Web- and Phone-Based Behavioral Therapy Offer Long-Term IBS Relief

By Josh Garcia
Friday, November 1, 2019
Specialty: 

Telephone- and web-based cognitive behavioral therapy (CBT) show promise as effective long-term treatments for irritable bowel syndrome (IBS) symptoms, according to a recent study.

The link between body and mind — specifically, gut and mental health — has long been of interest to researchers looking for IBS treatments. Many studies, including one previously published in Gut, urge management of IBS-related anxiety and depression to help provide relief from physiological symptoms of the condition.

“There are studies showing that hypnosis, [CBT] and antidepressants can all have an effect against IBS,” Magnus Simren, Professor and specialized physician at the University of Gothenburg in Sweden, notes in a news release about research in Gastroenterology examining the link between psychological and physical symptoms of the condition.

ACTIB Trial

A newer study published in Gut and co-authored by Rona Moss-Morris, PhD, Professor of Psychology as Applied to Medicine at King’s College London, examined the results of the Assessing Cognitive-behavioural Therapy in Irritable Bowel syndrome (ACTIB) trial.

This trial was designed to compare the clinical impact and cost-effectiveness of telephone-delivered CBT (TCBT) and web-based CBT (WCBT) to treatment as usual (TAU) among 558 participants with refractory IBS who were not already receiving CBT. TAU referred to any treatment participants were already receiving and was not changed for purposes of the study.

Researchers found that adding either TCBT or WCBT to treatment regimens resulted in improved patient outcomes at 12 months when compared with TAU alone. IBS Symptom Severity Scores (IBS-SSS) were measured in all three groups, with lower scores translating to less severe symptoms. Though the TAU group’s IBS-SSS score decreased by 52.9 points, the TCBT and WCBT groups exhibited additional 61.6- and 35.2-point decreases — a total of 133.3- and 101.2-point decreases, respectively.

“With this particular scale, a change of 50 points marks a clinically significant improvement,” Moss-Morris explains.

Further findings, taken at 24 months, will be released later.

“We know that the stress system basically feeds into symptoms and makes them worse. If we can affect how people respond to stress, we may be able to help regulate this system.”
— Rona Moss-Morris, PhD, Professor of Psychology as Applied to Medicine, King’s College London

Improving Access

Moss-Morris and fellow researchers hope to increase access to CBT for people with IBS. They previously evaluated the efficacy of manualized CBT for IBS and used their findings to create a web-based manual for IBS-focused CBT, called Regul8.

Regul8 was used as the basis for WCBT in Moss-Morris’ study and may provide a template for similar web-based therapy in the future.

“We need to find a way to make CBT available to more people,” Moss-Morris says. “The advantage of having a web-based platform is the ability to scale up. We as researchers feel responsible to do that.”