IDDF2019-ABS-0189 Yoga-enhanced cognitive behavioural therapy (Y-CBT) versus rifamixin-probiotic sequential treatment for irritable bowel syndrome (IBS): a randomised clinical trial

Abstract Background Irritable bowel syndrome (IBS) is a common disease that affects the quality of life (QOL) and social functioning of sufferers. Visceral anxiety is currently considered a key factor in the onset and exacerbation of IBS, and cognitive-behavioural therapy (CBT) targeting visceral anxiety is thought to be effective. However, access to CBT is limited due to the lack of trained therapists, the substantial time required for therapy and the associated costs. Group CBT (GCBT) may solve some of these problems. We have therefore planned this trial to examine the efficacy of GCBT for IBS. Methods The trial is a two-armed, parallel group, open label, stratified block randomized superiority trial. The study group will consist of 112 participants (aged 18–75 years) with IBS (Rome-III or IV criteria). Participants will be randomly allocated 1:1 to (i) the intervention group: ten-week GCBT plus treatment as usual (TAU) or (ii) the control group: waiting list (WL) plus TAU. The co-primary outcomes are the change in IBS severity or disease-specific quality of life from baseline to week 13 which is 1 month after the end of treatment. The efficacy of GCBT for IBS will be examined through mixed-effects repeated-measures analysis. Discussion GCBT, if found effective, can address the issues of the shortage of therapists as well as the time required and the costs associated with individual CBT. Clinically, the findings will help make effective CBT programmes accessible to a large number of distressed IBS patients at lower costs. Theoretically, the results will clarify the relationship between IBS and psychological stress and will help elucidate the underlying mechanisms of IBS. Trial registration UMIN, CTR-UMIN000031710. Registered on March 13, 2018.

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How can cognitive behavioural therapy help irritable bowel syndrome?

Gastrointestinal Nursing ◽

10.12968/gasn.2010.8.4.48069 ◽

2010 ◽

Vol 8 (4) ◽

pp. 11-14 ◽

Cited By ~ 1

Keyword(s):

Irritable Bowel Syndrome ◽

Cognitive Behavioural Therapy ◽

Behavioural Therapy ◽

Cognitive Behavioural ◽

Irritable Bowel

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Do Symptoms of Irritable Bowel Syndrome Improve when Patients Receive Cognitive Behavioural Therapy for Co-morbid Anxiety Disorders in a Primary Care Psychological Therapy (IAPT) Service?

Behavioural and Cognitive Psychotherapy ◽

10.1017/s1352465817000200 ◽

2017 ◽

Vol 45 (5) ◽

pp. 433-447 ◽

Cited By ~ 6

Author(s):

Mark Kenwright ◽

Jason McDonald ◽

Jo Talbot ◽

Kinza Janjua

Keyword(s):

Primary Care ◽

Irritable Bowel Syndrome ◽

Anxiety Disorders ◽

Cognitive Behavioural Therapy ◽

Behavioural Therapy ◽

Psychological Therapy ◽

Public Places ◽

Cognitive Behavioural ◽

Irritable Bowel

Background: Irritable bowel syndrome (IBS) is a common co-morbid condition with anxiety disorders, and patients often report a fear of incontinence in public places. This type of bowel control anxiety (BCA) can be conceptualized as a phobic syndrome. Yet little evidence exists on the prevalence or outcomes of these co-morbidities in routine primary care psychological therapy (Improving Access to Psychological Therapies, IAPT) services. Aims: To examine the prevalence and outcomes of IBS and BCA patients treated with cognitive behavioural therapy (CBT) for anxiety disorders within a routine IAPT service. Method: An observational cohort study screened 2322 referrals to an IAPT service over 12 months for the presence of IBS. Patients with co-morbid anxiety disorders and IBS were grouped into those with, and without BCA. Patients completed the IBS symptom severity scale and the IAPT minimum data set. Diagnoses and outcomes were examined for all groups up to 6 months follow-up. Results: A greater proportion of BCA patients had a primary diagnosis of phobic disorder. After receiving CBT, patients made clinically significant improvement in both anxiety and IBS symptoms at 6 months follow-up. Patients with BCA made greater improvement in phobia scales and IBS symptoms than non-BCA patients. Conclusions: Anxiety disorders with co-morbid IBS improved significantly in a routine IAPT service. A significant proportion of co-morbid IBS sufferers had a fear of incontinence in public places (BCA). Directly addressing and modifying these fears with CBT appeared to enhance improvement in both phobic anxiety and IBS symptoms.

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