IBS Part 4: Placebo

To further illustrate just how interconnected the mind is with our guts, we should take a minute to look at a remarkable study done by a man named Ted J. Kaptchuk. A scholar of East Asian medicine, Professor of Medicine at Harvard Medical school and Director of the Harvard-wide Program in Placebo Studies and the Therapeutic Encounter at Beth Israel Deaconess Medical Center in Boston, Kaptchuk put together a remarkable scientific study looking at the effects of using placebos in the treatment of irritable bowel syndrome.

But before we explain what this study did, let’s take a step back and look at the gold standard of how scientific studies are performed when evaluating the efficacy of a given medicine. After hand-picking the participants in a study (human subjects are always best), two groups are chosen, at random, to be administered either the medicine in question, or a sugar pill which has no therapeutic effect, otherwise known as a placebo. (We spoke about the nocebo effect earlier—this is its opposite.) When the study is done properly, neither the administering physician nor the participating patient know which pill s/he is being given, enabling both parties to be “blinded” to the details that could potentially affect how the medicine (or placebo) is given, taken, and ultimately benefit the patient. This is called having a “double-blind” study. The scientists studying this of course know who is given which pill, and analyze the data that is collected when retrieving results. Ultimately, the reason for doing this is to see how much more the medicine in question benefits the patients than the placebo, as placebo always has some amount of positive effect. Now, back to the study at hand.

What Ted Kaptchuk did in his study was very different than what was described above. One of his primary questions was whether or not deception of the fact that one was taking a placebo could affect the outcome. So, in his study, there were two groups: one that received a placebo for the treatment of IBS, and another that received no treatment; both groups met weekly with a physician to discuss their current condition. Before the trial began, the group that received the placebo was informed that what they were going to take was a placebo, what the definition of a placebo is, and that it would also be useful to practice some kind of mindfulness about the treatment while getting it—even if it wasn’t medicine. The results were that there was a 59% improvement in the group that received the placebo pills. This included people that actively thought that, after having tried many other active medical compounds to treat their IBS, this treatment would not do anything.

What does this tell us? That as much as our guts may be able to have ill effects on our mental state, our minds are also capable of healing ourselves, even when it is behind our backs.

References:

Kaptchuk TJ, Friedlander E, Kelley JM, Sanchez MN, Kokkotou E, Singer JP, et al. (2010) Placebos without Deception: A Randomized Controlled Trial in Irritable Bowel Syndrome. PLoS ONE 5(12): e15591. Please visit this website to read more: https://doi.org/10.1371/journal.pone.0015591

Zuckerman et al. “Placebo: Can the Mond Cure You?” Science Vs. Podcast, May 9, 2019. Please visit this website to hear podcast: https://gimletmedia.com/shows/science-vs/5whgzd

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