This blog is #5 in a series of blogs in the form of questions or statements about a health issue and answers. These are in the typical format used when doctors take tests.
Question #5:
A 32-year-old female presents with IBS-D that has worsened since starting a new job that has been stressful.
She is having 4-6 watery, non-bloody stools a day with cramping and bloating. She does not want to be told, “this is all in your head.” The most appropriate strategy in explaining the mind-body connection to encourage acceptance would be:
(Before I give the choices, let me make sure everyone knows what IBS-D means. It stands for Irritable Bowel Syndrome-Diarrhea. When the IBS shows up as frequent, loose, watery stools. As opposed to IBS-C which is when IBS shows up as constipation. Not having bowel movements as often as you should and they tend to be hard to pass.)
Now the choices…
- “Your symptoms got worse when you started your stressful job. I am going to refer you to a psychologist.”
- “Until you get your mind under control, your gut will never be the same.”
- “This is a stress-related disease. It is outside of my area of expertise and I can’t help you.”
- “The mind and the gut are interconnected by a large pathway called the vagus nerve. We can use this powerful connection to your advantage by recruiting your mind as a therapeutic ally to help your gut heal.”
That’s correct! #4.
Communicating the importance and power of the mind-body connection in IBS is an important skill.
Answer 1 does not relieve the patient’s fears.
Answer 2 would make the patient feel blamed with projection of the clinician’s belief and no explanation of the complicated multifocal nature of this disease.
Answer 3 gives up on the patient. We can always be of some service through our presence and willingness to stick with the patient towards health and healing.
Answer 4 is the best answer. It gives the patient an explanation of how the mind-body is interconnected by a specific pathway that can be used to their advantage towards improving symptoms and quality of life.
This enhances understanding and a sense of control that helps switch belief from a negative perception to a proactive one.
