How to treat patients with irritable bowel syndrome (IBS) who do not respond to pharmacotherapy is an unsolved problem. Psychotherapy, which has been reported on in previous studies, is available only in specific centers. We describe in this study a novel and simple psychotherapy; that is, the fasting therapy (FT) for treatment of patients with IBS. Of 84 inpatients with IBS, 58 patients who still had moderate to severe IBS symptoms after 4-week basic treatment were investigated retrospectively. Of the 58 patients enrolled in this study, 36 underwent FT, whereas the remaining 22 received a consecutive basic treatment (control therapy). There were no significant differences in the 4-point severity scales of gastrointestinal and psychological symptoms between the 2 groups before the start of FT. The basic treatment consisted of pharmacotherapy and brief psychotherapy, whereas the FT consisted of 10 days of starvation followed by 5 days of refeeding. Changes in scores of symptoms before and after each treatment were analyzed. FT significantly improved 7 out of the 10 symptoms assessed; that is, abdominal pain-discomfort (p < .001), abdominal distension (p < .001), diarrhea (p < .001), anorexia (p = .02), nausea (p < .01), anxiety (p < .001), and interference with life in general (p < .001). However, the control therapy significantly improved only 3 out of the 10 symptoms assessed; that is, abdominal pain-discomfort (p = .03), abdominal distension (p < .01), and interference with life (p = .01). Our results suggest that FT may have beneficial effects on intractable patients with IBS.
American Psychiatric Association. (1980). Diagnostic and statistical manual of mental disorders (3rd ed.). Washington, DC: Author.
American Psychiatric Association. (1987). Diagnostic and statistical manual of mental disorders (3rd ed., Rev. ed.). Washington, DC: Author.
Anderson, R. (1984). The immunostimulatory, anti-inflammatory and anti-allergic properties of ascorbate. Advances in Nutritional Research, 6, 19–45.
Atkinson, W., Sheldon, T. A., Shaath, N., & Whorwell, P. J. (2004). Food elimination based on IgG antibodies in irritable bowel syndrome: A randomized controlled trial. Gut, 53, 1459–1464.
Bennet, P., & Wilkinson, S. (1985). A comparison of psychological and medical treatment in the irritable bowel syndrome. British Journal of Clinical Psychology, 24, 215–216.
Bentley, S. J., Pearson, D. J., & Rix, K. J. B. (1983). Food hypersensitivity in irritable bowel syndrome. Lancet, 2, 295–297.
Benton, D., Griffiths, R., & Haller, J. (1997). Thiamine supplementation mood and cognitive function. Psychopharmacology, 129, 66–71.
Brody, S. (2002). High-dose ascorbic acid increases intercourse frequency and improves mood: A randomized controlled clinical trial. Biological Psychiatry, 15, 371–374.
Bueno, L., Fioramonti, J., & Ruckebusch, Y. (1977). Mechanisms of propulsion in the small intestine. Annales de Recherches Veterinaires, 8, 293–301.
Drossman, D. A., Camilleri, M., Mayer, E. A., & Whitehead, W. E. (2002). AGA technical review on irritable bowel syndrome. Gastroenterology, 123, 2108–2131.
Faulkner, G., Soundy, A. A., & Lloyd, K. (2003). Schizophrenia and weight management: A systemic review of interventions to control weight. Acta Psychiatrica Scandinavica, 108, 324–332.
Finn, R., Smith, M. A., Youngs, G. R, Chew, D., Johnson, P. M., & Barnes, R. M. (1987). Immunological hypersensitivity to environmental antigens in the irritable bowel syndrome. British Journal of Clinical Practice, 41, 1041–1043.
Fischer, N. (1967). Obesity, affect, and therapeutic starvation. Archives of General Psychiatry, 17, 227–233.
Gohler L., Hahnemann, T., Michael, N., Oehme, P., Steglich, H. D., Conradi, E., et al. (2000). Reduction of plasma catecholamines in humans during clinically controlled severe underfeeding. Preventive Medicine, 30, 95–102.
Guthrie, E., Creed, F., Dawson, D., & Tomenson, B. (1991). A controlled trial of psychological treatment for the irritable bowel syndrome. Gastroenterology, 100, 450–457.
Hasselbalch, S. G., Knudsen, G. M., Jacobsen, J., Hageman, L. P., Holm, S., & Paulson, O. B. (1994). Brain metabolism during short-term starvation in humans. Journal of Cerebral Blood Flow Metabolism, 14, 125–131.
Kanazawa, M., Endo, Y., Whitehead, W. E., Kano, M., Hongo, M., & Fukudo, S. (2004). Patients and nonconsulters with irritable bowel syndrome reporting a parental history of bowel problems have more impaired psychological distress. Digestive Diseases and Sciences, 49, 1046–1053.
Kano, M., Fukudo, S., Kanazawa, M., Endo, Y., Narita, H., Tamura, D., et al. (2006). Changes in intestinal motility, visceral sensitivity and minor mucosal inflammation after fasting therapy in a patient with irritable syndrome: A case report. Journal of Gastroenterology and Hepatology, 21, 1078–1079.
Kollar, E. J., & Atkinson, R. M. (1966). Responses of extremely obese patients to starvation. Psychosomatic Medicine, 28, 227–246.
Komaki, G., Tamai, H., Sumioki, H., Mori, T., Kobayashi, N., Mori, K., et al. (1990). Plasma beta-endorphin during fasting in man. Hormone Research, 33, 239–243.
Kunz, R., & Oxman, A. D. (1998). The unpredictability paradox: review of empirical comparisons of randomised and non-randomised clinical trials. British Medical Journal, 31, 1185–1190.
Lydiard, R. B. (1997). Anxiety and the irritable bowel syndrome: psychiatric, medical, or both? Journal of Clinical Psychiatry, 58, 51–58.
Manning, A. P., Thompson, W. G., Heaton, K. W., & Morris, A. F. (1978). Towards positive diagnosis of the irritable bowel syndrome. British Medical Journal, 2, 653–654.
Milner, G. (1963). Ascorbic acid in chronic psychiatric patients: A controlled trial. British Journal of Psychiatry, 109, 294–299.
Molina, P. E., Hashiguchi, Y., Meijerink, W. J., Naukam, R. J., Boxer, R., & Abumrad, N. N. (1995). Modulation of endogenous opiate production: Effect of fasting. Biochemical and Biophysical Research Communications, 207, 312–317.
Niec, A. M., Frankum, B., & Talley, N. J. (1998). Are adverse food reaction linked to irritable bowel syndrome? American Journal of Gastroenterology, 93, 2184–2190.
O’Connor, K. P., Marchand, A., Belanger, L., Mainguy, N., Landry, P., Savard, P., et al. (2004). Psychological distress and adaptational problems associated with benzodiaz epine withdrawal and outcome: A replication. Addictive Behaviors, 29, 583–593.
Sandler, R. S. (1990). Epidemiology of irritable bowel syndrome in the United States. Gastroenterology, 99, 409–415.
Simon, G. E., Von Korff, M., Wagner, E. H., & Barlow, W. (1993). Patterns of antidepressant use in community practice. General Hospital Psychiatry, 15, 399–408.
Skoldstam, L., & Magnusson, K. E. (1991). Fasting, intestinal permeability, and rheumatoid arthritis. Rheumatic Diseases Clinics North America, 17, 363–371.
Stewart, R. L. (1985). Psychoanalysis and psychoanalytic psychotherapy. In H. I. Kaplan & B. J. Sadock (Eds.), Comprehensive textbook of psychiatry (4th ed., pp. 1331–1365). Baltimore: Williams & Wilkins.
Suzuki, J., Yamamoto, H., & Komuro, U. (1979). Fasting therapy for psychosomatic disorders in Japan. Psychotherapy and Psychosomatics, 31, 307–314.
Suzuki, J., Yamauchi, Y., Horikawa, M., & Yamagata, S. (1976). Fasting therapy for psychosomatic diseases with special reference to its indication and therapeutic mechanism. Tohoku Journal of Experimental Medicine, 118, 245–259.
Svedlund, J., Sjodin, I., Ottosson, J., & Dotevall, G. (1983). Controlled study of psychotherapy in irritable bowel syndrome. Lancet, 10, 589–592.
Talley, N. J., Owen, B. K., Boyce, P., & Paterson, K. (1996). Psychological treatments for irritable bowel syndrome: A critique of controlled treatment trials. American Journal of Gastroenterology, 91, 277–283.
Thompson, W. G., Dotevall, G., Drossman, D. A., Heaton, K. W., & Kruis, W. (1989). Irritable bowel syndrome: Guidelines for the diagnosis. Gastroenterology International, 2, 92–95.
Toner, B. B., Segal, Z. V., Emmott, S., Myran, D., Ali, A., DiGasbarro, I., et al. (1998). Cognitive-behavioral group therapy for patients with irritable bowel syndrome. International Journal of Group Psychotherapy, 48, 215–243.
Whitehead, W. E., & Crowell, M. D. (1991). Psychologic considerations in the irritable bowel syndrome. Gastroenterology Clinics of North America, 20, 249–267.
Whorwell, P. J., Prior, A., & Faragher, E. B. (1984). Controlled trial of hypnotherapy in the treatment of severe refractory irritable bowel syndrome. Lancet, 2, 1232–1234.
Yamamoto, H., Suzuki, J., & Yamauchi, Y. (1979). Psychophysiological study on fasting therapy. Psychotherapy and Psychosomatics, 32, 229–240.
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Kanazawa, M., Fukudo, S. Effects of fasting therapy on irritable bowel syndrome. Int. J. Behav. Med. 13, 214–220 (2006). https://doi.org/10.1207/s15327558ijbm1303_4
- irritable bowel syndrome
- fasting therapy