Questions Answered By Expert
Eva Szigethy, MD, PhD
Professor of Psychiatry, Medicine & Pediatrics
Director, Behavioral Health with the Chief Medical and Scientific Officer
Founder, Visceral Inflammation & Pain (VIP) Center
A: There are numbing agents that you can swish in your mouth that your gastroenterologist can tell you about. Hypnosis can also be very useful for helping ulcers. hide answer
A: Disrupted sleep can make IBD worse- worse inflammation, more pain, and also predisposes people to more anxiety and depressed mood. Disrupted sleep can be having trouble falling asleep, multiple awakenings or not getting enough sleep. Many medical sleep societies recommend all adults need 7-9 hours per sleep a night. Most important things to do to help sleep disruption is doing enough physical activity during the day to be tired by night, good sleep hygeine (so no bright lights including computers or cell-phone screens in bed) and going to bed and getting up at the same time each night. Sleep can now be monitored on gadgets like fitbits or also apps like sleepcycle. hide answer
A: Different GI clinics or practices have different ways they handle pain management. Some gastroenterologists have algorithms that they try first. Many have psychosocial resources available who specialize in pain. Pain experts can be counselors or pain anesthesiologists who can sometimes have success with nerve blocks, TENS units, or vagal nerve stimulators- though these latter techniques have not been well studied. hide answer
A: To ease the discomfort you describe, you might consider distraction techniques. These are either activities you can do to forget about the gurgling or mind techniques such as meditation or hypnosis. To learn about certified medical hypnotists in your area, you can go to the website of the American Society of Clinical Hypnosis. There are also some good apps available to help teach meditation like headspace.com. Finally, there are educational stress management websites such as www.gameplan.com that can give you ideas too. hide answer
A: The more chronic the pain, the more it involves the brain. What I mean is that the brain re-organizes if constantly bombarded by pain signals and neighboring brain regions that process emotions (anxiety, depression) and thoughts can also be affected. Most research supports learning coping skills to reduce these negative emotions or negative or pessimistic thinking as the best way to reduce pain perception. You are correct narcotics have many side effects and have been associated with greater risk of infections and death in patients with Crohn’s disease. There are non-opioid pain medications that have evidence in helping pain – working both on the nerves and in the brain. Finding a pain doctor or psychiatrist who specialized in chronic pain can help you find specific options. hide answer