Overview & Efficacy: A mixture of a few small controlled studies, a moderate number of small clinical studies, and many clinical case studies provide reasonably convincing evidence that biofeedback can effectively reduce or cure this problem.

This therapy is rated as between possibly and probably efficacious (levels 2 to 3 on a scale of 1 - 5 with 5 being the best).

Why biofeedback would help this problem: The underlying causes of irritable bowel syndrome are unknown for over 2/3 of the people suffering from this disorder. There are two main reasons biofeedback is thought to help IBS. First, stress responses which are expressed as abnormally great gastric reactions (compromised absorption, abnormal muscle contractions related to transport of materials through the gut, etc.) are a key part of the problem for between 1/3 and ½ of the people with IBS. Biofeedback has been shown to be very helpful in teaching people to recognize and control these overreactions. Second, biofeedback recordings can help just about everybody with IBS to recognize when their intestinal tract is about to react abnormally - before they would normally notice symptoms. This knowledge can be used to learn to be aware of when the system is just beginning go get out of wack and to prevent it from doing so.

Brief summary of evidence supporting the efficacy of biofeedback for IBS:

Verne et al (2003) have reviewed the literature showing that there is both visceral and cutaneous hypersensitivity in irritable bowel syndrome. They have also demonstrated that fMRIs of the brains of people with irritable bowel syndrome are very different from those of controls in areas related to cognitive processing as well as pain. This coincides with Donaldson's work combining EEG and peripheral biofeedback in the treatment of irritable bowel syndrome. Stress related Irritable Bowel Syndrome (IBS) can be very effectively treated using behavioral interventions (e.g., Blanchard et al 93; Humphries and Gevirtz 2000). Blanchard and his team feel that cognitive restructuring is highly effective for the third of irritable bowel syndrome patients who produce a conversion "V" on the MMPI. There are numerous of placebo controlled, studies with reasonably long term follow-ups. They also feel that biofeedback may speed up the process. Gevirtz feels that biofeedback alone is at least or more effective than cognitive restructuring if the correct type of biofeedback is given. He feels that resonant frequency training for homeostatic quieting is optimal (Gevirtz, 1999). Banez and Bigham (2003) have reviewed the effectiveness of psychophysiological techniques for assessment and intervention of abdominal pain in children. Much of the work is based on Bigham's doctoral work which demonstrates that these techniques are highly effective. See Blanchard's work (e.g., Payne and Blanchard 1995) and Toner et al's 1998 review for more details on this issue.

Detailed information on biofeedback augmented treatment of IBS

A. Citations to the papers summarized in the "brief summary":

Banez G, Bigham E: Recurrent abdominal pain in children and adolescents. Biofeedback 31: 23-25, 2003.

Blanchard EB, Greene B, Scharff L, Schwarz-McMorris SP: Relaxation training as a treatment for irritable bowel syndrome, Biofeedback Self Regulation 18:125-32, 1993.

Gevirtz R: Irritable Bowel Syndrome. Biofeedback News magazine Winter Issue, 1999 Humphreys P, Gevirtz R: Treatment of recurrent abdominal pain: components analysis of four treatment protocols, J Pediatr Gastroenterol Nutr 31:47-51, 2000.

Payne R, Blanchard E: Irritable Bowel Syndrome. J of Consulting and Clinical Psychology 63: 779-786, 1995. Toner M: Irritable Bowel Syndorme. Int J of group Psychotherapy 48: 215 - 242, 1998.

Verne G, Himes N, Robinson M, Gopinath K, Briggs R, Crosson B, Price D: Central representation of visceral and cutaneous hypersensitivity in the irritable bowel syndrome. Pain 103: 99-110. 2003.