Answer to irritable bowel syndrome is in the mind

IRRITABLE bowel syndrome is partly psychological and can be controlled better by means of mental training than with mainstream drugs, a new trial has shown.

More effective treatment may have come closer for thousands of IBS sufferers after research found that even telephone and webbased cognitive behavioural therapy (CBT) had a significant impact on symptoms. CBT is traditionally offered to a patient face-to-face by a therapist.

IBS, characterised by abdominal pain, bloating and distressing bowel habits, affects up to 20 per cent of people. Its causes are unknown.

Standard treatments include antispasmodic drugs, laxatives and medicines that relieve diarrhoea.

The trial, conducted by Southampton and King’s College London universities, suggests that the condition is significantly psychological in origin. In the trial, 558 serious IBS sufferers were given either CBT or standard care.

The symptoms of those in the CBT group were more likely to have significantly improved after a year, according to the findings, reported in the journal Gut.

The impact of IBS on their work and daily life was also considerably less than for those not receiving the psychological therapy.

CBT is a talking treatment that aims to help people overcome harmful behaviour and ways of thinking. For the study, sessions were conducted over the phone or online.

Dr Hazel Everitt, the lead researcher, from Southampton, said: “The fact that both telephone and web-based CBT sessions were shown to be effective is really important and exciting.

“Patients are able to undertake these treatments at a time convenient to them.”

The National Institute for Health and Care Excellence (Nice) recommends CBT for patients whose IBS symptoms have persisted for 12 months despite medications and lifestyle advice.

However, in practice these services are extremely limited on the NHS.

The researchers said the priority now was to make CBT more widely available, and so they had started to train NHS therapists.

Laura Day, 31, a patient who took part in the study, said: “There’s no other way of putting it – this trial has changed my life.”

She had been diagnosed at 13, but had lived with the symptoms “for as long as I can remember”, she said. Ms Day said that since the trial she had been “symptom-free 98 per cent of the time” and “barely think about” the condition any more.

The techniques she had learnt through CBT had given her a sense of “real control” and changed old behaviours, she added.

“I’ve spent my whole life avoiding certain foods, restaurants and situations, thinking I was controlling my IBS – when I was actually adding fuel to the flame.”