***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND Despite the rapidly growing body of literature on health-related quality of life ( HRQoL ) . placing the results in a context that is meaningful to clinicians and patients is often overlooked . OBJECTIVE This study sought to quantify the impact of irritable bowel syndrome ( IBS ) on HRQoL by comparing the Medical Outcomes Study 36-item Short-Form Health Survey ( SF-36 ) scores of IBS patients with normative US data and with the scores of patients having other chronic gastrointestinal ( GI ) and non-GI disorders . METHODS Two IBS reference groups were identified from the published literature : a largely untreated community sample of health maintenance organization ( HMO ) members ( N = 92 ) and a sample of patients with IBS recruited through clinics and in the community ( N = 140 ) . SF-36 scores for these groups were compared with published US population norms ( N = 2474 ) and with published scores for 3 other IBS sample s ( N = 464 ) ; a sample with other chronic GI disorders ( dyspepsia [ N = 126 ] , gastroesophageal reflux disease [ GERD ] [ N = 516 ] ) ; and sample s with other chronic episodic disorders ( asthma [ N = 375 ] , migraine [ N = 303 ] , panic disorder [ N = 73 ] , rheumatoid arthritis [ N = 693 ] ) . RESULTS The scores of patients in both IBS reference groups were significantly lower on several SF-36 domains than those of the US normative population ( P < 0.003 ) . Scores on several SF-36 scales were also significantly lower in the IBS reference groups compared with the GERD , asthma , and migraine sample s ( P < 0.003 ) . Depending on the IBS sample used , scores did not differ or were higher compared with those in the sample with dyspepsia . Relative to the sample s with panic disorder and rheumatoid arthritis , the IBS groups had significantly higher scores on most SF-36 domains ( P < 0.003 ) . Scores for the HMO reference group were generally higher than those for the clinic/community reference group . CONCLUSIONS Based on the results of this analysis , IBS is associated with impairment of HRQoL relative to US population norms and to population s with GERD , asthma , or migraine . HRQoL appears to be greater in patients with IBS than in those with panic disorder or rheumatoid arthritis , although the relative symptom severity in these sample s was not known Objective . This r and omized trial evaluated the therapeutic effect of emotional awareness training on the severity and frequency of pain in patients with irritable bowel syndrome ( IBS ) . Patients ’ level of alexithymia was also measured . Method . The study involved 100 patients diagnosed with IBS according to the Rome-III criteria . Patients ’ mean age was 34.98 years ( st and ard deviation 10.22 years ) and 60 % of the patients were female . Seventy eligible patients were assigned r and omly to one of two treatment groups . One group received st and ard symptom-oriented medical treatment only ( MT group ) , while the second group , termed the emotional awareness group ( EMT ) , was educated to increase conscious awareness of eight primary emotions in addition to receiving st and ard symptom-oriented medical treatment . This study was conducted over 20 months . All patients received 5 weeks of symptom-oriented medical treatment ; patients in the EMT group also had two emotion awareness training sessions and recorded their emotions in a daily diary . Sixty patients completed the study . Results . Patients with IBS scored significantly higher on all aspects of alexithymia compared with healthy controls . The severity of pain decreased significantly in both groups , with a larger percentage of the patients in the EMT group who completed the study having a significant decrease in pain ( 54 % in the EMT group vs. 36 % in the MT group ) ; this finding was replicated in an intent-to-treat analysis . The same results were observed for frequency of pain in patients who completed the study ( 59 % in the EMT group vs 43.4 % in the MT group ) , but this finding was not replicated in an intent-to-treat analysis . These patterns were not influenced by level of alexithymia , age , or gender . Conclusion . Adding emotional awareness training to medical treatment result ed in a better therapeutic response in abdominal pain in patients with IBS . ( Journal of Psychiatric Practice 2014;20:3–11 Background Internet-based cognitive behavior therapy ( ICBT ) has shown promising effects in the treatment of irritable bowel syndrome ( IBS ) . However , to date no study has used a design where participants have been sample d solely from a clinical population . We aim ed to investigate the acceptability , effectiveness , and cost-effectiveness of ICBT for IBS using a consecutively recruited sample from a gastroenterological clinic . Methods Sixty-one patients were r and omized to 10 weeks of ICBT ( n = 30 ) or a waiting list control ( n = 31 ) . The ICBT was guided by an online therapist and emphasized acceptance of symptoms through exposure and mindfulness training . Severity of IBS symptoms was measured with the Gastrointestinal symptom rating scale - IBS version ( GSRS-IBS ) . Patients in both groups were assessed at pre- and post-treatment while only the ICBT group was assessed 12 months after treatment completion . Health economic data were also gathered at all assessment points and analyzed using bootstrap sampling . Results Fifty of 61 patients ( 82 % ) completed the post-treatment assessment and 20 of 30 patients ( 67 % ) in the ICBT group were assessed at 12-month follow-up . The ICBT group demonstrated significantly ( p < .001 ) larger improvements on the IBS-related outcome scales than the waiting list group . The between group effect size on GSRS-IBS was Cohen 's d = 0.77 ( 95 % CI : 0.19 - 1.34 ) . Similar effects were noted on measures of quality of life and IBS-related fear and avoidance behaviors . Improvements in the ICBT group were maintained at 12-month follow-up . The ICBT condition was found to be more cost-effective than the waiting list , with an 87 % chance of leading to reduced societal costs combined with clinical effectiveness . The cost-effectiveness was sustained over the 12-month period . Conclusions ICBT proved to be a cost-effective treatment when delivered to a sample recruited from a gastroenterological clinic . However , many of the included patients dropped out of the study and the overall treatment effects were smaller than previous studies with referred and self-referred sample s. ICBT may therefore be acceptable and effective for only a subset of clinical patients . Study dropout seemed to be associated with severe symptoms and large impairment . Objective and empirically vali date d criteria to select which patients to offer ICBT should be developed . Trial Registration Clinical Trials.gov : OBJECTIVES : Gut-directed hypnotherapy has been found to be effective in  irritable bowel syndrome ( IBS ) .  However , r and omized , controlled studies are rare and few have been performed outside highly specialized research centers . The objective of this study was to study the effect of gut-directed hypnotherapy in IBS in different clinical setting s outside the traditional research units . METHODS : The study population included IBS patients refractory to st and ard management . In study 1 , patients were r and omized to receive  gut-directed hypnotherapy  ( 12 sessions , 1 h/week ) in psychology private practice s or supportive therapy , whereas patients were r and omized to receive gut-directed hypnotherapy  in a small county hospital or to serve as waiting list controls in study 2 . Gastrointestinal symptom severity and quality of life were evaluated at baseline , at 3 months follow-up and after 1 year . RESULTS : We r and omized 138 IBS patients refractory to st and ard management , 90 in study 1 and 48 in study 2 . In both the studies , IBS-related symptoms were improved at 3 months in the gut-directed hypnotherapy groups ( P<0.05 ) , but not in the control groups ( ns ) . In study 1 , a significantly greater improvement of IBS-related symptom severity could be detected in the gut-directed hypnotherapy group than in the control group ( P<0.05 ) , and a trend in the same direction was seen in study 2 ( P=0.17 ) . The results seen at 3 months were sustained up to 1 year . CONCLUSIONS : Gut-directed hypnotherapy is an effective treatment alternative for patients with refractory IBS , but the effectiveness is lower when the therapy is given outside the highly specialized research centers Introduction The study aims to investigate two kinds of treatment in patients suffering from irritable bowel syndrome ( IBS ) and consequently compares its efficacy on improving the symptoms and mental health of patients ; one with just medical treatment and another through a combination of psychotherapy and medical treatment . Material and methods Applying general sampling , 50 IBS patients were selected from among those who used to refer to a Gastroenterology Clinic . After physical and mental evaluations based on ROME-II scale and SCL-90-R question naires , the subjects were r and omly superseded into : the control group with medical treatment and , the case group with a combination of medical and psychological treatments . The acquired data were then analyzed through t-test and Mann-Whitney U-test . Results The findings show that the mental health of patients receiving cognitive behavioral therapy along with the medical treatment was higher than those of the control group at post-test level . It was observed that the therapy reduces the disability caused by IBS . Comparatively , while the cognitive therapy and medical treatments  cured 80 % of the patients , those receiving cognitive therapy alone showed an extensive reduction of symptoms . Conclusions Considering the role of cognitive behavioral therapy , it is therefore recommend that such patients be managed by a combined team of gastroenterologists and psychologists This study was conducted to evaluate the comparative effect of yogic and conventional treatment in diarrhea-predominant irritable bowel syndrome ( IBS ) in a r and omized control design . The patients were 22 males , aged 20–50 years , with confirmed diagnosis of diarrhea-predominant IBS . The conventional group ( n=12 , 1 dropout ) was given symptomatic treatment with loperamide 2–6 mg/day for 2 months , and the yogic intervention group ( n=9 ) consisted of a set of 12 asanas ( yogic poses , i.e. , Vajrasana , Shashankasana , Ushtrasana , Marjariasana , Padhastasana , Dhanurasana , Trikonasana in two variations , Pawanmuktasana , and Paschimottanasana ) along with Surya Nadi pranayama ( right-nostril breathing ) two times a day for 2 months . All participants were tested at three regular intervals , at the start of study —0 month , 1 month , and 2 months of receiving the intervention— and were investigated for bowel symptoms , autonomic symptoms , autonomic reactivity ( battery of five st and ard tests ) , surface electrogastrography , anxiety profile by Spielberger 's Self Evaluation Question naire , which evaluated trait and state anxiety . Two months of both conventional and yogic intervention showed a significant decrease of bowel symptoms and state anxiety . This was accompanied by an increase in electrophysiologically recorded gastric activity in the conventional intervention group and enhanced parasympathetic reactivity , as measured by heart rate parameters , in yogic intervention group . The study indicates a beneficial effect of yogic intervention over conventional treatment in diarrhea-predominant IBS One hundred two patients with irritable bowel syndrome were studied in a controlled trial of psychological treatment involving psychotherapy , relaxation , and st and ard medical treatment compared with st and ard medical treatment alone .  Patients were only selected if their symptoms had not improved with st and ard medical treatment over the previous 6 months . At 3 months , the treatment group showed significantly greater improvement than the controls on both gastroenterologists ' and patients ' ratings of diarrhea and abdominal pain , but constipation changed little . Good prognostic factors included overt psychiatric symptoms and intermittent pain exacerbated by stress , whereas those with constant abdominal pain were helped little by this treatment . This study has demonstrated that psychological treatment is feasible and effective in two thirds of those patients with irritable bowel syndrome who do not respond to st and ard medical treatment Background Irritable bowel syndrome ( IBS ) is a functional disorder of the lower gastrointestinal ( GI ) tract affected by stress , which may benefit from a biopsychosocial treatment approach such as mindfulness-based stress reduction ( MBSR ) . Purpose A treatment as usual ( TAU ) wait-list controlled trial was conducted in Calgary , Canada to investigate the impact of MBSR on IBS symptoms . It was hypothesized that MBSR patients would experience greater reduction in overall IBS symptom severity and self-reported symptoms of stress relative to control patients . Method Ninety patients diagnosed with IBS using the Rome III criteria were r and omized to either an immediate MBSR program ( n = 43 ) or to wait for the next available program ( n = 47 ) . Patients completed IBS symptom severity , stress , mood , quality of life ( QOL ) , and spirituality scales pre- and post-intervention or waiting period and at 6-month follow-up . Intent-to-treat linear mixed model analyses for repeated measures were conducted , followed by completers analyses . Results While both groups exhibited a decrease in IBS symptom severity scores over time , the improvement in the MBSR group was greater than the controls and was clinical ly meaningful , with symptom severity decreasing from constantly to occasionally present . Pre- to post-intervention dropout rates of 44 and 23 % for the MBSR and control groups , respectively , 
    Output:
    
However , across approaches , short-term benefits were seen .
IBS symptoms improved significantly among patients in cognitive and behavioral therapies , mindfulness-based stress reduction , guided affective imagery , and emotional awareness training compared with controls ; there was a similar trend for gut-directed hypnotherapy .