Healing Irritable Bowel Syndrome with Diaphragmatic Breathing

After having constant abdominal pain, severe cramps, and losing 15 pounds from IBS, I found myself in the hospital bed where all the doctors could offer me was morphine to reduce the pain. I searched on my smart phone for other options. I saw that abdominal breathing could help. I put my hands on my stomach and tried to expand it while I inhaled. All that happened was that my chest expanded and my stomach did not move. I practiced and practiced and finally, I could breathe lower. Within a few hours, my pain was reduced. I continued breathing this way many times. Now, two years later, I no longer have IBS and have regained 20 pounds. – 21-year old woman who previously had severe IBS

Irritable bowel syndrome(IBS) affects between 7% to 21% of the general population and is a chronic condition. The symptoms usually include abdominal cramping, discomfort or pain, bloating, loose or frequent stools and constipation and can significantly reduce the quality of life (Chey et al, 2015). A precursor of IBS in children is called recurrent abdominal pain (RAP) which affects between 0.3 to 19% of school children (Chitkara et al, 2005). Both IBS and RAP appear to be functional illnesses, as no organic causes have been identified to explain the symptoms. In the USA, this results in more than 3.1 physician visits and 5.9 million prescriptions written annually. The total direct and indirect cost of these services exceeds $20 billion (Chey et al, 2015). Multiple factors may contribute to IBS, such as genetics, food allergies, previous treatment with antibiotics, severity of infection, psychological status and stress. More recently, changes in the intestinal and colonic microbiome resulting in small intestine bacterial overgrowth are suggested as another risk factor (Dupont, 2014).

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What is BCIA? Why is BCIA Certification Important?

What Is the Role of the Biofeedback Certification International Alliance (BCIA)?

BCIA serves as the certification body for the clinical practice of biofeedback and neurofeedback, including Pelvic Floor Muscle Dysfunction Biofeedback. BCIA serves as the standard bearer for the fields of biofeedback and neurofeedback.  The BCIA mission statement is quite simple:

            BCIA certifies individuals who meet education and training standards in

            biofeedback and neurofeedback, and progressively recertifies those who

            advance their knowledge through continuing education.

 It is apparent from this mission statement that education and training should be the main focus for BCIA– and they are!  Where does the educational process start?

It all starts with the blueprints of knowledge.  BCIA’s Board of Directors has spent countless hours reviewing the science and the literature on biofeedback, neurofeedback, and self-regulation to ensure that the three blueprints carefully outline the fundamental science, history, and theory of the modalities and thus set templates for what every beginning clinician needs to know.  As the science and clinical efficacy literature have evolved, we have revised the blueprints to keep pace and to truly represent current best practice.

BCIA can only add information to our blueprints when efficacy has been scientifically established. We recommend that you read LaVaque and colleagues’ (2002) informative “Template for developing guidelines for the evaluation of the clinical efficacy of psychophysiological evaluations.” Additionally, the BCIA blueprints must be free of commercial bias. Once beginners can understand the accepted fundamental science, the same science as others who are certified, they are better able to review the field and make a good decision about various theories or equipment choices.

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Using Biofeedback to Address Male Incontinence

Urinary incontinence, defined by the International Continence Society as “a condition in which involuntary loss of urine is a social or hygienic problem and is objectively demonstrable,” is largely seen in our society as a woman’s problem.

And the statistics support that perception. Urinary incontinence is more common in women than men by a 2-1 ratio. However, 18 percent of men are affected by incontinence sometime in their lifetime and should be not ignored.

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Pelvic Muscle Dysfunction (PMD)

The Biofeedback Certification Institute of America (BCIA) is currently investigating the creation of a separate, entry level, BCIA Certification in Pelvic Muscle Dysfunction (PMD). A multidisciplinary committee of pelvic muscle dysfunction experts was assembled with the task of formulating academic, professional, didactic, and supervision requirements for a PMD Certification. The committee was also asked to delineate requirements for the grandfathering of experienced clinicians in the field. BCIA would appreciate your reviewing the PMD materials posted on our website at BCIA.org and responding to our survey.

If you have come to this page looking for help with (IC) Interstitial Cystitis please visit the IC Help section of our site.

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Medicare coverage of biofeedback for urinary incontinence


35-27 BIOFEEDBACK THERAPY Biofeedback therapy provides visual, auditory or other evidence of the status of certain body functions so that a person can exert voluntary control over the functions, and thereby alleviate an abnormal bodily condition. Biofeedback therapy often uses electrical devices to transform bodily signals indicative of such functions as heart rate, blood pressure, skin temperature, salivation, peripheral vasomotor activity, and gross muscle tone into a tone or light, the loudness or brightness of which shows the extent of activity in the function being measured. Biofeedback therapy differs from electromyography, which is a diagnostic procedure used to record and study the electrical properties of skeletal muscle. An electromyography device may be used to provide feedback with certain types of biofeedback. Biofeedback therapy is covered under Medicare only when it is reasonable and necessary for the individual patient for muscle re-education of specific muscle groups or for treating pathological muscle abnormalities of spasticity, incapacitating muscle spasm, or weakness, and more conventional treatments (heat, cold, massage, exercise, support) have not been successful. This therapy is not covered for treatment of ordinary muscle tension states or for psychosomatic conditions. (See HCFA-Pub. 14-3, §§2200ff, 2215, and 4161; HCFA-Pub. 13-3, §§3133.3, 3148, and 3149; HCFA-Pub. 10, §§242 and 242.5 for special physical therapy requirements. See also §35-20 and 65-8.) Rev. 138

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Pelvic Floor Dysfunction

Dr. Moldwin is Assistant Professor of Urology at the Albert Einstein College of Medicine and is Director of the Interstitial Cystitis Center at Long Island Jewish Medical Center (LIJMC) in New Hyde Park, NY. Dr. Moldwin completed his clinical training at the University of Chicago and his urological training at LIJMC. He then received a Valentine’s Fellowship award and pursued research investigations in IC at Thomas Jefferson Medical College. He subsequently returned to New York to establish the Interstitial Cystitis Center at LIJMC. Dr. Moldwin is active in both basic and clinical IC research and has published extensively. He is a frequent contributor to the ICA Update and has recently written and published a patient-oriented book entitled, The Interstitial Cystitis Survival Guide (New Harbinger Publications).

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The Use of EMG Biofeedback for Training Pelvic Floor


Incontinence is a major healthcare problem costing a conservative estimate of $15 billion, annually, in the USA. This reality is mirrored in countries worldwide. Patients with this problem often lead lives of quiet desperation and social isolation.

Incontinence is among the leading causes of nursing home admission, with approximately 50% of all residents being incontinent. While it is estimated that the number of incontinent geriatric patients can be as high as 80%(11), it is more difficult to estimate the incidence in younger populations, though studies by Nygaard show incontinence to be common in young nulliparous women, particularly during physical activities. One Danish study(5), conducted with a group of 45-year-old women, found that 22% experienced stress incontinence. It was also noted that only three percent of these women sought medical attention for their problem.

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Behavioral vs Drug Treatment for Urge Urinary Incontinence

A Randomized Controlled Trial

Kathryn L. Burgio, PhD; Julie L. Locher, MA; Patricia S. Goode, MD; J. Michael Hardin, PhD; B. Joan McDowell, PhD, CRNP; Marianne Dombrowski, DO; Dorothy Candib, MD

Context.—Urinary incontinence is a common condition caused by many factors with several treatment options.

Objective.—To compare the effectiveness of biofeedback-assisted behavioral treatment with drug treatment and a placebo control condition for the treatment of urge and mixed urinary incontinence in older community-dwelling women.

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Billing codes acknowledge psychology’s role in health and behavior assessment

Psychologists now have a more accurate, refined way of billing for services provided to patients with a physical health diagnosis, thanks to the advent of six new reimbursement codes under the Current Procedural Terminology (CPT) coding system.

As of January 1, 2002, codes for health and behavior assessment and intervention services now apply to behavioral, social, and psychophysiological procedures for the prevention, treatment or management of physical health problems. Developing these new codes involved the combined efforts of the APA’s Practice Directorate and the Interdivisional Healthcare Committee (IHC), representing APA divisions 17, 22, 38, 40 and 54. This constitutes a milestone in the recognition of psychologists as health care providers.

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