Running head: RESEARCH UTILIZATION PAPER: MEDITATION-BASED STRESS

Research Utilization Paper:

Meditation-Based Stress Reduction Training in Irritable Bowel Syndrome
Melissa Alberto
NUR 204, Spring 2013
June 14, 2013

RESEARCH UTILIZATION PAPER: MEDITATION-BASED STRESS

PHASE I: VALIDATION PHASE

Clinical Problem
The UCLA Digestive Disease Clinic (DDC) receives many tertiary referrals for irritable
bowel syndrome (IBS) patients who are desperate for a way to manage their symptoms. Over
the years, the number of referrals has been increasing resulting in a three to five month waiting
list to see a gastroenterologist. The prevalence of IBS in the U.S. is 10-15% (Drossman, Camilleri,
Mayer, & Whitehead, 2002). IBS is a functional gastrointestinal disorder that is characterized by
abdominal pain or discomfort associated with diarrhea, constipation, or both (Thompson et al.,
1999), and can cause significant disability, quality of life impairment, and health care burden
(Drossman, 2005). Conventional treatments for IBS have primarily focused on diet and lifestyle
modifications, behavioral treatments, and pharmacological agents; however, many patients do
not achieve adequate relief (Whitehead et al., 2004). There has been increasing interest in
incorporating biopsychosocial models as a basis for integrative treatment approaches,
specifically mind body interventions. Research has shown that programs such as mindfulnessbased stress reduction (MBSR) that involve training and practice of mindfulness can reduce
stress and pain symptoms in chronic functional disorders such as fibromyalgia (Lush et al.,
2009). Since pain is a prominent symptom in IBS and stress exacerbates IBS symptoms (Gaylord
et al., 2011), MBSR training programs would seem to be a reasonable treatment approach for
this condition.
The MBSR program was developed by Jon Kabat-Zinn and Saki Santorelli at the
University of Massachusetts. It is based on Buddhist traditions of meditation and mindfulness,

RESEARCH UTILIZATION PAPER: MEDITATION-BASED STRESS

and has been adapted for a wide range of health conditions. Only a few studies have evaluated
MBSR intervention in the IBS population:
Gaylord, S. A., Palsson, O. S, Garland, E. L., Faurot, K. R., Coble, R. S., Mann, J. D., Whitehead,
W. E. (2011). Mindfulness training reduces the severity of irritable bowel syndrome in
women: Results of a randomized controlled trial. American Journal of Gastroenterology,
106, 1678-1688. doi: 10.1038/ajg.2011.184
Kearney, D. J., McDermott, K., Martinez, M., & Simpson, T. L. (2011). Association of
participation in a mindfulness programme with bowel symptoms, gastrointestinal
symptom-specific anxiety and quality of life. Alimentary Pharmacology and
Therapeutics, 34, 363-373. doi: 10.1111/j.1365-2036.2011.04731.x
Zernicke, K. A., Campbell, T. S., Blustein, P. K., Fung, T. S., Johnson, J. A., Bacon, S. L., & Carlson,
L. E. (2012). Mindfulness-based stress reduction for the treatment of irritable bowel
syndrome symptoms: A randomized wait-list controlled trial. International Journal of
Behavioral Medicine. Advance online publication. doi: 10.1007/s12529-012-9241-6
In the first article, Gaylord et al. (2011) compared the efficacy of MBSR training with an
IBS support group in reducing IBS symptom severity. They enrolled and randomized 75 women
between the ages of 18 and 75 years with a diagnosis of IBS by a physician. The participants
were randomized by a computer into the MBSR group (N=36) or the IBS support group (N=39).
Both intervention groups underwent eight weekly 2-hour sessions plus a half-day retreat.
Participants were asked to record the minutes of practice time and their IBS symptoms in a
daily diary and to complete homework assignments each week. The MBSR group learned how
to perform body scans (i.e. focusing attention on different parts of the body), sitting and

RESEARCH UTILIZATION PAPER: MEDITATION-BASED STRESS

walking meditation, and mindful yoga while the IBS support group focused on specific predesignated topics and involved open group discussions about the individuals experiences with,
or reaction, to the topic. IBS symptom severity, quality of life, gastrointestinal (GI) symptomspecific anxiety, psychological symptoms, and mindfulness were measured at baseline, posttreatment, and at 3 month follow-up. Gaylord et al. (2011) found that the MBSR group had
significantly improved IBS symptom severity at post-treatment and 3 month follow-up
compared to the support group. In addition, the MBSR group had improved quality of life,
psychological distress, and GI symptom-specific anxiety at the 3 month follow-up compared to
the support group. The MBSR group showed a significantly greater increase in mindfulness
scores than the support group. These findings suggest that MBSR training has beneficial effects
on IBS symptom severity, quality of life, and psychological distress, which persisted to at least 3
months after treatment. One limitation of this study is small sample size of only women; thus,
the results cannot be generalized. Another, limitation is the short follow-up period so the
duration of these positive effects remain unknown.
Another study conducted by Kearney et al. (2011) examined the association of the
MBSR training program and IBS-related symptoms, GI-specific anxiety, and quality of life. They
enrolled 93 male and female veterans from the VA Puget Sound Health Care System in Seattle.
Participants were determined to have IBS based on symptom-based diagnostic criteria
questionnaire. Forty three of the 93 participants met the criteria for IBS. All participants
underwent a weekly 2.5 hour MBSR class for 8 weeks plus a 7 hour retreat. During the class,
they learned mindful meditation and yoga; however, there was no specific teaching on GI
symptoms rather mindfulness was taught as a way to encompass all aspects of experience,

RESEARCH UTILIZATION PAPER: MEDITATION-BASED STRESS

including thoughts, emotions, and bodily sensations. They were also assigned homework that
focused on intention, attention, and attitude. IBS symptoms, quality of life, GI symptomspecific anxiety, and health status were measured at baseline, post-treatment, and 6 month
follow-up. When analyzing responses for both groups, Kearney et al. (2011) found that the
quality of life, GI symptom-specific anxiety, and mental health significantly improved between
baseline and the 6 month follow-up. There were no significant changes to symptom severity,
quality of life, GI specific anxiety, and mental health in the IBS group in both follow-up time
points. However, there was a significant improvement in physical health (i.e. physical
functioning, role limitations because of physical problems, bodily pain, general health and
vitality) at the 6 month time point. These findings suggest that participating in MBSR training is
associated with improved quality of life and GI symptom-specific anxiety. Limitations of the
studies included not having a well-defined IBS sample, not using randomization, and not having
a control intervention.
In the last study, Zernicke et al. (2012) investigated the efficacy of an MBSR program in
reducing symptoms of stress and improving psychological will being as well as IBS symptoms.
Ninety men and women between the ages of 18 and 77 with a diagnosis of IBS by a
gastroenterologist in Calgery, Alberta, Canada, were enrolled into the study. Participants were
randomized into the MBSR intervention (N=43) or to the treat as usual (TAU) control group
(N=47). The MBSR group met for 8 weekly 90 minute group sessions plus a 3 hour morning
retreat. The TAU group did not receive an intervention rather they continued with their normal
routine during the study; however, they did have the option of receiving free MBSR training
after the end of the study. IBS symptom severity, quality of life, mood, stress, and spirituality

RESEARCH UTILIZATION PAPER: MEDITATION-BASED STRESS

were measured at baseline, post-treatment, and 6 month follow-up. Zernicke et al. (2012)
found that IBS symptom severity and stress significantly improved from baseline to posttreatment and was maintained over the 6 month follow-up. Although the TAU group did not
see an improvement in IBS symptoms and stress between baseline and post-treatment, they
did see significant improvement at the 6 month follow-up. Mood, quality of life, and spirituality
improved at the post-treatment and 6 month follow-up regardless of the group. These findings
suggest that MBSR training can reduce IBS symptoms and stress and these effects can be
maintained up to 6 months after training. Limitations of the study are the small sample size, the
lack of a control intervention, and limited generalizability due to the exclusion of comorbidities
and inclusion of highly educated participants.
Overall, these studies found benefits to MBSR training. Gaylord et al. (2011) and
Zernicke at al. (2012) found that MBSR training can reduce IBS symptoms and stress. These
benefits can be maintained up to 6 months. Kearney et al. (2011) may not have these findings
because they did not clearly identify participants diagnosed with IBS. In addition, Gaylord et al.
(2011) and Kearney et al. (2011) found that MBSR training improved quality of life. Based on
these studies results, it is reasonable to believe that offering MBSR training at the DDC will
reduce IBS symptoms and stress and improve quality of life.
PHASE II: COMPARATIVE EVALUATION PHASE
Fit of Setting
This intervention can work well at the DDC because the leading gastroenterologists in
functional gastrointestinal disorder attract many IBS patients to UCLA Health System. The DDC
is located close to the Marissa Leaf conference room which can accommodate 10-15 people for

RESEARCH UTILIZATION PAPER: MEDITATION-BASED STRESS

the MBSR classes. In addition, right across the street is the UCLA Mindfulness Awareness
Research Center that employs trained MBSR instructors. The benefit of working at an academic
institution is that it facilitates collaboration between different specialties.
Substantiating Evaluation
Although all the studies differ in study design and population, they all found some
benefits to MBSR training. To reiterate, Gaylord et al. (2011) and Zernicke at al. (2012) found
that MBSR training can reduce IBS symptoms and stress. These benefits can be maintained up
to 6 months. Kearney et al. (2011) may not have these findings because they did not clearly
identify participants diagnosed with IBS. In addition, Gaylord et al. (2011) and Kearney et al.
(2011) found that MBSR training improved quality of life.
Basis for Practice
Using the Stetler Model of evidenced-based practice (Stetler, 2001), we identified MBSR
training as the intervention we would like to investigate in IBS patients seen at the DDC. During
the preparation phase, we noticed a growing number of IBS patients that were unsatisfied with
conventional therapies. This clinical problem is relevant for UCLA Health System because we
want to improve patient outcomes and increase health care satisfaction in this population. In
order to do so we need to provide novel interventions that reduces IBS symptoms and
improves quality of life. During the validation phase, we performed a literature review search
for possible interventions in the IBS population, critiqued the articles, and selected credible
resources. During the comparative evaluation/decision making phase, we compared the
different interventions and identified MBSR training as the novel intervention that would be
feasible in our tertiary care setting. During the translation/application phase, we will recruit IBS

RESEARCH UTILIZATION PAPER: MEDITATION-BASED STRESS

patients from the DDC who will undergo MBSR training as described in previous research
studies. We will use of the IBS symptom severity scale (IBS-SSS) to measure symptom severity,
the primary outcome measure. In addition, we will measure stress (Calgery Symptom of Stress
Inventory [C-SOSI]) and quality of life (IBS-QOL) as secondary outcomes. During the evaluation
phase, we will analyze the IBS-SSS, C-SOSI, and IBS-QOL scores at baseline, post-treatment, and
two follow up time points to determine if MBSR training can reduce IBS symptoms and stress
and improve quality of life.
Feasibility
The benefits of offering MBSR training include better patient outcomes and satisfaction,
drawing new patients to UCLA by offering a novel and safe intervention, and more profit for
UCLA Health System. The disadvantage of implementing this intervention is the initial
investment of time and resources. This includes giving up the use of the conference room so
that it is available for the classes and health care providers spending more time educating and
consenting potential participants, which means they will see less patients in the day and make
less profit. In addition, resources are needed to pay for the MBSR instructors.
PHASE III: DECISION-MAKING PHASE
Pilot Study
The purpose of this pilot study would be to determine if MBSR training is could be a
standardized intervention in reducing IBS symptoms and stress in IBS patients. Men and women
age 18 years and older, with a diagnosis of IBS from a gastroenterologist, and that has never
participated in a MBSR-like program before will be recruited from the DDC. Participants who
sign the consent form will complete the IBS-SSS, C-SOSI, IBS-QOL, VSI, and Mindful Attention

RESEARCH UTILIZATION PAPER: MEDITATION-BASED STRESS

Awareness Scale (MAAS) questionnaires. The MAAS will indicate if participants became more
mindful after receiving training. Within 1-3 weeks they will begin the MBSR training. The MBSR
training course will involve weekly 2 hour classes over 8 weeks. Each class will consist of about
10 patients. During each group session, an instructor leads patients in guided relaxations,
guided meditations, awareness exercises, yoga, and group discussions, with the intent of
helping foster mindful awareness of how one responds to stress. Classes will be conducted by
an instructor with long-standing meditation experience who has completed a UCLA Center for
Mindfulness Awareness Research Center approved training course for teachers. The MBSR
group participants are also expected to participate in 30 minutes of daily home practice six days
a week during the eight-week course. In addition, participants will attend a half day retreat
between the week 6 and 7. Homework assigned each week throughout the course will included
daily mindfulness practices and readings from a provided text, Full Catastrophe Living (KabatZinn, 1990). Participants will be asked to keep a daily diary to report the amount of MBSR
practice time completed. At that end of the MBSR training program, participants will repeat the
IBS-SSS, C-SOSI, IBS-QOL, and MAAS questionnaires. When the participants return to the DDC
for their regular 3 month and 6 month follow-up visits with their physicians, they will be asked
to fill out the questionnaires. Scores at baseline, post-treatment, 3 month follow-up, and 6
month follow-up will be compared in order to determine if there is an improvement in IBS
symptoms, stress, and quality of life; and to determine if these benefits can be maintained over
time.
In order to implement this intervention at the DDC, the director of the clinic, nurses,
physicians, administration, and patients must be accept that MBSR training is an intervention

RESEARCH UTILIZATION PAPER: MEDITATION-BASED STRESS

10

that can reduce IBS symptoms and is supported by evidence-based research. Later, health
insurance companies also need to accept this change so that they can cover the cost of the
therapy.
The motivation for patients to accept MBSR training is to decrease their symptoms using
nonpharmological methods, avoid medication side effects, and improve their quality of life.
The motivation for the clinic director, nurses, and doctors are to provide the best evidencebased interventions to their patients and improve the quality of life for their patients. The
motivation for the clinic director, administrators, and health insurances companies is cutting
down costs. It is estimated that there are 3.6 million physician visits in the U.S. annually for IBS
and that IBS care consumes over $20 billion in both direct and indirect expenditures (Everhart &
Ruhl, 2009). It costs $185 for six 2 hour MBSR training sessions, which have been shown to
reduce IBS symptoms. A reduction in IBS symptoms will result in less physician visits.
The main barrier for all patients, unit director, administrators, health care providers, and
health insurance companies is the lack of dissemination of the evidence-based MBSR research.
Since this is a novel intervention in IBS the public does not know of the benefits of MBSR
training. Other barriers for the patient include: inconvenience to attend weekly classes,
wanting a quicker fix to their symptoms, and the belief that treatment only comes in the form
of therapeutic drugs. The additional barrier for the clinic director, nurses, and physicians will be
finding the resources to implement this intervention, such as the time to educate the
participants about MBSR training, staff to consent patients and administer the paperwork, and
staff committed to following up with the patients.

RESEARCH UTILIZATION PAPER: MEDITATION-BASED STRESS

11

In order to overcome the main barrier of the lack of dissemination of the MBSR
program, we can hold a symposium for the unit director, health care providers, and health
insurance representatives in order to discuss the current research on MBSR training in various
medical conditions. In addition, we can offer free sessions to them so that they understand the
benefits of MBSR training. In order to overcome the barrier of convenience for patients, we can
offer the classes in the evenings or the weekends so that it does not interfere with their work
schedules. In order to overcome the barrier of conventional treatment options, the health care
providers can educate the patient on the different treatment options and their pros and cons.
To make health care providers more willing to participate in the study provide free weekly
lunches for the clinic. In order to overcome the lack of resources, we can invite philanthropists
affiliated with UCLA and that have an interest in mind-body approaches to health care to a
dinner to hear more about our proposal. Hopefully, we can find some generous donors.
In order to disseminate our research findings to UCLA administrators, we can create a
power point presentation that explains the purpose, methods, and results of our study. In
order to communicate our findings to the nurses and physicians within the UCLA health system,
we can invite them to journal club or present a poster at the Department of Medicine Research
Day. In addition, submitting a manuscript to an academic journal can disseminate the findings
even further to the clinical and scientific community. In order to reach the lay public, we can
approach LA Times or LA Weekly to publish an article about the benefits of MBSR training.
During IBS month, one of the gastroenterologists can appear on the television show, The
Doctors, to discuss our findings.

RESEARCH UTILIZATION PAPER: MEDITATION-BASED STRESS

12

References
Drossman, D. A. (2005). What does the future hold for irritable bowel syndrome and the
functional gastrointestinal disorders? Journal of Clinical Gastroenterology, 39, S251S256. Retrieved from http://journals.lww.com/jcge/pages/default.aspx
Drossman, D. A., Camilleri, M., Mayer, E.A., & Whitehead, W.E. (2002) AGA technical review on
irritable bowel syndrome. Gastroenterology, 123, 2108-2131.
doi:10.1053/gast.2002.37095
Everhart, J. E., & Ruhl, C. E. (2009). Burden of digestive diseases in the United States part II:
Lower gastrointestinal diseases. Gastroenterology, 136, 741-754.
doi:10.1053/j.gastro.2009.01.015
Gaylord, S. A., Palsson, O. S, Garland, E. L., Faurot, K. R., Coble, R. S., Mann, J. D., Whitehead,
W. E. (2011). Mindfulness training reduces the severity of irritable bowel syndrome in
women: Results of a randomized controlled trial. American Journal of Gastroenterology,
106, 1678-1688. doi: 10.1038/ajg.2011.184
Kabat-Zinn, J. (2005). Full catastrophe living: Using the wisdom of your body and mind to face
stress, pain, and illness. New York, NY: Delta Trade Paperbacks.
Kearney, D. J., McDermott, K., Martinez, M., & Simpson, T. L. (2011). Association of participation
in a mindfulness programme with bowel symptoms, gastrointestinal symptom-specific
anxiety and quality of life. Alimentary Pharmacology and Therapeutics, 34, 363-373. doi:
10.1111/j.1365-2036.2011.04731.x
Lush, E., Salmon, P., Floyd, A., Studts, J. L., Weissbecker, I., & Sephton, S. E. (2009). Mindfulness
meditation for symptom reduction in fibromyalgia: Psychophysiological correlates.

RESEARCH UTILIZATION PAPER: MEDITATION-BASED STRESS

13

Journal of Clinical Psychology in Medical Settings, 16, 200-207. doi: 10.1007/s10880009-9153-z.

Stetler, C. (2001). Updating the Stetler Model of research utilization to facilitate evidence-based
practice. Nursing Outlook, 49, 272-279. doi:10.1067/mno.2001.120517
Thompson, W. G., Longstreth, G. F., Drossman, D. A., Heaton, K. W., Irvinee, E. J., & MllerLissnerf, S. A. (1999). Functional bowel disorders and functional abdominal pain. Gut, 45,
II43-II47. doi:10.1136/gut.45.2008.ii43
Whitehead, W. E., Levy, R. L., Von Korff, M., Feld, A. D., Palsson, O.S., Turner, M., & Drossman,
D. A. (2004). The usual medical care for irritable bowel syndrome. Alimentary
Pharmacology & Therapeutics, 20, 1305-1315. doi: 10.1111/j.1365-2036.2004.02256.x
Zernicke, K. A., Campbell, T. S., Blustein, P. K., Fung, T. S., Johnson, J. A., Bacon, S. L., & Carlson,
L. E. (2012). Mindfulness-based stress reduction for the treatment of irritable bowel
syndrome symptoms: A randomized wait-list controlled trial. International Journal of
Behavioral Medicine. Advance online publication. doi: 10.1007/s12529-012-9241-6

RESEARCH UTILIZATION PAPER: MEDITATION-BASED STRESS

CITATION
Gaylord, S. A.,
Palsson, O. S,
Garland, E. L.,
Faurot, K. R., Coble,
R. S., Mann, J. D.,
Whitehead, W. E.
(2011). Mindfulness
training reduces the
severity of irritable
bowel syndrome in
women: Results of a
randomized
controlled trial.
American Journal of
Gastroenterology,
106, 1678-1688.
doi:
10.1038/ajg.2011.1
84

THEORY
--

Kearney, D. J.,
McDermott, K.,
Martinez, M., &
Simpson, T. L.
(2011). Association
of participation in a
mindfulness
programme with

--

PURPOSE
Randomized clinical
trial that compared
the efficacy of group
training in mindfulness
techniques with an IBS
support group in
reducing IBS symptom
severity.

SAMPLE/SETTING
75 IBS females
between the ages
of 18 and 75 were
recruited through
either an
existing registry of
IBS patients,
physicians
offices, or local
advertisements
around the
University of
North Carolina
School of
Medicine, in
Chapel Hill, NC.

Prospective study that

examined the
association of the
MBSR training
program and IBSrelated symptoms, GIspecific anxiety, and
quality of life.

They enrolled 93
male and female
veterans from the
VA Puget Sound
Health Care
System in Seattle.
Participants were
determined to

14

METHODS
The participants were
randomized by a computer into
the MBSR group (N=36) or the
IBS support group (N=39). Both
intervention groups underwent
eight weekly 2-hour sessions
plus a half-day retreat.
Participants were asked to
record the minutes of practice
time and their IBS symptoms in
a daily diary and to complete
homework assignments each
week. The MBSR group learned
how to perform body scans (i.e.
focusing attention on different
parts of the body), sitting and
walking meditation, and mindful
yoga while the IBS support
group focused on specific predesignated topics and involved
open group discussions about
the individuals experiences
with, or reaction, to the topic.
IBS symptom severity, quality of
life, gastrointestinal (GI)
symptom-specific anxiety,
psychological symptoms, and
mindfulness were measured at
baseline, post-treatment, and at
3 month follow-up.
All participants underwent a
weekly 2.5 hour MBSR class for
8 weeks plus a 7 hour retreat.
During the class, they learned
mindful meditation and yoga;
however, there was no specific
teaching on GI symptoms rather
mindfulness was taught as a

RESULTS
The MBSR group had
significantly improved IBS
symptom severity at posttreatment and 3 month followup compared to the support
group. In addition, the MBSR
group had improved quality of
life, psychological distress, and
GI symptom-specific anxiety at
the 3 month follow-up
compared to the support group.
The MBSR group showed a
significantly greater increase in
mindfulness scores than the
support group. These findings
suggest that MBSR training has
beneficial effects on IBS
symptom severity, quality of life,
and psychological distress,
which persisted to at least 3
months after treatment.

DISCUSSION & LIMITATIONS

Mindfulness training can
reduce IBS symptom severity
and improvement in quality
of life and psychological
symptoms can be achieved
over time.

When analyzing both groups as

a whole, the quality of life, GI
symptom-specific anxiety, and
mental health significantly
improved between baseline and
the 6 month follow-up. There
were no significant changes to
symptom severity, quality of life,

These findings suggest that

participating in MBSR
training is associated with
improved quality of life and
GI symptom-specific anxiety.

A limitation of the study is

only enrolling females.
Another, limitation is the
short follow-up period so the
duration of these positive
effects remain unknown.

Limitations of the studies

included not having a well-

RESEARCH UTILIZATION PAPER: MEDITATION-BASED STRESS

bowel symptoms,
gastrointestinal
symptom-specific
anxiety and quality
of life. Alimentary
Pharmacology and
Therapeutics, 34,
363-373. doi:
10.1111/j.13652036.2011.04731.x

Zernicke, K. A.,
Campbell, T. S.,
Blustein, P. K., Fung,
T. S., Johnson, J. A.,
Bacon, S. L., &
Carlson, L. E.
(2012).
Mindfulness-based
stress reduction for
the treatment of
irritable bowel
syndrome
symptoms: A
randomized waitlist controlled trial.
International
Journal of
Behavioral
Medicine. Advance
online publication.
doi:
10.1007/s12529012-9241-6

have IBS based on

symptom-based
diagnostic criteria
questionnaire.
Forty three of the
93 participants
met the criteria
for IBS.

--

Randomized clinical
trial that investigated
the efficacy of an
MBSR program in
reducing symptoms of
stress and improving
psychological will
being as well as IBS
symptoms.

90 men and
women between
the ages of 18 and
77 with a
diagnosis of IBS by
a
gastroenterologist
in Calgery, Alberta,
Canada, were
enrolled into the
study.

15
way to encompass all aspects of
experience, including thoughts,
emotions, and bodily
sensations. They were also
assigned homework that
focused on intention, attention,
and attitude. IBS symptoms,
quality of life, GI symptomspecific anxiety, and health
status were measured at
baseline, post-treatment, and 6
month follow-up.
Participants were randomized
into the MBSR intervention
(N=43) or to the treat as usual
(TAU) control group (N=47).
The MBSR group met for 8
weekly 90 minute group
sessions plus a 3 hour morning
retreat. The TAU group did not
receive an intervention rather
they continued with their
normal routine during the
study; however, they did have
the option of receiving free
MBSR training after the end of
the study. IBS symptom
severity, quality of life, mood,
stress, and spirituality were
measured at baseline, posttreatment, and 6 month followup.

GI specific anxiety, and mental

health in the IBS group in both
follow-up time points. However,
there was a significant
improvement in physical health
(i.e. physical functioning, role
limitations because of physical
problems, bodily pain, general
health and vitality) at the 6
month time point.

defined IBS sample, not using

randomization, and not
having a control
intervention.

IBS symptom severity and stress

significantly improved from
baseline to post-treatment and
was maintained over the 6
month follow-up. Although the
TAU group did not see an
improvement in IBS symptoms
and stress between baseline and
post-treatment, they did see
significant improvement at the 6
month follow-up. Mood, quality
of life, and spirituality improved
at the post-treatment and 6
month follow-up regardless of
the group.

These findings suggest that

MBSR training can reduce IBS
symptoms and stress and
these effects can be
maintained up to 6 months
after training.
Limitations of the study are
the small sample size, the
lack of a control
intervention, and limited
generalizability due to the
exclusion of comorbidities
and inclusion of highly
educated participants.