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Kaiser Permanente program helps teenagers with IBS

The teen-age years can be difficult -- especially for adolescents dealing with the often debilitating symptoms of irritable bowel syndrome (IBS).

The chronic intestinal disorder affects an estimated 20 percent of all adolescents, many who battle frequent bouts of belly pain and bloating, combined with diarrhea or constipation. In addition, the condition can include sleep disturbances, migraines, and jaw pain. 

While there is no proven cure for IBS, there is hope for an improved quality of life for local youth struggling to cope with the condition.

Over the past two years, Michael Lawson, MD, a gastroenterologist from the Kaiser Permanente Sacramento Medical Center and a small team of dedicated health professionals have piloted a fun and interactive interventional program for adolescent members with IBS and their parents. The program includes two consecutive 90-minute group sessions that use a behavioral modification approach, combining diet and exercise education with cognitive behavioral therapy.

The results have been dramatic, with participants reporting a 50 percent reduction in their pain and symptom scores, and an 86 percent reduction in related return office visits. These results are sustained even six months after completing the program.

Additionally, a recent European study showed that 85 percent of patients who participated in a cognitive behavioral intervention program for IBS responded favorably, compared to just 35 percent of those who underwent standard treatment, which typically includes medication for symptom relief.

While the causes of IBS are unknown, it’s widely believed that symptoms are related to problems with the signals sent between the brain and the intestines. For some patients, certain foods, stress, hormonal changes, and some antibiotics trigger pain and other symptoms.

As part of our intervention program, health educators teach cognitive behavior techniques, including relaxation skills using self-guided imagery to help reduce stress and induce sleep. An exercise physiologist leads participants through yoga, Pilates, and stability ball exercises.  A registered dietitian discusses proper nutrition, including certain foods that can trigger pain and other symptoms.

Dr. Lawson says getting teens to attend the first class has sometimes been a challenge, but once they go, they’re hooked.

“They think they are freaks, but it’s reassuring for them once they walk into a room and see a group of peers just like them who are also dealing with IBS,” he says.

Dr. Lawson says parental influence appears to be a key factor in the development of IBS in childhood. And because half the teens have parents who also suffer from IBS, it’s essential that parents participate in the program too, he says. 

“Many of these kids are high-achieving, with type-A personalities,” explains Dr Lawson. “Many of them have high levels of stress, and stress makes their symptoms worse.”

Dr. Lawson says he’s extremely pleased with the results of the two-year-old pilot, and recently presented the concept at a medical conference in Philadelphia.

“We have a program that is proving to be successful in improving IBS symptoms and reducing health care utilization,” he says. “However, this condition continues to be a very under-diagnosed disorder. I know there are a lot more kids out there that we could be helping.”

For more information about IBS and the program, please consult your child’s physician, who can refer the youth to Dr. Lawson’s program.