Fight SCI with therapy, deep breathing

Kevin Yu remembers the terrible year his stomach held him "prisoner". There was constant pain, the constant need to use the bathroom from the moment he woke up until he went to bed.

"The only time I felt really good was when I was sleeping or sleeping on the toilet," said the 38-year-old.

Yu also had a bad reflux and a "steady build up of gas" in her stomach. "All these really strange diseases," he said. The pain was so aggravated that Yu eventually went to the emergency room.

"The doctors did not understand anything," said the telecommunications product manager.

GI specialists at the University of Pennsylvania collected blood, stool samples and endoscopy; everything is negative.

"My doctor said: 'We do not see any physical signs that something is wrong with you,' which was good news, but I did not see it as good", Yu said.

"Eventually, they came to me and said," Kevin, we think you're in that big bucket of patients we just call IBS, "or irritable bowel syndrome.

IBS is a chronic disease characterized by pain in the stomach, diarrhea or constipation or alternating between the two. According to the National Institutes of Health, it affects about 12% of Americans, or nearly one in eight people.

IBS treatments failed, doctors sent him to therapy

The doctors prescribed the drug Yu for the SCI. They also asked him to limit his diet to foods less likely to produce gas, known as low FODMAP.

"For six months, I literally only ate rice and potatoes at the bottom." But, Yu added, rushes to the toilet continued, as did the pain.

It was then that Yu's doctors said that they wanted to try something new.

They suggested to Yu to see a psychiatrist who was working with their GI department. The psychiatrist suspected that Yu's stomach problems could be resolved, in part, with an antidepressant.

Yu was extremely stressed at the onset of symptoms in 2015.

He had started a new job and worked at least 12 hours a day. Yu and his wife were in the middle of renovating their new home and they had tried, without success, to have a baby.

Yu recalled that the psychiatrist had told him, "Maybe you have IBS, but it's largely the link between your brain and your stomach."

A week after taking the antidepressant, Yu said, "I have noticed a dramatic change in my constant need for stool."

The psychiatrist suggested that Yu begin to see a clinical psychologist at the University of Pennsylvania, Melissa Hunt, specializing in cognitive-behavioral therapy for the treatment of chronic disorders of the IG.

Fight or flight: the intestine-brain connection

Yu had a breakthrough on her first visit with Hunt.

"It was like drinking water in a fire hose," Yu said. "I was learning a lot."

Hunt explained what stress could cause to your stomach. "When you're anxiously excited and your body goes into a fight or flight mode, many biological processes occur, including increased heart rate, blood pressure, and breathing, increased sweating, increased muscle tension, and gastrointestinal discomfort, "she said.

Hunt explained that gastrointestinal discomfort may include "spasmodic bowel cramps" that will lead to urgency and the immediate need to go to the toilet – in other words , diarrhea.

Stress can also lead to constipation, Hunt said, because muscle tension affects the pelvic floor and the sphincter muscles.

"Every time I'm under a lot of stress, I started to realize that I was squeezing my stomach," Yu said.

"When I looked into my life, I began to realize how much there was a connection between my brain and my stomach."

Deep breathing, fight against "catastrophic thinking", burn stress energy

During Yu's first therapy session with Hunt, they did some deep breathing exercises.

Deep breathing calms the nervous system and reduces anxiety.

"Then I take a deep breath and she says:" Kevin, do you see how you take all the air out of your chest, and none of that is going in your stomach? "You almost want to inflate your stomach . "

As his breathing became deeper, what is called diaphragmatic breathing, "not only did I feel calmer, but also a feeling of serenity that I had not felt for a long time."

Yu moves when he remembers that day, three years ago. "I had tears in my eyes.

"At that time, I realized that breathing was the best way to calm my anxiety and help calm me when I was in this state of great distress," Yu said.

Hunt asked Yu to practice deep breathing every day. She said to him, "It can be walking, watching television, focusing a little on your breathing."

"I would say that in less than two or three weeks, I really started buying," said Yu. "When I suffer a lot, the pain goes from nine or ten to four or five. Was remarkable. "

To worry about the pain has aggravated the pain

Although breathing alone helped, there were several other pieces of the puzzle. When Yu's stomach hurt, it sent him into a psychological fall.

He described his thinking as follows: "Oh no, it's the end of the world, I will not be able to go to work, my employer will be disappointed, my wife will be disappointed that she can not help around the house. ".

Psychologists call this "a catastrophic thought".

"It was almost cyclical that my stomach would cause anxiety and yet my anxiety added to further discomfort," Yu said.

This is a huge factor in IBS, said Hunt. This is what is called "visceral hypersensitivity".

"The pain signals from the intestine are amplified inappropriately," she said. It's like a feedback loop.

"If I was uncomfortable with gas, it was" I have a stomach ache ". If I had lactose intolerance, it was "I have a stomach ache," Yu said.

In just a few sessions, Hunt taught Yu how to be less anxious when he felt pain.

Hunt asked Yu, "Do not say it hurts." Say, "I feel uncomfortable now." "

Yu began to interpret the signals of hunger, anxiety and pain caused by the gases differently. "My mind then begins to distinguish," OK, I know it's not a pain, oh, it's hungry "or" I'm just a little stressed right now. " "

Hunt also encouraged Yu to increase her physical activity to reduce the stress caused by flight or combat.

In recent months, Yu has not found the time to train like he did when he was younger. Instead, he played with his daughter (who was born during his therapy) and kicked the ball with his dog. Even gardening has made a difference for him.

The house version for IBS also works

Yu's success with cognitive-behavioral therapy for IBS is not unique. Dozens of studies show its effectiveness in patients with IBS. Researchers at Harvard University examined 13 of them in a meta-analysis.

Patients who tried psychological approaches exhibited an improvement in their digestive symptoms superior to that of patients receiving only conventional medical treatment.

One of the most compelling studies has been published this year. This is the largest non-drug clinical trial on federally-funded irritable bowel syndrome. It involved more than 400 patients with IBS. The study found that more than 60% of patients reported a substantial improvement in their gastrointestinal symptoms in just four or fewer visits to the psychologist, in addition to working from home. They practiced deep breathing and worked to change their tone of self so as not to disrupt events and other known triggers.

They also learned to "improve their flexibility in how they approach problems," said Laurie Keefer, lead researcher of this study.

Keefer is a gastrointestinal health psychologist and director of psycho-behavioral behavior research at Mount Sinai School of Medicine.

"We ask patients to write their stressors so that they can look at them a little more objectively," she said. "These homework is really at the heart of this type of therapy, when they examine their stressors, they question their approach."

For example, people write their worst fears and how they feel. Then the patient examines this fear objectively. What is the probability that the worst case scenario will occur? Often, this is unlikely to happen. In the event that this happens, the patient will note how he will do it so that his plan is manageable.

"People continued to benefit a long time after their interruption of surgery, and we found that patients were still doing very well at one-year follow-up."

Keefer said many people were reluctant to consult a psychologist because of the stigma that still surrounds the treatment. Trying these methods at home also reduces expenses.

"Access to therapists performing this type of treatment is very limited," she said, but the study shows that learning some of these methods for practicing at home is effective .

"I'm fine today."

It's been three years that Yu felt for the first time the eddies of the SCI. Today, he rarely suffers. He regularly practices deep breathing when he feels the onset of stress and that he is watching TV or that he is relaxing. He continues reprogramming his thoughts and negative reflections on himself. "Something as simple as a simple stream of thought can really dramatically change your life," Yu said.

"I'm back to live my life, I'm reaching out to my friends," he said.

"I'm no longer in my twenties, I can not face the world anymore, I had to step back to do things one at a time, I'm not Superman."