Dr Spiegel will present the Rick MacDermott Lecture at the Advances in Inflammatory Bowel Disease 2020 virtual meeting on the use of virtual reality technology to help patients with inflammatory bowel disease management pain, depression, and anxiety. His recent book on the subject, "VRX: How Virtual Therapeutics Will Revolutionize Medicine" was named one of the top 8 science books of the year by Wired magazine.

Brennan Spiegel, MD, is director of Health Services Research at Cedars-Sinai Medical Center in Los Angeles, and a professor of medicine at Cedars-Sinai and the University of California at Los Angeles.

TRANSCRIPT

Hi, I'm Brennan Spiegel. I'm director of health services research at Cedars-Sinai Medical Center here in Los Angeles. I'm a professor of medicine and public health at Cedars-Sinai and at UCLA.

In my talk at AIBD, I'm going to be talking about an unusual topic, which is the use of virtual reality as a treatment, a new type of treatment, for our patients throughout gastroenterology but with IBD in particular.

The idea behind this is we know that organic disorders like IBD, of course, they respond to a whole variety of medications. We also know that the brain and the gut are connected, and that even after we clear up inflammation, there can be persistent symptoms, abdominal pain, bloating, and discomfort, and many patients very much like irritable bowel syndrome.

We've been learning over time that mind-body treatments like virtual reality, in particular, can be helpful for managing this type of pain. I'll be talking about that in my discussion. When most people think of virtual reality, they think about a gaming platform, with teenagers playing first-person shooter games in their parents' bedroom or basement or something like that.

They don't think of it as a therapeutic platform for patients with IBD or other forms of chronic pain. In fact, we now have over 5,000 studies that show that virtual reality can be helpful across a whole range of conditions throughout medicine, including visceral pain.

The way it works, at Cedars-Sinai, we've been using virtual reality with our IBD patients and other patients with functional GI disorders for several years now. You can imagine that what the way it works is you wear a headset over your face.

Rather than playing games, we can transport people to healing environments. Rather than being in a hospital room, we can have them swimming around with dolphins underwater or on a beach or on a helicopter going on a tour over Icelandic fjords, for example.

This just changes the brain's perception of the world around it, and in many cases can help distract from pain. More than that, even after the headset comes off, people often have persistent benefits in their pain as if the brain has been temporarily inoculated against the pain.

We're also using virtual reality now as a platform for cognitive behavioral therapy. People can go home and use virtual reality every day at home for 10 minutes or so to learn new skills about how to live with their chronic disease.

For example, in one of the experiences that I'll talk about, people can sit in a forest. As they slowly breathe in and out, the microphone in the headset detects that breathing and can actually blow life into a dying tree, for example.

In a metaphorical narrative, we learn how to use your body to enrich the world around you and, in the process, learn how you can enrich the world within you through this mind-body feedback. A lot of this sounds like New Age, kind of weird stuff, but it's supported by many studies now, including randomized control trials showing that virtual reality can help with some of the most severe pains a human can go through.

I'll be talking about this approach of using virtual reality for pain but also is being used for anxiety, for depression, for post-traumatic stress disorders, and a wide variety of other topics. In fact, I've just recently published this book. It's called "VRx -- How Virtual Therapeutics Will Revolutionize Medicine," where I talked all about this new field of medicine called Medical Extended Reality or MXR.

I introduced the topic of MXR in my new talk here in AIBD and, in the process, talk about how gastroenterologists may want to learn how to use this technology with their patients with IBD, with functional GI disorders, and other related conditions.

We do have a website called virtualmedicine.org. On it, you can find all sorts of resources including our favorite VR programs and how to get started. I'll talk a little bit about that.

The last thing I'll say is in the area of COVID-19 where patients are increasingly isolated or even quarantine, there is a need to deliver care where people are particularly in rural environments, not just in urban environments, to get evidence-based cognitive behavioral therapies and other mental health therapies in a digital format too where people actually live.

We now have been using virtual reality of Cedars-Sinai and sending it to their homes to help them cope and manage their IBD and other chronic pain disorders at home. I'll talk a little bit about that as well.

I hope this overview is helpful. I hope that you can join me at the talk to learn more about this exciting new area of medicine. Thanks very much. I hope to see you soon