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Pharmacological therapies for IBS-C are designed to alleviate abdominal discomfort and enhance bowel function. In patients with IBS-C, fiber supplements may help soften stools and decrease straining, but may also lead to increased gas production and bloating. Osmotic laxatives like milk of magnesia are frequently used to soften stools and increase stool frequency in IBS-C patients. In addition, two drugs approved for use in severe IBS-C adult cases are linaclotide (Linzess) and lubiprostone...
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Irritable Bowel Syndrome (IBS) is characterized by functional disturbances in the gastrointestinal system, presenting a cluster of symptoms without evident structural or biochemical abnormalities. It primarily affects the large intestine and may cause abdominal pain, bloating, excessive gas, diarrhea, constipation, or both.
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Internet-Delivered Exposure-Based Cognitive Behavior Therapy for Irritable Bowel Syndrome: A Clinical Effectiveness

Hugo Wallén1, Brjánn Ljótsson1, Perjohan Lindfors2

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Internet-delivered exposure-based cognitive behavior therapy (ECBT) effectively reduced irritable bowel syndrome (IBS) symptoms in a real-world setting. The treatment

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Area of Science:

  • Gastroenterology
  • Psychiatry
  • Digital Health

Background:

  • Irritable bowel syndrome (IBS) is a prevalent and disabling condition.
  • Dietary and pharmacological treatments are not always effective for IBS.
  • Access to psychological interventions for IBS is limited, necessitating technological solutions.

Purpose of the Study:

  • To evaluate the real-world effectiveness of Internet-delivered exposure-based cognitive behavior therapy (ECBT) for IBS.
  • To confirm the mechanism of action for ECBT in IBS treatment.

Main Methods:

  • 309 patients with IBS received 12 weeks of ECBT.
  • Patient outcomes including IBS symptoms, quality of life, avoidance behaviors, and anxiety were monitored.
  • A bivariate cross-lagged panel model analyzed changes in symptoms and avoidance behaviors over time.

Main Results:

  • IBS symptoms significantly decreased from baseline to 6 months post-treatment (P < 0.001).
  • A large effect size (Cohen's d = 1.30) was observed.
  • Reduced avoidance behaviors predicted reduced IBS symptoms, but not vice versa, indicating behavioral change as a mediator.

Conclusions:

  • Internet-delivered ECBT is an effective treatment for IBS in real-world settings.
  • The reduction of avoidance behaviors is a key mechanism driving treatment success.
  • ECBT offers a scalable solution for managing IBS symptoms.