Irritable Bowel Syndrome 'partly psychological' after therapy found to be helpful

Irritable Bowel Syndrome (IBS) is partly psychological and can be controlled better through cognitive behavioural therapy (CBT) than with mainstream drugs, a new study has revealed.

The common gut condition affects up to 20% of people and triggers symptoms such as stomach cramps, bloating, diarrhoea and constipation.

Though experts are exactly sure what causes the disorder, it has been linked to things like food passing through your gut too quickly or too slowly, oversensitive nerves in your gut, stress, and a family history of IBS.

Typical treatments to date include antispasmodic drugs, laxatives and medicines that relieve diarrhoea, but a new trial results suggest that the condition is at least partly psychological.

Doctors studied 558 serious IBS sufferers who were either put on a programme of cognitive behavioural therapy (CBT) or received standard care.

READ MORE: One in five women have said no to sex due to IBS symptoms, according to study

The results, reported in the Journal Gut, found that patients in the CBT group were more likely to have experienced significant improvement in their symptoms after a year.

The impact of the condition had on their work and daily life was also significantly less than it was for those not receiving the psychological therapy.

Commenting on the findings lead researcher Dr Hazel Everitt, from the University of Southampton, said: “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.’’

Now the trial researchers are calling to make CBT more widely available to people with IBS.

According to Dr Sonal Shah, NHS GP and Lifestyle medicine expert there are several reasons the latest findings are good news for sufferers including the fact that it reinforces the idea that IBS is a lifestyle and diet related problem.

“It also moves away from the need to take medications that often are not very effective,” she adds.

Dr Shah also says the findings could help patients to get better control of their own symptoms, but availability and funding is key.

“IBS is such a common problem, and the new research may hopefully encourage more funding and availability and accessibility of CBT as it is currently not freely available to all, or may have long waiting lists,” she explains.

“For some IBS can be really debilitating, so anything that is evidence based to improve symptoms, will make a big difference to individual health and overall wellbeing,” she adds.

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What is IBS?

“Irritable bowel condition is a very common disorder affecting the digestive tract. Sometimes I refer to it as a ‘nervous gut’,” says Dr Shah. “It affects up to 1 in 5 people and can be embarrassing, debilitating and problematic for some.”

“Irritable bowel syndrome is not the same as the more serious condition of inflammatory bowel syndrome such as ulcerative colitis and crohn’s disease,” she adds.

What are the symptoms of IBS?

Dr Shah says they can vary from person to person but common symptoms include: abdominal pain, cramps, changes in bowel habits, such as diarrhoea and or constipation, and often alternating between the two.

Other symptoms can include bloating, flatulence, trapped wind, a sensation that the bowels are incompletely emptied, and rectal passing of mucus.

“The condition can also be associated with headaches, fatigue and muscle pains,” Dr Shah adds.

How is IBS currently treated?

“According to NICE guidelines dietary and lifestyle measures is key in to learning to manage the symptoms,” says Dr Shah.

These include drinking adequate fluid, avoiding fizzy drinks, restricting caffeine intake, reducing alcohol intake. Further there is good evidence that relaxation, meditation and other mindfulness practices maybe helpful, as well as increasing physical activity.

“With regards to dietary changes it depends on the nature of an individuals symptoms some benefit from increasing fibre intake, others may need to reduce their fibre intake.

“There is evidence that eating a low FODMAP diet may be helpful, such as eating a limited amount of wheat, onions, legumes and lactose, although we don’t recommend excluding these completely unless supervised by a dietician,” she adds.

Psychological therapies for IBS

The NHS explains that CBT can help if stress or anxiety is triggering sufferers symptoms of IBS. It can also help you cope with your condition better.

If you prefer, you can refer yourself directly to a psychological therapies service without seeing your GP. These offer psychological therapies like CBT for common mental health problems like stress, anxiety and depression.