Abstract
Introduction
Irritable bowel syndrome (IBS) is characterized by patients’ high level of suffering. Up to 60%ofpatients with IBS have symptoms of anxiety or depression and only little attention has beenpaid to their specific requirements. Anthroposophical multimodal therapy (AMT) has beenshowntosignificantly improve health-related quality of life of patients with high symptomatic burden.
Objective
The aim of this pilot study was to find out whether AMT meets the needs of IBS patients and the interactions of AMT with IBS, depression and anxiety.
Methods
Patients with diagnosed IBS were included in a feasibility study and received 12 sessions of AMTover8weeks(drks.de, DRKS00016890). Theprimary endpoint was the changeof the IBS severity score (IBS-SSS) and changes were calculated by linear mixed effects analyses. The secondary endpoints were changes of self-reported PHQ-9 and GAD-7 for mental comorbidity as well as self-valued effectiveness and satisfaction of AMT.
Results
Thirty-six patients, 89% female, were included in the study. AMT was successfully applied to IBS patients (-45 points in the IBS-SSS, p < .05). AMT had a large positive effect (-84 points in IBS-SSS, p < .003) on patients without anxiety or depression. Over time, patients with higher anxiety scores worsened with regard to their IBS compared to patients with depression and without mental comorbidity. The AMT effect was maintained at a 12 month follow up and both mentally affected and unaffected patients, had even lower IBS severity than shortly after AMT. AMT modules were rated by IBS patients as very effective.
Conclusion
Ourfindings suggest that an 8-week program of AMT improves the severity of IBS with an ongoing effect at a 12 month follow-up. Especially for patients without psychological comorbidities, AMT is very successful. Future IBS therapies should incorporate a modified multimodal concept with stronger psychological therapy modules in parallel for patients with depression and anxiety.
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