Researchers from Stanford University in California set out to determine how VR technology could be used to help children and young adults manage symptoms associated with IBD. They focused on short sessions centered on mindfulness and asked participants to rate their pain and anxiety before and after the session. They presented their findings at the 2020 Crohn’s and Colitis Congress. RELATED: Mindfulness Meditation Reduces IBS Symptoms and Anxiety, Study Finds The small study included 52 IBD patients ages 10 to 25 years old, all of whom were being treated for IBD at an outpatient clinic. They were asked to record their pre-session levels of pain and anxiety, and then strap on a VR headset. The session lasted just six minutes. First, users were immersed in a scene that helped them focus on their breathing. Their awareness was then shifted to a meadow with a waterfall. With some guidance, they used their senses to focus on different parts of the scene. At one point, a butterfly landed on a flower, then lifted itself back in the air and repeated the movement, bringing the person’s attention around the scene and reminding them of the pace of their breathing. For the final part of the experience, the scene shifted to dusk, and the aurora borealis moved in the night sky. Participants could see their breath in front of them, both giving the illusion that the temperature had dropped and reminding them once again to focus on their breathing. According to Ana Wren, PhD, a clinical psychologist at Stanford Children’s IBD Center, who led the study, the team was glad to see that VR-based mindfulness appeared to be effective in reducing pain and anxiety in young IBD patients, but that wasn’t the only information they found helpful. “What we were most excited about was the deep interest the participants expressed. They were so eager for this to be more accessible to them outside the clinic and they had a lot of useful feedback regarding how they would like to use VR-based mindfulness as part of their IBD treatment,” says Dr. Wren. Participants thought the intervention would be helpful in de-stressing and curbing anxiety before colonoscopies, having labs done, or during infusions. “They really wanted it during or before any kind of pokes, and that was most interesting to us,” says Wren. According to Stephen Lupe, PsyD, a clinical health psychologist at Cleveland Clinic’s digestive disease and surgery institute, VR likely has a place throughout patient care. “We can incorporate biofeedback, for example. People can practice lowering their heart rate and then see that reflected in the VR imagery, such as slowing down a waterfall,” says Dr. Lupe. In addition to improving a person’s outlook on living with chronic disease, mindfulness has been shown to be an effective way to reduce stress, which is strongly tied to ulcerative colitis (UC) and Crohn’s disease flares, though stress does not cause either disease, according to the Crohn’s and Colitis Foundation. “Our brain and our gut are very connected, and when you have more inflammation in your body that can lead to more stress, it goes both ways,” says Wren. According to Lupe, managing all triggers is key. “It’s like a mixing board connected to a speaker. Stress is one dial, and if enough dials get turned up — stress, environmental conditions, natural hormone cycles in the body, diet — it’s like the speaker blows, or the person goes into a flare. By managing the overall volume of all those dials, we can manage flares,” he says. According to Wren, while VR-based mindfulness can benefit people of all ages, she and her team wanted to focus on how it can be used in a pediatric IBD center, since the technology is already widely available in that setting, and children are typically very open to using technology in new ways, having been born into the digital age. The intervention can also be given without a trained therapist present, further improving accessibility. “And it holds their attention,” says Wren, a key factor in practicing effective mindfulness. Lupe notes that the way patients are treated is changing across the board, including in IBD. “We are understanding there is no such thing as just physical and just psychological. We are whole beings, and interdisciplinary care, working with a team of specialists from psychologists to nutritionists, is how we are going to do things moving forward,” he says.
