Calgary, Calgary, Alberta, Canada

    Kristin A. Zernicke, Tavis S. Campbell, Jillian A. Johnson & Linda E. Carlson

  2. Department of Medicine, University of Calgary, Calgary, Alberta, Canada

    Philip K. Blustein

  3. Information Technologies, University of Calgary, Calgary, Alberta, Canada

    Tak S. Fung

  4. Department of Exercise Science, Concordia University, Montréal, Quebec, Canada

    Simon L. Bacon

  5. Department of Oncology, University of Calgary, Calgary, Alberta, Canada

    Linda E. Carlson

  6. Department of Psychosocial Resources, University of Calgary, 2202 2nd Street SW, Calgary, Alberta, T2S 3C1, Canada

    Linda E. Carlson

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  1. Kristin A. Zernicke
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  2. Tavis S. Campbell
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  7. Linda E. Carlson
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Correspondence to Linda E. Carlson.

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Zernicke, K.A., Campbell, T.S., Blustein, P.K. et al. Mindfulness-Based Stress Reduction for the Treatment of Irritable Bowel Syndrome Symptoms: A Randomized Wait-list Controlled Trial. Int.J. Behav. Med. 20, 385–396 (2013). https://doi.org/10.1007/s12529-012-9241-6

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