Writing calms IBS

Their study is the first to test so-called "expressive writing" in people with IBS, and the results are still very preliminary.

However, they support with earlier research showing that this particular type of writing, in which participants are encouraged to "really let go" and get to the bottom of their feelings, can be beneficial for some.

The exercise has helped people with depression, for instance, as well as rheumatoid arthritis, chronic pain, high blood pressure and Aids, the authors of the new study note in the American Journal of Gastroenterology.

Quality of life

Symptoms of IBS may include abdominal pain, diarrhoea, bloating and constipation. The 82 patients in the IBS study reported improvements in disease severity, coping and thinking (including negative thoughts) one and three months after writing.

At three months, they also said their quality of life was better."In general people keep too many darn secrets," said Mark A. Lumley, an expert in expressive writing at Wayne State University in Detroit, who was not involved in the study.

"When we avoid dealing with emotional experiences, that appears to take a physiological toll."

Psychologic stress can depress the immune system, for example, and the link between the brain and the gut's nervous system plays a well-established role in IBS. As a consequence, IBS patients would make good candidates for expressive writing, Lumley said.

Yet the way the study was designed, he added, the findings might easily appear more impressive than they really are.

The study

The researchers had advertised their project on IBS-related websites, and then recruited only people who completed 30 minutes of internet-based writing on four consecutive days. They asked those who had volunteered but never got started on the writing to complete questionnaires so that they could act as a control group.

While the writers did better than the non-writers, saying they felt more in control of their symptoms, it's hard know what the reason is. It is possible that they were inherently more motivated people, or they might have believed in the treatment so much that it actually appeared to work.

While the authors recognise the need for further study, they say psychological treatment strategies for IBS are becoming increasingly popular. Given that seeing a therapist is both time-consuming and costly, they say online expressive writing "offers self-help to patients with IBS and may possibly reduce the health-care utilisation associated with this common chronic gastrointestinal disorder".

Lumley said he was probably "a little more skeptical than the authors of this technique," but added that it made sense to begin treatment with a cheap, non-medical approach."We should start there," he said. "If it works, great, if it doesn't, then we try something else." - (Reuters Health, June 2010)