Culturally Adapted Psychological Intervention for the Management of Irritable Bowel Syndrome (IBS)
Condition: Irritable Bowel Syndrome
MeSH terms: Irritable Bowel Syndrome; Syndrome
Study type: Interventional

Summary: 
      Irritable bowel syndrome (IBS) is a highly prevalent functional bowel disorder routinely
      encountered by healthcare providers although it's not life-threatening, this chronic disorder
      has ability to reduce patients' quality of life and imposes a significant economic burden to
      the healthcare system.Despite the high prevalence of IBS and its association with disability
      and adverse effect on health related quality of life we are not aware of any published trial
      of psychological intervention for IBS from Pakistan. We aim to test the feasibility and
      acceptability of culturally adapted Cognitive Behaviour Therapy (CBT) for the management of
      IBS in Karachi, Pakistan compared to treatment as usual.
    

Detailed description: 
      A systematic review suggested no overall difference in the rates of IBS in East and West . In
      a population based study from Pakistan. Prevalence of IBS was assessed using Rome II criteria
      in relation to psychological distress, disability and life events in men and women
      separately. The prevalence of Rome II IBS was 13.3% which was higher than most
      population-based studies in Asia using Rome II criteria and similar to reports from Turkey
      and Malaysia.The findings also suggest equal sex ratio of IBS in urban Pakistan which may be
      because of the close association between marked distress and IBS in men similar to that found
      in women in the west.The results indicated that diarrhea-predominant IBS was associated with
      less disability compared to the constipation-predominant IBS which was associated with marked
      disability. This might be explained by the explanatory models; constipation is considered
      harmful as toxins or other harmful substances are retained within the body whereas diarrhea
      is not considered harmful as any toxins etc are removed from the body. Distress and life
      events contributed independently to high disability. In psychological treatments there is an
      assumption that there are some critical features which need to be addressed in the treatment
      process such as stress and anxiety; it also suggests that stress has a major role in
      increasing IBS symptoms as well as stress reactivity which results in IBS symptoms. The goal
      of cognitive-behavioral treatments is to increase awareness regarding the association between
      stress, thoughts, and IBS symptoms, it is important to identify and modify cognitive
      appraisals and to change depressive and/or anxiety-based schema. These interventions play a
      major role in decreasing IBS symptoms severity and associated anxiety and depression when
      compared to no treatment or standard medical care.
    

Intervention name(s): Culturally adapted Cognitive Behavior Therapy for IBS
Intervention type(s): Behavioral
Intervention description(s): Culturally adapted Cognitive Behavior Therapy for IBS
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: Irritable Bowel Syndrome, Low Income Country