CBT for IBS by Phone or Online: What a 558-Person Trial Found
Bloating & DigestionArticleIf IBS has lasted a year or more despite diet changes and medicines, therapy aimed at the gut can still help, and it doesn't have to be in an office. In the UK ACTIB trial, eight hours of phone CBT cut symptom scores by about 62 points at a year and 40 at two years. A web program with brief calls helped too, though its symptom gain faded by year two. Here is what was involved.
Being sent to a therapist for a gut problem can sound like being told it’s all in your head. The ACTIB trial measured gut symptoms, in people whose IBS hadn’t budged with ordinary treatment.
Who was in it
- 558 adults whose IBS had caused significant symptoms for at least a year despite first-line treatments.1
- Recruited from 74 general practices and 3 hospital clinics in London and the South of England. 76% were women, average age 43.1
What each group got
| Group | What it involved |
|---|---|
| Phone CBT | A self-help manual with homework, six 1-hour phone sessions with a therapist over 9 weeks, and two booster calls at 4 and 8 months: 8 hours of therapist time1 |
| Web CBT | An online program called Regul8, three 30-minute calls, and two short boosters: 2.5 hours of therapist time1 |
| Usual care | Whatever care they were already getting1 |
What happened
On the IBS Symptom Severity Score (0 to 500), compared with usual care:
| At 12 months | At 24 months | |
|---|---|---|
| Phone CBT | 61.6 points lower1 | 40.5 points lower2 |
| Web CBT | 35.2 points lower1 | 12.9 points lower, no longer a clear difference2 |
At two years, a drop of 50 points or more from the start was seen in 71% of the phone group, 63% of the web group and 46% of the usual-care group.2 Both CBT groups also did better on work and social life at two years.2 No harms were linked to treatment.12
The limits
People knew which group they were in.1 Only 58% were followed to two years.2 And 91% were white, all from southern England.1
How to ask for it
CBT for IBS is a specific, gut-focused program, not general talk therapy. Ask whether it’s available by phone, video or online where you live. If hypnosis appeals more, see gut-directed hypnotherapy for IBS. For the basics, see what IBS is and can stress upset your stomach?
Try: “My IBS hasn’t improved after a year of diet changes and medicine. Is IBS-specific CBT available to me, by phone or online?”
Bloated by Dinner covers this in Chapter 10, “Gut Feelings,” in a section called “Therapy by Phone.” Its Belly Clock gives you a before-and-after record, so you can see whether a few months of therapy changed your evenings. See the book.
This article is for general educational purposes only and is not medical advice. It isn't a substitute for diagnosis or treatment from a qualified healthcare professional who knows your health history. New bowel changes after 50, blood in your stool, weight loss you can't explain, anemia or waking at night with diarrhea need tests before anything is called IBS. Girl Playbook does not endorse any specific product, test, or provider.
Girl Playbook sells this book. It provides education and worksheets, not individualized medical care.
Sources
The research behind this article, in the order it’s cited. How we source our articles.
- Gut journal (via PubMed Central), 2019Assessing telephone-delivered cognitive-behavioural therapy (CBT) and web-delivered CBT versus treatment as usual in irritable bowel syndrome (ACTIB): a multicentre randomised trial (opens in a new tab)abcdefghij
- Lancet Gastroenterology & Hepatology (abstract via PubMed), 2019Cognitive behavioural therapy for irritable bowel syndrome: 24-month follow-up of participants in the ACTIB randomised trial (opens in a new tab)abcdef
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