Online cognitive therapy for irritable bowel syndrome (IBS)
About one in ten people have IBS. It is a chronic condition caused by problems in the communication between the brain and gut.
The key symptom is tummy pain linked to changes in bowel frequency (going to the toilet more/less often), stool consistency (hard/watery) and often bloating/wind. Psychological factors such as stress, micro-organisms (bugs) living in the gut and certain foods can all trigger symptoms. IBS has no cure and incurs significant health costs, estimated at €8billion per year in Europe.
Whole person care
In line with our interest in whole person care, we set out to understand the way psychological factors may bring on or worsen IBS. We showed that people who were more stressed, anxious, ‘boom-and-bust’ in response to symptoms, and thought negatively about their IBS symptoms were more likely to get IBS after food poisoning.
In another study, we showed certain avoidance/safety behaviours such as not going out unless knowing where toilets are and erratic eating made symptoms worse. This helped us develop a new treatment based on cognitive behavioural therapy (CBT), specific to IBS.
Individualised CBT approach
The treatment includes an individualised approach to how thoughts, feelings and behaviours affect bowel functioning. We ran three trials, including substantial input from people with IBS, where we improved the treatment and created a digital version, Regul8. With colleagues from Southampton University, we successfully completed the largest trial of CBT in IBS. Both therapist and web-delivered CBT were effective at reducing the severity and impact of IBS symptoms and distress.
The guidance manuals for delivering therapist-delivered CBT helped define core national clinical training competencies for IBS treatment for the Improving Access to Psychological Therapies (IAPT) services throughout England. We have trained over 500 IAPT therapists to deliver the treatment with materials made freely available.
Licensed and NICE approved
Regul8 has now been licensed by King’s College London to a US company, Mahana Therapeutics. It is one of few digital therapies approved by the National Institute for Health and Care Excellence for implementation in practice. Renamed Mahana IBS by the company, the product is the world's first FDA and CE cleared digital therapy providing gut-directed CBT.
The Mahana UK Team are now piloting use of the Mahana IBS at IAPT and Gastroenterology NHS services and have been selected to be part of the prestigious NHS London Digital Health Accelerator Programme in 2022. Mahana IBS has the opportunity to transform access to CBT by offering a user-friendly and accessible new treatment option for millions of IBS patients who could benefit. The Mahana IBS Online Programme (Therapist Guided) and the Mahana IBS App (Self-Guided) is now available in the UK at pilot sites through the NHS.
IMPACT AREAS:
Whole Person Care | Novel Diagnostics and Therapeutics | Industry Collaboration | Improving Access and Uptake
