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1/2. A psychosomatic approach to treatment in the irritable bowel syndrome and peptic ulcer disease with aspects of the design of clinical trials.

    To compare the effects of conventional medical treatment with treatment that combines medical treatment and psychotherapy, 101 out-patients with irritable bowel syndrome (IBS) and 103 with peptic ulcer disease (PUD) were randomly allocated to two treatment groups. All patients with PUD received medical treatment with antacids and anticholinergics or antacids and H2-receptor antagonists, while the patients with IBS received bulk-forming agents and, when appropriate, anticholinergic drugs, antacids and minor tranquillisers. In addition, the patients in one group with IBS and one group with PUD received dynamically oriented individual psychotherapy in ten hour-long sessions spread over three months. There was a greater improvement in the psychotherapy groups for patients with IBS after three months and for both IBS and PUD patients after 15 months. The difference had become more pronounced after 15 months, with the patients given psychotherapy showing further improvement, and the patients who had received medical treatment only showing some deterioration. In the short-term, the results were more in favour of the psychotherapy group in patients with IBS than PUD, but in the long run, the combination of medical treatment with psychotherapy improved the outcome for both IBS and PUD.
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2/2. A psychological perspective of irritable bowel syndrome.

    irritable bowel syndrome (IBS) is a common and often intractable disorder. Although the causes of this syndrome are not clear, psychological factors do play a major role in determining whether a patient seeks medical care. patients who have IBS tend to suffer from a psychiatric disorder, most notably anxiety and depression. Traditional medical care with its emphasis on pharmacological interventions and dietary changes has not been effective. psychotherapy has been shown to be an important, yet underutilized, approach in the treatment of IBS. A clinical example of a young man suffering from IBS illustrates how traditional medical care and psychotherapy enhance the treatment of this disorder.
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keywords = psychotherapy
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