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IBS symptoms improved more by talking therapy than drugs, finds major trial

Web-based service could be available through NHS services ‘within months’ and would help make highly effective therapy available to thousands of IBS sufferers

Alex Matthews-King
Health Correspondent
Thursday 11 April 2019 06:02 BST
CBT helps IBS sufferers avoid unhelpful habits they have developed to manage their symptoms
CBT helps IBS sufferers avoid unhelpful habits they have developed to manage their symptoms (Getty/iStock)

Psychological therapy delivered over the phone or online can drastically improve the symptoms and quality life of irritable bowel syndrome (IBS) sufferers when drugs have failed, a major trial has found.

UK researchers showed that a remotely delivered course of cognitive behavioural therapy (CBT) tailored to help IBS patients was able to halve the severity of symptoms and their impact on work and home life.

This was a 30 per cent improvement on conventional treatment with dietary advice and drugs to reduce spasms or diarrhoea. CBT also helped more patients see significant improvements, with only a minority seeing gains from drugs.

Face-to-face CBT, talking therapy which aims to improve patients’ quality of life by targeting unhelpful beliefs and coping behaviours, is recommended as a treatment for IBS but GPs rarely have the option to offer it.

“It is constrained resources within the NHS that mean this hasn’t been a priority for funding,” said Dr Hazel Everitt, a GP and lead author of the study, from the University of Southampton.

By demonstrating the therapy can be successful when delivered through a web tool, or over the phone, the researchers believe that tens of thousands more patients could benefit.

“A lot of people in our trial had symptoms for 10 or 15 years, they’ve tried everything and nothing is helping them,” Dr Everitt added.

“So although they may have been quite sceptical when they came into the trial, they were willing to give it a try and a lot had huge benefits.”

IBS is very common, affecting between 10 and 20 per cent of people in the UK. The condition causes bloating and cramps, as well as bouts of diarrhoea and constipation that can interfere with work, relationships and sufferers’ mental health.

While not all IBS cases are severe around half of patients will consult their GP about symptoms and between 55 per cent and 70 per cent of these will still be experiencing symptoms one year after diagnosis.

This means there are tens, if not hundreds of thousands, of people who could benefit from CBT who might not have the option at the moment.

“I personally think this should be one of the first options [for people with IBS] because it’s an effective treatment,” said Professor Trudie Chalder, from King’s College London, who helped lead the study.

Laura Day, 31 was diagnosed with IBS at age 13. She was sceptical about the trial at first but says it helped her understand how techniques she had been using to avoid problem foods or difficult social situations were “adding fuel to the flames” of her condition.

“There’s no other way of putting it: this trial has changed my life,” she said.

“Everything used to revolve around my IBS, not by choice but through fear of being caught out by my symptoms. Now, at 31 years old, I barely think about it because I’m symptom-free 98 per cent of the time.”

The latest findings, published in the journal Gut, are just part of the work being undertaken by Dr Everitt and colleagues from King’s College London.

They are now working on showing how cost-effective the services are and the potential savings for the NHS and economy if it rolls out these remotely delivered services, compared to face-to-face treatment currently recommended.

While the best results in the trial were seen with telephone-supported CBT, the web based programme also reduced symptom severity by 20 per cent more than medication alone.

The tool is now being considered by the National Institute of Health and Care Excellence, which appraises the cost effectiveness of new treatments, and could be available “within months” on the NHS, the authors said at a briefing.

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