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Role of Relaxation Therapy In Diarrhea Predominant Irritable Bowel Syndrome
Pravir Gambhire1, Ravi Thanage1, Ashok Mohite1, Vinay Zanwar1, Sreelakshmi Vaidyanathan2, Samit Jain1, Alka Subramanyam2, Pravin Rathi1
1Department of Gastroenterology, 2Department of Psychiatry, TNMC and B.Y.L Nair Hospital, Mumbai, India. 

Corresponding Author
Dr Pravir Gambhire


Background: Irritable bowel syndrome (IBS) is a chronic condition. Some patients may benefit from probiotics and rifaximin in diarrhea-predominant IBS (IBS-D). Relaxation therapy has also been tried. 
Aims and Objectives: To assess the efficacy of rifaximin, VSL#3, and relaxation therapy in IBS-D patients. 
Methods: 196 patients with IBS-D were randomly assigned to three groups. Group A, B, and C received rifaximin, VSL#3, and relaxation therapy, respectively. Patients were followed up for six months. 
Results: Relaxation therapy (2.69 ± 0.67) group had significantly improved generalized ill-feeling over VSL# (3.87 ± 0.34) at the end of 6 months. IBS severity score improved in all the groups till the end of the study but relaxation therapy (199.19 ± 30.02) was significantly better than rifaximin (217.21 ± 39.9) and VSL# (250.41 ± 14.78). The subjective global assessment was improved significantly in the relaxation therapy group (2.05 ± 0.9) as compared to rifaximin (3.02 ± 0.85) and VSL#3 (3.84 ± 0.37).
Conclusion: Patients with IBS-D do better with rifaximin and VSL#3 in the short term. Patients respond better to relaxation therapy at the end of 6 months. Relaxation therapy is being a non-pharmacological and cost-effective therapy, could be implemented on a long-term basis.