ABSTRACT
Chronic gastrointestinal disorders fall into three subgroups: functional GI disorders (e.g., irritable bowel syndrome [IBS]); motility disorders; and organic (structural) disorders in which tissue pathology and other pathognomonic indicators can be identified (e.g., inflammatory bowel disease [IBD]). Patients suffering from these chronic GI conditions can benefit from psychosocial interventions (including cognitive-behavioral therapy [CBT], hypnosis, and mindfulness-based interventions) that target pain, symptom management, and coping; clinical benefits have been especially demonstrated in IBS and IBD patients. While most of these disorders have pain as part of their symptom profiles, impaired health-related quality of life [HRQL], distress, and disability are also highly associated with anxiety, depression, catastrophizing, fear of food, and maladaptive avoidance. As such, CBT is well positioned to address many of the factors that contribute to poor quality of life in these patient populations. In the case of IBS, CBT can actually reduce symptom severity and pain as well. This chapter focuses primarily on elucidating the etiology of pain in IBS (especially centrally mediated visceral hypersensitivity) and on evidence-based behavioral interventions to improve HRQL for IBS and IBD patients.
