OnMedica – News – CBT by phone or online could help IBS

Researchers say new ways to offer CBT will expand access and give hope when drugs fail

Research * suggests that cognitive behavioral therapy (CBT) sessions, delivered remotely over the telephone and over the Internet, have been shown to be more effective than standard treatments in helping people with irritable bowel syndrome (IBS).

In addition to improving the "treatment as usual", researchers say that the administration of CBT according to these innovative methods would make them more accessible via the NHS and more convenient for patients.

Write in the newspaper IntestineA group of researchers from the University of Southampton and Kings College London randomly badigned 558 people with persistent symptoms of IBS to one of three approaches. One group simply continued to take their usual medications and received information about their diet and lifestyle, while the other two groups also participated in a CBT.

For a CBT group, this was a manual session and six one hour telephone therapy sessions over a nine-week period, followed by two one-hour sessions at each. four and eight months to help manage outbreaks. For the other group, participants had access to an online TCC course, as well as three half-hour telephone calls in the first five weeks and two others thereafter.

The results reveal that all three groups improved in the 12 months following the start of the trial, both in terms of symptoms and impact that IBS had on their everyday life.

When the team examined the IBS symptom severity scores among the 391 participants for whom data were available, they found that 44% of those who were on regular treatment had a significant improvement 12 months after onset of the study. However, this number increased to 66% among those who also took the combined CBT course on the Web and by telephone and 73% among those who took the CBT intensive course by telephone.

Although the team did not compare the impact of distance CBT courses with face-to-face therapy, and noted that people who did not like CBT would not have participated in the trial, the results look promising for distance therapy for people with IBS. and that the benefits are sustainable.

Since 2008, the National Institute for Health and Care Excellence has recommended that if drug therapies do not help patients after one year and that symptoms persist, which researchers say is a common occurrence, they should be see offer a CBT.

"Unfortunately, this system is not available on the NHS As a general practitioner, I am therefore not able to recommend an IBS for cognitive behavioral therapy," said Dr. Hazel Everitt, first author from research at the University of Southampton.

The team indicated that it was still studying why CBT was beneficial, but said that the therapy was specifically adapted to IBS and that, among its characteristics, it provided participants with information about the functioning of CBI. bowel, practical tips on how to eat and exercise, and how to manage sleep stress and emotions.

It also included ways to break down patterns of unnecessary behaviors and ideas, such as people with diarrhea immediately going to the toilet if urgently needed, or people waking up with stomach problems. and therefore baduming the day.

"For some people, it's about managing [the condition] but … for some people, in fact, they no longer suffer from the symptoms of IBS, it's an effective treatment for IBS, "said Professor Rona Moss-Morris, co-author of the King's College London study .

However, the team added that IBS was not a mental health problem and that the benefits found did not result primarily from a reduction in anxiety and depression – although some participants showed such improvements.

*Everitt HA, Landau S, O'Reilly G, et al. Evaluation of Cognitive Behavioral Therapy (CBT) and CBT Delivered Over the Internet Against Routine Treatment in Irritable Bowel Syndrome (ACTIB): A Multicenter Randomized Trial. Intestine. Posted online first: April 10, 2019. doi: 10.1136 / gutjnl-2018-317805