Dr Miriam Stoppard: Phone and online therapy give hope to sufferers of irritable bowel syndrome – Miriam Stoppard

Irritable bowel syndrome affects between 10%-20% of the population. It’s a cause of great discomfort, even disability, and lost working days.

Symptoms include bloating, constipation and diarrhoea. There’s no cure, and people with the condition often have recurrent flare-ups. Their lives can be ruled by IBS.

Usual treatment includes maintaining a healthy lifestyle, attention to diet, and medication such as laxatives and antispasmodics. Face-to-face cognitive behavioural therapy helps, but it’s hard to get on the NHS , and some people find it difficult to attend appointments.

Options, such as web and telephone therapy can help overcome these obstacles, but their effectiveness for IBS has yet to be proven.

But now, a large, new study in the British Medical Journal outlines that web and telephone therapy delivered by a trained therapist could be a promising alternative to face-to-face CBT.

This trial included 558 people with irritable bowel syndrome that hadn’t responded to usual treatments. They were recruited from 74 general practice surgeries and three gastroenterology outpatient clinics around the UK.

People were divided into three groups and each group received treatment as usual or via the web or telephone. The study was aimed at fostering healthy eating patterns, managing stress, and lessening patients’ focus on symptoms.

The telephone group received a self-help manual and eight hours of telephone therapist support. The web participants received online access to an interactive website and 2.5 hours of telephone therapist support.

Assessments were undertaken before the study started and at three, six and 12 months.

According to the irritable bowel syndrome severity score (IBS-SS) – a scale of 0 (not affected) to 500 (severe) – all groups saw a sustained lessening of symptoms at 12 months.

The telephone cognitive behavioural therapy group fell 61.6 points lower than the usual treatment group, with the web cognitive behavioural therapy group 35.2 points lower. The authors had previously determined that a 35 point change between groups was a definite improvement.

The results were also measured by the work and social adjustment scale, scored between 0 (not affected) and 40 (severely affected). A slight improvement was seen in the treatment-as-usual group where scores improved from 12.4 to 10.8. Scores in the telephone cognitive behavioural group improved to 3.5 points lower than the treatment-as-usual, with the web cognitive behavioural group 3.0 points lower than the usual treatment group.

Easy, convenient and available, this clearly gives new hope.

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