Patient Attributes for Optimal Treatment Outcome in Irritable Bowel Syndrome.

Although research has demonstrated the efficacy of various psychological and pharmacological
treatments for irritable bowel syndrome (IBS)1, health professionals have limited
information about how to determine which specific treatment regimens lead to optimal
outcomes for specific IBS populations 2,3. A prevalent syndrome, with high healthcare costs,
IBS is a debilitating chronic functional bowel disorder with increasingly interconnected
psychosocial and gastrointestinal afflictions4. In general, IBS sufferers have not been
found to respond consistently to a single medication or class of medications5. In the wake
of the failures of medical therapies, many psychological interventions, adjunct to standard
IBS treatments, have been examined1,6 such as Blanchard and Scharff's 2002 review of 12
random controlled trials that found strong evidence for the utility of hypnotherapy,
cognitive behavioral therapy (CBT), and brief psychodynamic psychotherapy in helping to
alleviate IBS symptoms7. Similarly, in a more recent study involving a meta-analysis of
seventeen studies, with randomized trials comparing classes of psychological interventions,
found that these psychological treatments also play a role in improving quality of life of
IBS suffers1. Among these psychological interventions, cognitive behavioral therapy (CBT), a
prescriptive therapy that specifically targets faulty thinking patterns, has been found to
be quite effective in many empirical investigations. Recent evaluations of CBT interventions
have found the therapy to have a direct effect on global improvements of IBS symptoms and
quality of life8. Despite its demonstrated effectiveness, however, CBT does not work for all
patients3,6,8. The successes of medical therapy alone compared to a treatment regimen
combining psychological and pharmaceutical interventions have been greeted with mixed
results— leading to the unnecessary waste of health resources in the course of treatment3,6.
To decrease medical costs, as well to foster optimal treatment for IBS patients, there is a
need for a better method of identifying which patients will most benefit from specific
treatment options s (i.e. conventional medical treatment versus standard treatment and
CBT)2,3.

Inclusion Criteria:

- All newly diagnosed IBS patients using Rome III criteria above the age of 18.

Exclusion Criteria:

- Patients with non-functional GI disorders, severe psychiatric disorders, including
psychotic disorders, actively suicidal or alcoholism/other drug dependencies.

- Pregnant women and minors(under age 18) will also be excluded.

- Prisoners will also be excluded.