1. Kennedy, Maureen Shawn MA, RN

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Irritable bowel syndrome (IBS) affects as many as 17% of women in developed countries. The onset of symptoms (bloating and gas, constipation or diarrhea, and cramps) has been linked to stress, diet, inflammation, and infection. Researchers from the University of Washington in Seattle conducted a randomized trial to determine whether a cognitive and behavioral intervention would reduce symptoms and improve the quality of the women's lives.


A group of 144 predominantly white women, ranging in age from 18 to 48 years and diagnosed with IBS, were randomized into three groups. Two groups received instruction on IBS symptoms, dietary evaluation and counseling, relaxation strategies, and cognitive and behavioral strategies to minimize the effects of IBS. Some of these women received one-on-one support in the form of eight weekly sessions (the comprehensive protocol group), while others attended one class into which the information had been condensed (the brief protocol group). The third group of women received usual care. Follow-up evaluation of the comprehensive-protocol group was conducted one week after the end of the training (and nine weeks after the instructional session in the brief group and after baseline measurement in the usual-care group) and again at six and 12 months. All women kept a daily diary of IBS symptoms.


Women in the comprehensive-protocol group showed significantly higher quality-of-life scores and greater decreases in bloating, constipation, bowel dysfunction, and stress than those in the usual care group. In the brief-protocol group, quality-of-life scores at nine weeks were only slightly better than those in the usual-care group, but by one year, they showed almost as much improvement as the comprehensive group did. According to lead author Margaret Heitkemper, "Nurses in a variety of settings are in a prime position to educate patients who have this common condition, encouraging and supporting their self-management efforts."


Heitkemper MM, et al Clin Gostroenterol Hepatol 2004,2(7) 585-96

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