Working With Patients With Chronic Digestive Diseases

Megan E. Riehl and Tiffany H. Taft

Citation

Riehl, M.E. & Taft, T.H. (2021). Working With Patients With Chronic Digestive Diseases. Journal of Health Service Psychology, 47(2). https://doi.org/10.1007/s42843-021-00034-5

Abstract

Psychogastroenterology is the specialty treatment of patients living with chronic illnesses that affect the digestive tract using evidence-based methods, the most often being cognitive behavioral therapy tailored to the digestive illness and gut-directed hypnotherapy. While patients with all digestive conditions are referred for services, the most common are irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD). Clinical interventions target disease processes, including visceral hypersensitivity and autonomic nervous system arousal, while leveraging resilience and coping strategies to enhance patient self-management of their disease. Opportunities exist for psychologists both in integrated gastroenterology clinics and in private practice settings. The protocols and clinical process of working with the patient are described in detail.

References

Ananthakrishnan, A. N. (2015). Epidemiology and risk factors for IBD. Nat Rev Gastroenterol Hepatol, 12(4), 205-217. doi:10.1038/nrgastro.2015.34

Benchimol, E. I., Bernstein, C. N., Bitton, A., Murthy, S. K., Nguyen, G. C., Lee, K., . . . Kaplan, G. G. (2018). The Impact of Inflammatory Bowel Disease in Canada 2018: A Scientific Report from the Canadian Gastro-Intestinal Epidemiology Consortium to Crohn’s and Colitis Canada. Journal of the Canadian Association of Gastroenterology, 2(Supplement_1), S1-S5. doi:10.1093/jcag/gwy052

Bernstein, C. N., Rawsthorne, P., Cheang, M., & Blanchard, J. F. (2006). A population-based case control study of potential risk factors for IBD. Am J Gastroenterol, 101(5), 993-1002. doi:10.1111/j.1572-0241.2006.00381.x

Black, C.J., Thakur, E.R., Houghton, L.A., Quigley, E.M.M., Moayyedi, P. & Ford, A.C. Efficacy of psychological therapies in irritable bowel syndrome: systematic review and network meta-analysis. (2020). Gut, 69(8), 1441-1451. doi: 10.1136/gutjnl-2020-321191.

Czuber-Dochan, W., Ream, E., & Norton, C. (2013). Review article: Description and management of fatigue in inflammatory bowel disease. Aliment Pharmacol Ther, 37(5), 505-516. doi:10.1111/apt.12205

Ford, A.C., Lacy, B.E., & Talley N.J. (2017). Irritable bowel syndrome. N Engl J Med, 376, 2566-2578. doi: 10.1056/NEJMra1607547

Fourie, S., Jackson, D., & Aveyard, H. (2018). Living with Inflammatory Bowel Disease: A review of qualitative research studies. Int J Nurs Stud, 87, 149-156. doi:10.1016/j.ijnurstu.2018.07.017

Franklin, C. L., Raines, A. M., Cuccurullo, L. J., Chambliss, J. L., Maieritsch, K. P., Tompkins, A. M., & Walton, J. L. (2018). 27 ways to meet PTSD: Using the PTSD-checklist for DSM-5 to examine PTSD core criteria. Psychiatry Res, 261, 504-507. doi:10.1016/j.psychres.2018.01.021

Gracie, D. J., Guthrie, E. A., Hamlin, P. J., & Ford, A. C. (2018). Bi-directionality of Brain-Gut Interactions in Patients With Inflammatory Bowel Disease. Gastroenterology, 154(6), 1635-1646 e1633. doi:10.1053/j.gastro.2018.01.027

Grover, M., Herfarth, H., & Drossman, D. A. (2009). The functional-organic dichotomy: postinfectious irritable bowel syndrome and inflammatory bowel disease-irritable bowel syndrome. Clin Gastroenterol Hepatol, 7(1), 48-53. doi:10.1016/j.cgh.2008.08.032

Houghton, L. A., Lea, R., Agrawal, A., Reilly, B., & Whorwell, P. J. (2006). Relationship of abdominal bloating to distention in irritable bowel syndrome and effect of bowel habit. Gastroenterology, 131(4), 1003-1010. doi:10.1053/j.gastro.2006.07.015

Iqbal, S. & Quigley, E.M.M. (2016). Progress in our understanding of the gut microbiome: Implications for the clinician. Current Gastroenterology Reports, 18(49), doi.org/10.1007/s11894-016-0524-y

Kaplan, G. G. (2015). The global burden of IBD: from 2015 to 2025. Nature Reviews Gastroenterology & Hepatology, 12(12), 720-727. doi:10.1038/nrgastro.2015.150

Keefer, L., Taft, T.H., Kiebles, J.L., Martinovich, Z., Barrett, T.A., & Palsson, O.S. (2013). Aliment Pharmacol Ther, 38(7), 761-771. doi: 10.1111/apt.12449.

Keohane, J.M.B., O’Mahony, C., O’Mahony, L., O’Mahony, S., Quigley, E.M., Shanahan, F. (2010). Irritable bowel syndrome-type symptoms in patients with inflammatory bowel disease: A real association or reflection of occult inflammation? Am J of Gastroenterol, 105(8), 1789-1794. doi: 10.1038/ajg.2010.156

Kinsey, L., & Burden, S. (2016). A survey of people with inflammatory bowel disease to investigate their views of food and nutritional issues. Eur J Clin Nutr, 70(7), 852-854. doi:10.1038/ejcn.2016.57

Kinsinger, S.W. (2017). Cognitive-behavioral therapy for patients with irritable bowel syndrome: current insights. Psychol Res Behav Manag, 10, 231-237. doi: 10.2147/PRBM.S120817

Labus, J. S., Bolus, R., Chang, L., Wiklund, I., Naesdal, J., Mayer, E. A., & Naliboff, B. D. (2004). The Visceral Sensitivity Index: development and validation of a gastrointestinal symptom-specific anxiety scale. Aliment Pharmacol Ther, 20(1), 89-97. doi:10.1111/j.1365-2036.2004.02007.x

Levenstein, S., Prantera, C., Varvo, V., Scribano, M.L., Andreoli, C., Luzi, C…Marcheggiano, A. (2000). Stress and exacerbation in ulcerative colitis: a prospective study of patients enrolled in remission. Am J Gastroenterol, 95(5), 1213-1220. doi: 10.1111/j.1572-0241.2000.02012.x.

Lewis, S.J., & Heaton, K.W. (1997). Scand J Gastroenterol, 32(9), 920-924. doi: 10.3109/0036552970901120

Li, L., Xiong, L., Zhang, S., Yu, Q., & Chen, M. (2014). Cognitive-behavioral therapy for irritable bowel syndrome: A meta-analysis. J Psychosom Res, 77(1), 1-12. doi: 10.1016/j.jpsychores.2014.03.006.

Lindfors, P., Ljotsson, B., Bjornsson, E., Abrahamsson, H., & Simren, M. (2013). Patient satisfaction after gut-directed hypnotherapy in irritable bowel syndrome. Neurogastroenterol Motil, 25(2), 169-e186. doi:10.1111/nmo.12022

Long, M. D., & Drossman, D. A. (2010). Inflammatory bowel disease, irritable bowel syndrome, or what?: A challenge to the functional-organic dichotomy. Am J Gastroenterol, 105(8), 1796-1798. doi:10.1038/ajg.2010.162

Lovell, R. M., & Ford, A. C. (2012). Global prevalence of and risk factors for irritable bowel syndrome: a meta-analysis. Clin Gastroenterol Hepatol, 10(7), 712-721.e714. doi:10.1016/j.cgh.2012.02.029

Martin, C. R., Osadchiy, V., Kalani, A., & Mayer, E. A. (2018). The Brain-Gut-Microbiome Axis. Cell Mol Gastroenterol Hepatol, 6(2), 133-148. doi:10.1016/j.jcmgh.2018.04.003

Mayer, E. A. (2011). Gut feelings: the emerging biology of gut-brain communication. Nat Rev Neurosci, 12(8), 453-466. doi:10.1038/nrn3071

Mayer, E.A., Tillisch, K., & Gupta, A. (2015). Gut/brain axis and the microbiota. J Clin Invest, 125(3), 926-938. doi: 10.1172/JCI76304

Mearin, F., Lacy, B.E., Chang, L., Chey, W.D., Lembo, A.J., Simren, M., & Spiller, R. (2016). Bowel disorders. Gastroenterology, 150, 1393-1407. doi: 10.1053/j.gastro.2016.02.031

Molodecky, N. A., Soon, I. S., Rabi, D. M., Ghali, W. A., Ferris, M., Chernoff, G., . . . Kaplan, G. G. (2012). Increasing incidence and prevalence of the inflammatory bowel diseases with time, based on systematic review. Gastroenterology, 142(1), 46-54.e42; quiz e30. doi:10.1053/j.gastro.2011.10.001

Moloney, R.D., Desbonnet, L., Clarke, G., Dinan, T.G., Cryan, J.F. (2014) The microbiome: stress, health, and disease. Mamm Genome, 25(1-2), 49-74. doi: 10.1007/s00335-013-9488-5.

Navabi, S., Gorrepati, V. S., Yadav, S., Chintanaboina, J., Maher, S., Demuth, P., . . . Coates, M. D. (2018). Influences and Impact of Anxiety and Depression in the Setting of Inflammatory Bowel Disease. Inflamm Bowel Dis, 24(11), 2303-2308. doi:10.1093/ibd/izy143

Nguyen, V. Q., Jiang, D., Hoffman, S. N., Guntaka, S., Mays, J. L., Wang, A., . . . Sorrentino, D. (2017). Impact of Diagnostic Delay and Associated Factors on Clinical Outcomes in a U.S. Inflammatory Bowel Disease Cohort. Inflamm Bowel Dis, 23(10), 1825-1831. doi:10.1097/MIB.0000000000001257

Pallis, A. G., Mouzas, I. A., & Vlachonikolis, I. G. (2004). The inflammatory bowel disease questionnaire: a review of its national validation studies. Inflamm Bowel Dis, 10(3), 261-269. doi:10.1097/00054725-200405000-00014

Palsson, O.S. (2015). Hypnosis treatment of gastrointestinal disorders: A comprehensive review of the empirical evidence. Am J Clin Hypn, 58(2), 134-158. doi: 10.1080/00029157.2015.1039114.

Palsson, O. S., Whitehead, W., Törnblom, H., Sperber, A. D., & Simren, M. (2020). Prevalence of Rome IV Functional Bowel Disorders Among Adults in the United States, Canada, and the United Kingdom. Gastroenterology, 158(5), 1262-1273.e1263. doi:10.1053/j.gastro.2019.12.021

Patrick, D. L., Drossman, D. A., Frederick, I. O., DiCesare, J., & Puder, K. L. (1998). Quality of life in persons with irritable bowel syndrome: development and validation of a new measure. Dig Dis Sci, 43(2), 400-411. doi:10.1023/a:1018831127942

Peery, A. F., Crockett, S. D., Murphy, C. C., Lund, J. L., Dellon, E. S., Williams, J. L., . . . Sandler, R. S. (2019). Burden and Cost of Gastrointestinal, Liver, and Pancreatic Diseases in the United States: Update 2018. Gastroenterology, 156(1), 254-272.e211. doi:10.1053/j.gastro.2018.08.063

Peters, S. L., Muir, J. G., & Gibson, P. R. (2015). Review article: gut-directed hypnotherapy in the management of irritable bowel syndrome and inflammatory bowel disease. Aliment Pharmacol Ther, 41(11), 1104-1115. doi:10.1111/apt.13202

Peters, S. L., Yao, C. K., Philpott, H., Yelland, G. W., Muir, J. G., & Gibson, P. R. (2016). Randomised clinical trial: the efficacy of gut-directed hypnotherapy is similar to that of the low FODMAP diet for the treatment of irritable bowel syndrome. Aliment Pharmacol Ther, 44(5), 447-459. doi:10.1111/apt.13706

Raskov, H., Burcharth, J., Pommergaard, H. C., & Rosenberg, J. (2016). Irritable bowel syndrome, the microbiota and the gut-brain axis. Gut Microbes, 7(5), 365-383. doi:10.1080/19490976.2016.1218585

Rhee, S. H., Pothoulakis, C., & Mayer, E. A. (2009). Principles and clinical implications of the brain-gut-enteric microbiota axis. Nat Rev Gastroenterol Hepatol, 6(5), 306-314. doi:10.1038/nrgastro.2009.35

Richter, P., Werner, J., Heerlein, A., Kraus, A., & Sauer, H. (1998). On the validity of the Beck Depression Inventory. A review. Psychopathology, 31(3), 160-168. doi:10.1159/000066239

Riehl, M.E. & Keefer, L. Hypnotherapy for esophageal disorders (2015). Am J Clin Hyp, 58(1), 22-33. doi: 10.1080/00029157.2015.1025355.

Shapiro, J., El-Serag, H. B., & Chan, J. (2019). Durability and Effectiveness of Cognitive-Behavioral Therapy for Irritable Bowel Syndrome. Gastroenterology, 157(6), 1684-1686. doi:10.1053/j.gastro.2019.10.010

Sveen, J., Bondjers, K., & Willebrand, M. (2016). Psychometric properties of the PTSD Checklist for DSM-5: a pilot study. Eur J Psychotraumatol, 7, 30165. doi:10.3402/ejpt.v7.30165

Taft, T. H., Bedell, A., Craven, M. R., Guadagnoli, L., Quinton, S., & Hanauer, S. B. (2019). Initial Assessment of Post-traumatic Stress in a US Cohort of Inflammatory Bowel Disease Patients. Inflamm Bowel Dis, 25(9), 1577-1585. doi:10.1093/ibd/izz032

Taft, T. H., Triggs, J. R., Carlson, D. A., Guadagnoli, L., Tomasino, K. N., Keefer, L., & Pandolfino, J. E. (2018). Validation of the oesophageal hypervigilance and anxiety scale for chronic oesophageal disease. Aliment Pharmacol Ther, 47(9), 1270-1277. doi:10.1111/apt.14605

Torres, J., Bonovas, S., Doherty, G., Kucharzik, T., Gisbert, J. P., Raine, T., . . . Fiorino, G. (2020). ECCO Guidelines on Therapeutics in Crohn’s Disease: Medical Treatment. J Crohns Colitis, 14(1), 4-22. doi:10.1093/ecco-jcc/jjz180

van Langenberg, D. R., & Gibson, P. R. (2010). Systematic review: fatigue in inflammatory bowel disease. Aliment Pharmacol Ther, 32(2), 131-143. doi:10.1111/j.1365-2036.2010.04347.x

Van Oudenhove, L., Crowell, M.D., Drossman, D.A., Halpert, A.D., Keefer, L., Lackner, J.M…Levy, R.L. (2016). Biopsychosocial aspects of functional gastrointestinal disorders. Gastroenterology, 150(6), 1355-1367. doi: 10.1053/j.gastro.2016.02.027.

Wiklund, I. K., Junghard, O., Grace, E., Talley, N. J., Kamm, M., Veldhuyzen van Zanten, S., . . . Schoenfeld, P. (1998). Quality of Life in Reflux and Dyspepsia patients. Psychometric documentation of a new disease-specific questionnaire (QOLRAD). Eur J Surg Suppl(583), 41-49. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/10027672

Windsor, J. W., & Kaplan, G. G. (2019). Evolving Epidemiology of IBD. Curr Gastroenterol Rep, 21(8), 40. doi:10.1007/s11894-019-0705-6