Patient Attributes for Optimal Treatment Outcome in Irritable Bowel Syndrome.
Information source: Michigan Gastroenterology Institute
ClinicalTrials.gov processed this data on August 23, 2015 Link to the current ClinicalTrials.gov record.
Condition(s) targeted: Irritable Bowel Syndrome
Intervention: Cognitive Behavior Therapy(CBT) (Behavioral)
Phase: N/A
Status: Not yet recruiting
Sponsored by: Michigan Gastroenterology Institute Official(s) and/or principal investigator(s): Iftiker Ahmad, M.D., Principal Investigator, Affiliation: Michigan Gastroenterology Institute
Overall contact: Iftiker Ahmad, M.D., Phone: 517.332.1200, Ext: 221, Email: ahmadi@msu.edu
Summary
The purpose of this study is to determine if any specific patient characteristics lead to
improved outcome of IBS treatment, when conventional treatment as well as Cognitive
Behavioral Therapy is used in combination.
Clinical Details
Official title: Examining Patient Attributes To Determine Optimal Treatment Outcome in Irritable Bowel Syndrome.
Study design: Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Investigator), Primary Purpose: Treatment
Primary outcome: IBS Quality of Life Inventory(IBS QOLF)
Secondary outcome: Behavioral Symptom Inventory
Detailed description:
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.
Eligibility
Minimum age: 18 Years.
Maximum age: N/A.
Gender(s): Both.
Criteria:
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.
Locations and Contacts
Iftiker Ahmad, M.D., Phone: 517.332.1200, Ext: 221, Email: ahmadi@msu.edu
Michigan Gastroenterology Institute, East Lansing, Michigan 48823, United States; Not yet recruiting Iftiker Ahmad, M.D., Phone: 517-332-1200, Ext: 221 Iftiker Ahmad, M.D., Principal Investigator
Additional Information
Related publications: 1. Lackner JM, Mesmer C, Morley S, Dowzer C, Hamilton S. Psychological Lackner JM, Mesmer C, Morley S, Dowzer C, Hamilton S. Psychological Treatments for Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis. J Consult Psychol. 2004;72(6):1100-1113. 2. Spiller R, Aziz Q, Creed F, et al. Guidelines on the irritable bowel syndrome: mechanisms and practical management. Gut. 2007;56(12):1770-98. 3. Zijdenbos IL, de Wit NJ, van der Heijden GJ, Rubin G, Quartero AO. Psychological treatments for the management of irritable bowel syndrome. Cochrane Database Syst Rev. 2009;(1):CD006442. 4. Jones R, Latinovic R, Charlton J, Gulliford M. Physical and psychological co-morbidity in irritable bowel syndrome: a matched cohort study using the General Practice Research Database. Aliment Pharmachol Ther. 2006;24(5):879-886. 5.Jailwala J, Imperiale TF, Kroenke K. Pharmacologic treatment of the irritable bowel syndrome: a systematic review of randomized, controlled trials. Ann Intern Med. 2000 Jul 18;133(2):136-47. Review. PMID: 10896640 6. 6. Spanier JA, Howden CW, Jones MP. A Systematic Review of Alternative Therapies in the Irritable Bowel Syndrome. Arch Intern Med. 2003;163(3):265-674. 7.Blanchard EB, Scharf L. Psychosocial aspects of assessment and treatment of irritable bowel syndrome in adults and recurrent abdominal pain in children. J Consult Psychol. 2002;70(3):725-738. 8. Lackner JM, Jaccard J, Krasner SS, Katz LA, Gudleski GD, Blanchard EB. How does cognitive behavior therapy for irritable bowel syndrome work? A mediational analysis of a randomized clinical trial. Gastroenterology. 2007 Aug;133(2):433-44. Epub 2007 May 21. PMID: 17681164
Starting date: April 2011
Last updated: February 15, 2011
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