Irritable Bowel Syndrome Clinical Trial
Official title:
A Pilot Study of Cognitive-Behaviour Therapy for Irritable Bowel Syndrome and the Gut Microbiome
This study evaluates the effectiveness of a group cognitive behaviour therapy for Irritable Bowel Syndrome (IBS) in decreasing symptoms of IBS, improving quality of life, and normalizing the gut microbiome. Patients will complete an 11-week group cognitive behaviour therapy for IBS within 1 month of being deemed eligible for the study.
Irritable bowel syndrome (IBS) is a chronic, disabling functional gastrointestinal disorder
that is characterized by abdominal pain or discomfort and a disturbance in bowel habit.
Approximately five million Canadians currently suffer with this chronic illness, which can
have a significant impact on work and school absenteeism, productivity, social functioning
and quality of life (Fedorak et al., 2012). Although the etiology of IBS is still unclear,
there is increased interest in the role of the gut-brain axis in the development and
maintenance of IBS. A growing body of evidence has identified changes in the composition,
temporal stability and metabolic activity of the gut microbiome in IBS (Bolino & Bercik,
2010). Moreover, there is evidence for bidirectional communication between the gut and the
brain, such that the gut microbiota appear to influence as well as be modulated by brain
activity through neurohumoral mechanisms (Collins, Surette, & Bercik, 2012).
Currently, medications are the most widely used treatment for IBS (Ford et al., 2009; Ford
et al., 2014). Although there is good evidence for the effectiveness of medications in
reducing IBS symptomatology and improving quality of life, these medications are also often
associated with unpleasant side effects. As a result, there is a growing interest in the
utilization of psychological treatments, including cognitive behaviour therapy, for IBS.
Cognitive behaviour therapy is a psychotherapeutic approach that addresses maladaptive
cognitive processes and behaviours in a systematic, explicit fashion. Although there is good
evidence for the effectiveness of cognitive behaviour therapy for the treatment of IBS (Ford
et al., 2009; Ford et al., 2014), there is a lack of research examining the mechanisms
through which cognitive behaviour therapy influences symptoms of IBS.
Accordingly, the current study has three aims: 1) to evaluate the effectiveness of group
cognitive behaviour therapy for IBS on IBS symptomatology and quality of life; 2) to examine
whether there are any changes in the gut microbiome from pre to posttreatment; and 3) to
examine whether changes in the gut microbiome following cognitive behaviour therapy mediate
changes in IBS symptomatology and quality of life. The current study has the potential of
increasing knowledge about the role of the gut microbiome in IBS as well as the mechanisms
of cognitive behaviour therapy for IBS.
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Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
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