Implementing psychological therapies for gastrointestinal disorders in pediatrics, 2020, Reed et al

Open access, https://www.tandfonline.com/doi/full/10.1080/17474124.2020.1806055

 

Hmmmmm.... I won’t deny the gut affects the brain (edit to add: & visa versa) but I’m not so sure that giving psychological therapies can help long term gut conditions.

Sure, “butterflies in the tummy” before an important event can be managed with calming techniques, but in my view, it’s unlikely that long-term gut disorders are of this sort of origin. (Ie part of the “flight or fight” response that diverts blood to the brain, in preference to the gut, thus causing the gut to abort current digestion.)

Much more likely that generalised worry and mood issues will resolve once any gut issue is addressed.

I wonder is the gut biome an area in need of massive research?

Could a bad dose of the “wrong” bacteria affect mood? And I don’t just mean when the gut is noticeably dodgy, I also wonder if bacterial by-products could travel in the blood to affect mood long-term?

 

This!

 

As someone with gut issues from early childhood I can honestly say that looking at my diet, making long term changes to what I ate made a massive difference.

Sure, at times as a young adult I was fuelled by caffeine & nicotine, but generally my diet was probably not outrageously bad.

I also discovered that some food do unpleasant "things" to my insides. Peanuts for example & that is because I am mildly allergic.

When I developed ME, diet & gut candid overgrowth were considered to be potentially curative. It made no difference to ME symptoms. I have noticed that even fairly high stress makes virtually no difference to how my gut behaves.

If my "habits" change then thinking back will usually identify a cause - peanuts, pineapple, forgetting to eat fruit one day that kind of thing.

A bad gut can be extremely painful - the word discomfort doesn't cover it- being in pain all day, having your abdomen swell up so you increase by at least one dress size, needing to be near a loo just in case etc. are all perfectly reasonable concerns. Fix the gut issue and those worries disappear.

Plus, I have no doubt it is quite possible that by products of whatever is going on in the gut may well alter mood.

By all means deal with the psych issues if they don't resolve after one has dealt with the gut problems. Or are the gut problems just too difficult for 'em?

On another note - someone I was extremely close to died because they were so used to living with severe gut problems. Gut issues can cause very strong chest pain, especially if gas is trapped in the stomach. They didn't notice when they had a series of mini heart attacks until they dropped dead. Literally.

Time to stop this effing about guys. You'll kill people with this nonsense.

 

Couldn't agree more. It's "always" brain -> gut, "never" gut -> brain.
The gut and nutrition are mysteries that affect the body in every possible way, and can be involved in many physical and mental illnesses.
Psychology in particular has tunnel vision when it comes to the gut. It's worrying.

 

There are several problems with this psychological treatment for everything.

The first and most important is that the studies which "prove" these associations are done so badly with every type of bias used to get the results they want. If a proper study was done by gastroenterologists with a scientific background I would be reassured there was a real effect.

Another is that the psychological viewpoint is that there is a perfectly functioning gut/brain system that gets put out of kilter by emotional problems - so heal the emotions, heal the gut.

Yet the evidence is more plausibly interpreted as there being a broken system which is made worse by emotion or that emotions trigger more easily than normal. I have known people who get diarrhoea when they become emotional (good and bad emotions) and CBT could be of use to them. But something which stopped their gut being so sensitive would work too and maybe better.

 

There are so many layers to this nonsense but are these fools seriously arguing that individual psychotherapy affects people's environmental factors? And what the hell kind of standard is "address"? This is straight up alternative woo language. Explore your Chi. Address your karmic vectors. Optimize your spiritual Chakras.

Seriously the peer review process in clinical psychology is entirely over style and may as well not exist, anything gets published no matter how insane. How does nonsense like this pass peer review? Or frankly any oversight?

 

Poor poor children

 

Another day, another paper from psych zealots. All because there are illnesses that are poorly understood.

Let's not dig deeper and understand the human body and how it works. These studies are cheap, easy and ubiquitous. No puzzle here. Nothing unknown to explore.

This is another advert for the primacy of psychology. I suppose because (modern) psychology is new and shiny. Much more 'scientific' than referring to demons. For zealots (not all psychologists) it's the perfect fit for making belief respectable in the science arena. And MUS is their playground.

This in no way discusses the paper at hand and I make some sweeping general statements but this whole genre lacks credibility. They have NO data upon which to hang their (quite frank) ideological position that these illnesses are best healed by a psycho-theraputic approach.

In the arena of physical symptoms it seems much more likely that a primary bio-medical approach is the right approach. That's just occam's razor. They have not proven anything beyond that 'they prefer' psychology. Because they like it.

My usual type of comment to end: where is the social aspect in all this. I really think that it would be valuable to do some science on environmental factors in long term illness.

Not to mention a 'transdiagnostic approach' is not in any way validated simply because the field is moving toward a BPS approach.

 

o well i will just think happy thoughts and the flattened vilia that showed up after endoscopy will miraculously pull their socks up and stand to attention . damn if i had known this i would not of consented to the unpleasant endoscopy in the first place .

 

Elisabeth Bik on Twitter coordinates a weekly digest of microbiome research for anyone interested
https://twitter.com/user/status/1291063866324000768

 

I wonder what she would make of this....

 

I did ask. She raises a good point for the discussions we have here on IBS.

https://twitter.com/user/status/1291616478370787328

https://twitter.com/user/status/1291616736047841280


I've known people who got IBS at a stressful time in their lives, and once the stress was removed and they ate healthier it went away. Likely lots of causes.

It seems the BPS brigade found something that might help a few then extrapolate to all which is not right.