chapter  17
Functional bowel disorders (IBS and non-IBS)
Stress management and mindfulness-based approaches
BySimon Knowles, Kaveh Monshat
Pages 9

This chapter outlines what stress management is, the role of arousal reduction approaches in stress management and the efficacy of stress management in relation to functional bowel disorders (FBDs). Stress is defined as an acute threat to homeostasis, with short- and long-term consequences to the immune system and gastrointestinal tract. Stress management is recommended in FBDs. This includes cognitive approaches that target ways of thinking, or arousal reduction strategies oriented towards behavioural change. Arousal reduction strategies include progressive muscle relaxation, biofeedback, time management, communication skills, assertiveness, problem solving, breathing techniques, diet, exercise and mindfulness training. Mindfulness-based stress reduction (MBSR) is the most highly researched mindfulness training package, originally devised for hospital outpatients where allopathic interventions had been exhausted. The chapter summarizes the current evidence regarding stress management in irritable bowel syndrome (IBS). Mindfulness research – a newer and consequently smaller field – suggests symptom improvement, especially pain, but also improved overall quality of life.