Treatment may be the most effective way to relieve irritable bowel syndrome

Treatments that change the behavior of people with irritable bowel syndrome (IBS) may be more effective than current treatments. If delivered digitally, it can also help speed up their relief process.

IBS typically causes bloating, diarrhea, constipation, and abdominal pain. Although its causes are not clear, Disturbed gut and brain signals It is believed to play a major role. Gut infections or certain foods may trigger the digestive system to send alarm signals to the brain, while psychological stress can send it in the other direction, which is why People with IBS are encouraged to find ways to relax.

Dietary advice and medications such as laxatives can help, but for some, symptoms persist, prompting researchers to explore new approaches such as fecal transplantation. As somewhat of a last resort, doctors often turn to behavioral therapies, which a 2020 review suggested It may be more effective than routine care.

These can include cognitive behavioral therapy (CBT), which helps people change the way they think and act to manage and accept their symptoms, and gut-directed hypnotherapy, where people are placed in a trance-like state before receiving suggestions that their symptoms are improving.

As more studies have been published since then, Alexander Ford He and his colleagues, some of whom participated in the previous review, examined 67 randomized controlled trials, including more than 7,000 participants. These compared behavioral treatments that lasted between four and 12 weeks with different control groups who received standard interventions such as nutritional advice or laxatives, or who were on a waiting list for treatment.

“It is the largest review of behavioral IBS treatments in terms of number of studies and participants [to my knowledge]”, He says Bergjohan Lindfors At the Karolinska Institute in Sweden.

The researchers found that cognitive behavioral therapy and gut-directed hypnotherapy — delivered either in person, via an app, or the Internet — were more effective than standard treatments, based on participants comparing their symptoms before and after.

Rather than offering them only after standard interventions no longer help enough, and then usually only offering them in person, the findings suggest that behavioral treatments should be introduced much earlier, with digital approaches helping to achieve results quickly, Ford says. “They can give you a way to scale behavioral therapy to be more widely offered,” he says. But more trials that directly compare digital treatments with standard treatments are needed before the guidelines can be updated, says Ford, who believes this could take another five years.

Additionally, most study participants couldn’t know which group they belonged to, so some of the benefits may be due to the placebo effect, Lindfors says. Experiments in which participants receive either a full form of treatment or only parts of it can help assess the size of this effect, if they are all under the impression that they are receiving actual behavioral therapy, Lindfors says.

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