The National Institute for Clinical Excellence (NICE), recommends face-to-face cognitive behavioural therapy (CBT) for patients with IBS, however, Dr Hazel Everitt, Associate Professor in General Practice at the University of Southampton, realised that within the resource constrained NHS the availability of (CBT) for the treatment of IBS was extremely limited. With this in mind, a trial was conducted to fully understand the effectiveness of telephone CBT (TCBT) and web- based CBT (WCBT) compared to treatment as usual (TAU). Both TCBT and WCBT are likely to provide a viable way of patients accessing CBT that is both convenient to the patient and cost effective to the NHS.
588 participants with refractory IBS (IBS patients with significant ongoing symptoms despite having tried first line treatments for at least a year) were included in the trial and split randomly into the following groups: telephone CBT, web-based CBT, and treatment as usual.
They found that both TCBT and WCBT helped to halve the severity of symptoms and their impact on the quality of life for participants after 12 months of treatment compared to those who only received current standard IBS care. This is a 30% improvement on conventional treatments with dietary advise and drugs.
These results are indicate both methods of CBT are effective treatments for those with refractory IBS when compared to TAU.
However, adherence is an important limitation to consider. This type of treatment will only work if the course of therapy is completed, meaning participants must attend all sessions. The benefits of both TCBT and WCBT, is the ability to work around the patients time frame and can be completed at a pace the patient is comfortable with. This may mean higher levels of adherence to the treatment method meaning better results in terms of reducing symptoms.
Researchers are now furthering their investigation by evaluating the most appropriate form of CBT for patients with IBS and looking at which is most cost effective to the NHS. NICE are also considering the new research and assessing this form of treatment. At a briefing the authors were reported saying the treatment could be available ‘within months’.
Hopefully with this positive research paper CBT will be widely available on the NHS soon to help us with our IBS symptoms all from the comfort of our own home. Keep an eye out for this treatment becoming available in the coming months and ask your health care practitioner (GP, IBS specialised doctor) what current CBT treatments are available to you until then.
If you are fortunate to be able to afford private CBT treatment, investigate a good therapist in your area that specialises in the treatment of IBS.
Let me know in the comments if you have participated in CBT and if you have had any improvement. Or let me know your opinions on the research.
Original research paper:
Hazel Anne Everitt, Sabine Landau, Gilly O’reilly, Alice Sibelli, Stephanie Hughes, Sula Windgassen, Rachel Holland, Paul Little, Paul Mccrone, Felicity Bishop, Kimberley Goldsmith, Nicholas Coleman, Robert Logan, Trudie Chalder, Rona Moss-Morris On Behalf of Actib Trial Group. Assessing telephone-delivered cognitive–behavioural therapy (CBT) and web-delivered CBT versus treatment as usual in irritable bowel syndrome (ACTIB): a multicentre randomised trial. Gut, 2019