Irritable bowel syndrome (IBS) is a classic psychosomatic illness, arising as a result of the reaction of a special type of personality to stressful experiences. In the international classification of diseases, this syndrome belongs to the heading of mental disorders - "somatoform dysfunction of the autonomic nervous system of the lower gastrointestinal tract."
IBS is one of the most common categories of gastrointestinal disorders. Various variants of this disease are currently diagnosed in 10–20% of the world's population. As a rule, it proceeds chronically and can last for many years.
The disease is most often manifested by discomfort in the abdomen, flatulence, abdominal pain of varying intensity and frequency, stool disorders in the form of diarrhea and constipation, often with mucus secretion. These disorders in most cases proceed paroxysmal and are associated with the emotional state of the patient.
IBS is often associated with gastroesophageal reflux disease, chronic fatigue syndrome, fibromyalgia, headache, back pain.
Studies show that a significant number of patients with IBS have such personality traits as anxious suspiciousness, punctuality, pedantry, morality, difficulties in verbalizing their emotions (alexithymia), a tendency to obsessive reactions, dependence on the opinions of significant others. The frequent onset of discomfort in the gastrointestinal tract was noted in childhood as a reaction to dysfunctional relationships with parents.
Acute or chronic stress, as with many others chronic pain syndromes, is usually the starting link of this disease and the cause of its recurrence. panic disorder, alarm and depression occur in 50-60% of patients, and anxiety manifests itself already at the initial stages of the disease, and depression joins after a while. Therefore, a timely and qualified assessment of the mental state in this disease is the basis for the success of the treatment of patients.
Scientists note the closest relationship between the “brain-intestine” axis and the need for targeted therapeutic intervention, both somatic and psycho-emotional links of IBS. At the same time, the use of only intestinal-oriented drugs can only lead to a temporary improvement in the condition and contributes to the chronicity of the disease. Therefore, modern treatment of IBS includes psychotherapy, nutritional advice, prescription of drugs and the use of various additional methods, which will be discussed below.
The danger of ineffective treatment of IBS lies in its development into ulcerative colitis (NUC), a pathological condition of the intestine, which is based on a chronic inflammatory process. If IBS is accompanied only by functional changes, then with ulcerative colitis an organic defect of the intestinal mucosa is formed, which is much more serious. Increased stools up to 20-40 times, the admixture of mucus and blood in the feces, tenesmus (cutting pains with futile urge to defecate), deterioration in general condition are the main signs of nonspecific colitis with ulcerative lesions of the intestinal wall.
Effective in both diseases, in our experience, is a combination of psychotherapy with transcranial electrical stimulation (TDCS), contributing to the normalization of overexcited parts of the brain associated with the intestines.
A promising treatment for inflammation and pain associated with IBS and UC is infusion treatment with ketamine. Visceral (GI) pain has been shown to be associated with NMDA receptors, which are effectively affected by ketamine. It has also been found that this drug is able to reduce visceral hypersensitivity. Therefore, in irritable bowel syndrome and UC, it is advisable to use ketamine therapy in conjunction with psychotherapy and TES.
Combining psychotherapy with ketamine infusions, transcranial electrical stimulation (TES), rehabilitation of the brain "Neurohelp", body-oriented therapy and art therapy, a significant improvement in the health of patients can be achieved.