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Recording their thoughts and emotions might help patients relieve the symptoms of irritable bowel syndrome (IBS), researchers say.
Their study is the first to test so-called "expressive writing" in people with IBS, and the results are still very preliminary. But they support earlier research showing that this type of writing, in which the writer is encouraged to "really let go" and get to the bottom of their feelings, can be beneficial for some.
The exercise has helped people with depression, for instance, as well as rheumatoid arthritis, chronic pain, high blood pressure and AIDS, the authors of the new study noted online June 15th in the American Journal of Gastroenterology.
According to Dr. Albena Halpert of Boston Medical Center and colleagues, the 82 patients in the IBS study reported improvements in disease severity, coping and thinking (including negative thoughts) at one and three months after they started writing. At three months, they also said their quality of life was better.
"In general people keep too many darn secrets," said Mark A. Lumley, an expert in expressive writing at Wayne State University in Detroit, who was not involved in the study. "When we avoid dealing with emotional experiences, that appears to take a physiological toll."
Because psychologic stress can depress the immune system, and the link between the brain and the gut plays a well-established role in IBS, these patients would make good candidates for expressive writing, Lumley said. Yet the way the study was designed, he added, might make the results appear more impressive than they really are.
The researchers had advertised their project on IBS-related websites, and then recruited only people who completed 30 minutes of internet-based writing on four consecutive days. They asked those who had volunteered but never got started on the writing to complete questionnaires so that they could act as a control group.
While the writers did better than the non-writers, saying they felt more in control of their symptoms, it's possible they were inherently more motivated, or more likely to believe that writing could work for them.
While the authors recognize the need for further study, they say psychological treatment strategies for IBS are becoming increasingly popular.
Given that seeing a therapist is both time-consuming and costly, they say online expressive writing "offers self-help to patients with IBS and may possibly reduce the health-care utilization associated with this common chronic gastrointestinal disorder."
Lumley said he was probably "a little more skeptical than the authors of this technique," but added that it made sense to try it. "If it works, great," he said.
Am J Gastroenterol 2010.
Frederik Joelving • Reuters Health Information © 2010
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