Effects of fasting therapy on irritable bowel syndrome

Abstract

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.

References

  1. American Psychiatric Association. (1980). Diagnostic and statistical manual of mental disorders (3rd ed.). Washington, DC: Author.

  2. American Psychiatric Association. (1987). Diagnostic and statistical manual of mental disorders (3rd ed., Rev. ed.). Washington, DC: Author.

  3. Anderson, R. (1984). The immunostimulatory, anti-inflammatory and anti-allergic properties of ascorbate. Advances in Nutritional Research, 6, 19–45.

    PubMed  Google Scholar 

  4. 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.

    PubMed  Article  Google Scholar 

  5. 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.

    Google Scholar 

  6. Bentley, S. J., Pearson, D. J., & Rix, K. J. B. (1983). Food hypersensitivity in irritable bowel syndrome. Lancet, 2, 295–297.

    PubMed  Article  Google Scholar 

  7. Benton, D., Griffiths, R., & Haller, J. (1997). Thiamine supplementation mood and cognitive function. Psychopharmacology, 129, 66–71.

    PubMed  Article  Google Scholar 

  8. Brody, S. (2002). High-dose ascorbic acid increases intercourse frequency and improves mood: A randomized controlled clinical trial. Biological Psychiatry, 15, 371–374.

    Article  Google Scholar 

  9. Bueno, L., Fioramonti, J., & Ruckebusch, Y. (1977). Mechanisms of propulsion in the small intestine. Annales de Recherches Veterinaires, 8, 293–301.

    PubMed  Google Scholar 

  10. Drossman, D. A., Camilleri, M., Mayer, E. A., & Whitehead, W. E. (2002). AGA technical review on irritable bowel syndrome. Gastroenterology, 123, 2108–2131.

    PubMed  Article  Google Scholar 

  11. 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.

    PubMed  Article  Google Scholar 

  12. 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.

    PubMed  Google Scholar 

  13. Fischer, N. (1967). Obesity, affect, and therapeutic starvation. Archives of General Psychiatry, 17, 227–233.

    PubMed  Google Scholar 

  14. 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.

    PubMed  Article  Google Scholar 

  15. Guthrie, E., Creed, F., Dawson, D., & Tomenson, B. (1991). A controlled trial of psychological treatment for the irritable bowel syndrome. Gastroenterology, 100, 450–457.

    PubMed  Google Scholar 

  16. 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.

    PubMed  Google Scholar 

  17. 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.

    PubMed  Article  Google Scholar 

  18. 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.

    PubMed  Article  Google Scholar 

  19. Kollar, E. J., & Atkinson, R. M. (1966). Responses of extremely obese patients to starvation. Psychosomatic Medicine, 28, 227–246.

    PubMed  Google Scholar 

  20. 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.

    PubMed  Google Scholar 

  21. 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.

    Google Scholar 

  22. Lydiard, R. B. (1997). Anxiety and the irritable bowel syndrome: psychiatric, medical, or both? Journal of Clinical Psychiatry, 58, 51–58.

    PubMed  Google Scholar 

  23. 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.

    PubMed  Article  Google Scholar 

  24. Milner, G. (1963). Ascorbic acid in chronic psychiatric patients: A controlled trial. British Journal of Psychiatry, 109, 294–299.

    Article  Google Scholar 

  25. 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.

    PubMed  Article  Google Scholar 

  26. 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.

    PubMed  Article  Google Scholar 

  27. 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.

    PubMed  Article  Google Scholar 

  28. Sandler, R. S. (1990). Epidemiology of irritable bowel syndrome in the United States. Gastroenterology, 99, 409–415.

    PubMed  Google Scholar 

  29. 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.

    PubMed  Article  Google Scholar 

  30. Skoldstam, L., & Magnusson, K. E. (1991). Fasting, intestinal permeability, and rheumatoid arthritis. Rheumatic Diseases Clinics North America, 17, 363–371.

    Google Scholar 

  31. 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.

    Google Scholar 

  32. Suzuki, J., Yamamoto, H., & Komuro, U. (1979). Fasting therapy for psychosomatic disorders in Japan. Psychotherapy and Psychosomatics, 31, 307–314.

    PubMed  Google Scholar 

  33. 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.

    PubMed  Article  Google Scholar 

  34. Svedlund, J., Sjodin, I., Ottosson, J., & Dotevall, G. (1983). Controlled study of psychotherapy in irritable bowel syndrome. Lancet, 10, 589–592.

    Article  Google Scholar 

  35. 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.

    PubMed  Google Scholar 

  36. 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.

    Google Scholar 

  37. 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.

    PubMed  Google Scholar 

  38. Whitehead, W. E., & Crowell, M. D. (1991). Psychologic considerations in the irritable bowel syndrome. Gastroenterology Clinics of North America, 20, 249–267.

    PubMed  Google Scholar 

  39. 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.

    PubMed  Article  Google Scholar 

  40. Yamamoto, H., Suzuki, J., & Yamauchi, Y. (1979). Psychophysiological study on fasting therapy. Psychotherapy and Psychosomatics, 32, 229–240.

    PubMed  Article  Google Scholar 

Download references

Author information

Affiliations

Authors

Corresponding authors

Correspondence to Motoyori Kanazawa or Shin Fukudo.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

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

Download citation

Key words

  • irritable bowel syndrome
  • fasting therapy
  • psychotherapy
  • starvation