CBT for Chronic Gastrointestinal Disorders: They’re More Common Than You Think!

Gastrointestinal disorders of all kinds are exacerbated by stress and are also stressful. Irritable Bowel Syndrome (IBS) is a highly prevalent (approximately 10% of the general population but up to 30% of psychiatric treatment seeking individuals) disorder of gut-brain (or central-enteric) interaction that is highly co-morbid with anxiety disorders and depression and shares conceptual overlap with panic disorder, agoraphobia, social anxiety and ARFID.  It also leads to considerable disability and distress.  Managing these patients effectively requires a good conceptual understanding of the biopsychosocial and cognitive underpinnings of IBS as well as the kinds of avoidance behaviors (both obvious and subtle) that maintain and often exacerbate both symptoms and disability.  General CBT skills are essential, but incorporating GI specific phenomena (like bowel control anxiety and fear of food) are also important.  There is significant empirical evidence supporting the use of CBT in treating IBS, including multiple RCTs. 

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