A295 AN INTEGRATED MULTIDISCIPLINARY GROUP PROGRAM IMPROVES IRRITABLE BOWEL SYNDROME SYMPTOM SEVERITY: A PILOT STUDY

Abstract

Background: Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder that is characterized by abdominal pain associated with bowel movements. IBS affects 11% of the adult population. The pathogenesis of IBS symptoms is thought to be contributed by disturbances of the brain-gut axis. Cognitive behavioral therapy (CBT) has been shown to reduce self-rated abdominal and psychiatric symptoms. Low FODMAP diet has been demonstrated to reduce abdominal pain and bloating. Aims: The aim of this study is to investigate the efficacy of a formal group program that integrates psychosocial interventions and dietary education, conducted by a gastroenterologist, psychiatrist and registered dietician. Methods: 9 patients with a diagnosis of IBS in a tertiary referral center were enrolled to participate in a structured group program, involving a gastroenterologist, a psychiatrist and registered dieticians. Education on IBS, mindfulness/CBT, and low FODMAP diet were provided at the initial visit (week 0). Patients returned for follow up sessions at week 4 and week 12 where additional education and practice were provided. At each session, patients completed a 7-question anxiety questionnaire (GAD-7), a 9-question depression questionnaire (PHQ-9), a 15-question questionnaire on somatic symptoms (PHQ-15), an IBS symptom severity scale (IBS-SSS), and a patient satisfaction survey assessing usefulness and satisfaction of the group session. Mann-Whitney was used to analyze differences at enrollment and exit. Results: 8 patients were female (88%), with the average age of 57.3 +/-5.5 years. Based on the IBS-SSS, 7 patients (78%) had moderate IBS and 2 patients (22%) had severe IBS symptoms. At the end of 12 weeks, 6 patients (66.7%) completed the structured group program. The mean IBS-SSS on initial visit was 269.6 +/-60.3 and at completion (week 12) was 190.4 +/-53.0. There was a significant reduction in IBS symptoms (p = 0.034). There was no significant difference seen between the anxiety, depression, or somatic symptom scores (p > 0.10). Overall, patients found the program useful and were satisfied, with scores > 85% in all sessions. Conclusions: In this pilot study, a structured group program with a gastroenterologist, a psychiatrist and a registered dietician demonstrated a significant reduction in IBS symptoms over 12 weeks. Patients found these sessions useful and were satisfied throughout the program. Further qualitative research involving structured interviews with participants will allow for a needs analysis to be conducted, in view of optimizing the program for future participants. In addition, future randomized control study with a longer follow-up in the optimized program will further elucidate the role of this multidisciplinary group program in the care of IBS patients.