The latest research about IBS indicates that the brain–gut axis plays a key role in the disorder, and the presence of psychological factors contribute to symptom severity. Psychological treatment as a whole have demonstrated good results in reducing the severity of IBS symptoms. Cognitive Behavioral Therapy (CBT) has been tested most rigorously and consistently demonstrates significant and long lasting effects on IBS symptoms and quality of life.
Cognitive behavioral therapy (CBT) is a common type of talk therapy (psychotherapy). You work with a mental health professional (psychotherapist or therapist) in a structured way, attending a number of sessions. CBT helps you become aware of inaccurate or negative thinking so you can view challenging situations more clearly and respond to them in a more effective way.
Research has identified several psychological and central processing mechanisms that contribute to brain–gut dysregulation, including visceral hypersensitivity, central processing deficits, and visceral anxiety. These central processes are thought to contribute to the development and maintenance of IBS, and psychological treatments targeting these cognitive processes can directly influence the brain–gut axis and lead to symptom improvement.
Visceral hypersensitivity is one of the hallmark features of IBS and refers to an increased tendency to experience pain or discomfort in response to normal bowel functions. This has been demonstrated in research studies during which IBS patients have much lower pain tolerance for rectal balloon distension than healthy controls. Nerves in patients with IBS send amplified pain signals to the brain in response to normal bowel functioning. This is why normal amounts of gas in the intestines or muscle contractions of the colon can be perceived as highly painful for someone with IBS.
The GI tract is highly susceptible to the effects of stress, and stress is a significant contributor to brain–gut dysregulation in IBS. Research has shown that stress is associated with the onset of IBS and with more severe symptoms.
Components of CBT treatment for IBS:
- Cognitive restructuring
- Problem-solving skills
- Exposure techniques
The Rome GastroPsych Group was formed by US-based GI clinical health psychologists based on a need to connect and support an emerging, international group of professionals interested in the clinical and scientific intersection of psychology and gastroenterology. The Rome GastroPsych Group provides an online directory of therapists.
Psychol Res Behav Manag. 2017; 10: 231–237.
Mayo Clinic: Cognitive Behavioral Therapy
Last updated on Jan 12, 2021