To better understand the impact of mindfulness training on IBS symptoms, Bruce Naliboff, PhD, a clinical professor in the department of psychiatry and biobehavioral sciences at UCLA’s David Geffen School of Medicine led a team of researchers who followed 68 IBS patients through an eight-week mindfulness-based stress reduction (MBSR) class that included weekly group trainings and daily 30-minute meditation sessions at home. More than 70 percent of participants in the study reported a reduction in the severity of their IBS symptoms following the training, and benefits continued three months after its conclusion. Additionally, participants reported significant improvements in both their quality of life and reductions in anxiety associated with their IBS symptoms. The results were published in April 2020 in the journal Neurogastroenterology & Motility. Follow-up surveys found that participants also showed significant gains in three facets of mindfulness: observation, being nonjudgmental, and acting with awareness. The last of those three was of particular interest to the research team, who found that patients who developed their ability to act with awareness were the most likely to report a reduction in both the severity of their symptoms and the anxiety associated with IBS. They were also more likely to report a better quality of life at the three-month follow-up. Kirsten Tillisch, MD, a gastroenterologist at Ronald Reagan UCLA Medical Center and an author of the study, says she and her colleagues were surprised that acting with awareness translated to a reduction in IBS symptoms. In MBSR, acting with awareness means attending to activities in the present moment, rather than acting on autopilot or out of habit. This factor, which aims to let practitioners acknowledge thoughts and distractions as they arise without chasing them down, is one of the major outcomes of a successful mindfulness practice. “Mindfulness is a very popular term, but a lot of what practicing mindfulness does is generate awareness,” says Susan Gaylord, PhD, the director of the center for integrative medicine at the University of North Carolina School of Medicine in Chapel Hill. That awareness, Dr. Gaylord says, lets people bring their attention to the present, and then stay in that moment, operating from a fresh perspective. “As a disorder of internal sensations, at the beginning I would not have guessed that this factor that focuses on outward action would have made such a strong impact,” Dr. Tillisch says. Tillisch pointed out that the study was unable to explain why that impact seemed so strong. She speculated that transferring a patient’s attention to the external world and their immediate surroundings could simply leave less bandwidth for the brain to focus on internal matters, including the ruminations and predictions that may drive persistent IBS symptoms. Previous research has shown that this aspect of mindfulness may be helpful in preventing obsessive intrusive thoughts (OITs), such as shame around past situations or worries about what the future might hold — fears and worries that are commonly associated with IBS. For some patients, OITs can worsen symptoms and make the condition more difficult to manage. RELATED: IBS Treatment Options and Prevention Strategies
The Many Types of Meditations
Meditation is a skill that requires practice just like any other, and different types of meditation can result in different experiences. The practice has been studied for many conditions other than IBS, including heart disease, depression, and PTSD. Mindfulness meditation, which includes MBSR, focuses on creating and maintaining a sense of presence with the world around you and limiting emotional reactions and judgments, so you can assess situations thoughtfully, not just with gut feelings or instincts. MBSR training can vary from class to class and teacher to teacher, but it often touches on interacting with and interrogating emotional responses and often includes yoga practice. Through group discussions and homework, students work to become more attentive to their senses and aware of their surroundings, as well as their reactions to those surroundings. The new UCLA-led study suggests that MBSR training could improve the results of meditation and other mindfulness practices for individuals with IBS. Tillisch and her colleagues are eager to investigate that potential further, she said. “At this time, the traditional MBSR is the gold standard and is based on the broad research that shows its benefits across several mental health and physical symptom domains, [and] it should remain so,” Tillisch says. “But targeted interventions for specific disorders like IBS may be useful as stand-alone, shorter interventions.”
