Why Pain Reprocessing Therapy (PRT) and IBS?

When it comes to treating Irritable Bowel Syndrome (IBS) there is really good news, but, as I’m sure you know…..some bad news too. So – bad news first! According to the Cleveland Clinic, “There’s no cure for IBS. The goal of treatment is to manage symptoms.” (learn more about IBS in their well-done overview: here!).

This can be difficult to hear and accept, particularly in light of IBS being categorized as a “functional” disorder. How is it that IBS is considered “functional” when all the symptoms often feel extremely dysfunctional?

Well – this is where the good news comes in!! “Functional” disorders essentially mean there is no organ disease, cancer, or infection associated with the IBS diagnosis! — Shew! — While it may not feel like it… your IBS diagnosis means that your gastrointestinal system is largely “functional.” Nevertheless, the symptoms can be very persistent and often decrease quality of life. It can seem difficult to have an incurable condition that doctors can’t easily treat with medication or surgery due, in part, to its “functional” nature, but — it is good news!

Ultimately, when we truly pay attention to the latest in clinical research and science for how to treat Irritable Bowel Syndrome, the answers are right in front of us! We can treat IBS and effectively manage the symptoms with very accessible tools to do so.

NOTE: If you have not received an official IBS diagnosis from your doctor or gastroenterologist it is important you do so before starting any treatment. IBS Symptoms can mask other, more serious diseases.

How Do We Treat IBS Using the Latest Understanding in Pain Science?

First, A LOT of work and progress has been made to classify chronic pain and “functional” disorders like IBS better. A leading international team of researchers and practitioners have paved the way for understanding and classifying pain associated with IBS much more clearly than ever. In brief, we now classify IBS as chronic primary pain (e.g., see ICD-11).

This classification of chronic primary pain aligns well with the already well-established understanding of IBS as a “functional” (yes! There’s that “functional” word again) gastrointestinal — disorders of the gut-brain interaction (DGBIs). DGBIs highlight issues with how your gut and your brain interact. Essentially, the gut-brain axis is a 2-way street. The gut sends signals to the brain (full, bloated, pain) and the brain sends signals to the gut (anxiety, stress). Many of us know of times when we have been nervous for something and felt sick to our stomach. On the other hand, perhaps an upset stomach has completely ruined our mood and caused us to have to go home early at some point in our lives.

What is key to note though, is that while everyone experiences these effects of the gut-brain interaction, with DGBIs and chronic primary pain the interaction between the gut and, particularly, the brain is on HIGH ALERT!!! The gut overly communicates pain, gas, bloating, distension, and discomfort to the brain and the brain is overly sensitive to signals from the gut. Moreover, the brain overly communicates stress, anxiety, fear, and emotions directly to the gut which exacerbates symptoms further. Interestingly, research on the gut-brain axis is increasingly highlighting just how much the brain can truly disrupt the smooth muscle tissues of the gastrointestinal system. This can clearly slow motility leading to constipation and/or speed up motility leading to diarrhea. On the other hand, the research on how our gut interacts with our brain is substantial. Even down to the microscopic bacteria of our gut, which appear to have a significant interaction with our mood, depression, and how we feel emotionally day-to-day.

Wait! What Does This Have to Do With Pain Reprocessing Therapy (PRT) and IBS?

Simply put, PRT is a fantastic treatment for IBS because of the known effects of the gut-brain interaction and, as mentioned above, DGBIs are consistent with our understanding of chronic primary pain. PRT treats chronic primary pain.

Essentially, with chronic primary pain, the brain becomes overly sensitized and processes sensations in the body as pain when they are actually safe sensations. This is often due to fear of ongoing pain associated with a particular region in the body where a former injury or trauma occurred or where we might hold our emotions. The region may have been injured from an accident or may be affected from a surgery. The cause may be more “unknown” or has been deemed incurable or “functional” and the pain has lasted for more than 6 months.

Almost inevitably, this leads to us getting stuck in a loop of what is known as the pain-fear cycle! The more pain our brain becomes overly sensitized to identifying with, then the more fear we experience around an often “unknown,” incurable, or misunderstood pain we feel, and the more fear we experience then the more pain our brain overly senses… and on and on it goes!

Breaking this cycle of pain and understanding the underlying mechanisms driving the pain is our key to success! Unfortunately, practice has simply not yet caught up to science for many health practitioners. In the end though, this is where Pain Reprocessing Therapy (PRT) comes in as one of the best evidence-based treatments available to treat chronic primary pain, which categorically includes IBS. Again, PRT was actually developed to treat chronic primary pain and, therefore, it was developed to treat IBS.

In conclusion, PRT provides us with a deep, evidence based tool to disrupt the overly sensitized gut-brain interaction. PRT can help calm the central nervous system. It also can help calm the visceral hypersensitivity of the smooth muscle tissue of our gastrointestinal system. Combined this helps those with IBS find relief and increase quality of life.

Are you ready to take control of your IBS symptoms and improve your quality of life?

Begin your journey with Pain Reprocessing Therapy today.

P.S. — PRT is an excellent treatment for IBS, but we may still recommend a low FODMAP diet.

Why? In short, remember that IBS is a Disorder of the Gut-Brain Interaction (DGBI). At Awakened Actions, we use the recommended first line approach for IBS with the low FODMAP diet to help the GUT. Then, PRT brings evidence-based practice to directly affect the BRAIN!

We want to disrupt the overly sensitized gut-brain interaction and retrain our relationship with it. Thus, we implement a low FODMAP diet first with one of our low FODMAP Dietitians. The low FODMAP diet is the recommended first line approach for IBS management in clinical practice guidelines. This first line approach helps clients to discover initial relief and reinforce feelings of safety with your gastrointestinal system. Next, we then layer in PRT based tools to bring it all together. PRT helps to ensure we are relieving stress, anxiety, and other emotions often associated with DGBIs and chronic primary pain. At this stage we also leverage PRT to ensure any fear around food triggers are addressed. This is about integrative care for long-term success. We want to treat the GUT and the BRAIN and their respective roles in IBS.

Learn More about working with a low FODMAP Dietitian here!