Cognitive Behavioral Therapy (CBT) for IBS: long-term benefits

20 September 2019
Blog

Promising results have shown that web and telephone-based cognitive behavioral therapy (CBT) may be more effective than standard therapeutic treatments for IBS. Now new research suggests these results are long lasting. 

Difference between IBS and IBD

 

The main difference between irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD) is the presence of inflammation and disease. 

 

Inflammatory bowel disease typically includes some type of disturbance to bowel function but does not cause inflammation or severe damage. Common symptoms include abdominal pain, alternating between diarrhea and constipation, gas, and mucus in the stool.

 

Inflammatory bowel disease on the other hand is just that, a disease that can cause destructive inflammation and permanent harm to the intestines [1]. IBD is an umbrella term for disorders that cause chronic inflammation to the digestive tract. Typical types include ulcerative colitis and Crohn’s disease [2].

 

What is CBT?

 

Cognitive Behavioral Therapy (CBT) is a type of psychotherapy. It’s a goal oriented approach that encourages practical problem solving. The idea is to change automatic and negative patterns of thinking or behavior that cause you distress. It works by focusing on the cognitive process (thoughts, beliefs, attitudes) and how they influence how you feel or behave [3].

 

Real life example:

Say you go into work and your co-worker hasn’t said much to you today. You begin to wonder if they’re annoyed with you. Or maybe angry. You’re head starts to spin and assume the worst. 

 

“Maybe I didn’t do a good job on that last assignment”, you say to yourself. “Did I say something stupid yesterday?”, you begin to worry. Perhaps your thoughts spiral out of control, assuming that you’re going to get fired.

 

By practicing CBT and challenging unhelpful thoughts, you may change your inner dialogue to, “they must be tired, I remember they said their family is in town.” Or, “maybe it has nothing to do with me.” Increasing awareness of automatic thoughts can help you manage stress and as a result, improve symptoms of IBS.

 

CBT benefits continue 2 years after treatment

 

Previous research suggested that IBS specific Cognitive Behavioral Therapy (CBT) that’s given over the phone or online, is more effective in relieving the symptoms than current standard CBT care. Meaning online support, such as NoriHealth care, may be more helpful than just standard care. 

 

The original study was a three-group, randomised, controlled trial with 558 adults suffering from refractory IBS. They were randomly allocated to therapist CBT treatment via the telephone, web-based (with minimal therapist treatment), or just standard treatment. 

 

Science Daily featured the new study, noting how IBS affects 10 – 20 percent of people and how the bothersome symptoms, abdominal pain, boating, and alternating habits can significantly affect the quality of life.

 

The 24 month follow-up study, published in Lancet Gastroenterology and Hepatology, showed that the CBT benefits continue two years after treatment, even when patients don’t have treatment after the initial CBT course. 

 

A clinically significant change (≥50 points) from baseline to 24 months was found in:

  • 84 (71%) of 119 participants in the telephone-CBT group
  • 62 (63%) of 99 in the web-CBT group
  • 48 (46%) of 105 in the standard treatment group

Sustained improvements in IBS were seen in both the telephone and web-based treatment groups, when compared with the standard treatment. 

 

These results are important because previously there was uncertainty whether the initial benefits could be sustained long term. Currently there’s limited availability of CBT for IBS but this research indicates that easily accessible treatment could be provided to a large number of patients for effective, long-term relief. 

 

Professor Everitt, study lead, added: 

“the fact that both telephone and web based CBT sessions were shown to be effective treatments is a really important and exciting discovery. Patients are able to undertake these treatments at a time convenient to them, without having to travel to clinics and we now know that the benefits can last long term.”

 

 

This article has been written by Lisa Booth, registered dietitian and nutritionist, and co-founder of Nori Health. Content is based on her professional knowledge, and our collection of 100+ scientific research study papers.