Cognitive–behaviour therapy as a treatment for irritable bowel syndrome: a pilot study


  • Philip Boyce,

  • Jemma Gilchrist,

  • Nicholas J. Talley,

  • Donna Rose

  • Department of Psychological Medicine, The University of Sydney, Clinical Sciences Building, Nepean Hospital, PO Box 63, Penrith, New South Wales 2751, Australia. Email:

  • Nicholas J. Talley, Professor

  • Department of Medicine, The University of Sydney, Nepean Hospital, Sydney, Australia

  • Received 23 July 1999; revised 15 December 1999; accepted 17 December 1999.

PhilipBoyce Professor (Correspondence); Jemma Gilchrist, Research Psychologist, Donna Rose, Professor


Objective: The irritable bowel syndrome (IBS) is a chronic and often disabling functional bowel disorder. Psychological treatments, in particular cognitive and behavioural interventions, have been shown to be effective for this disorder. The aim of this study was to test the efficacy of a cognitive–behaviour program.

Method: Eight participants (seven female, one male) aged between 24 and 71 years, with a diagnosis of IBS according to the Rome criteria, were recruited from among the gastroenterology outpatients at Nepean Hospital, in Sydney, Australia. Participants were administered pretreatment on measures of psychological function and bowel symptom severity. Following a 2-week baseline period, participants began a structured psychological treatment comprising eight sessions of cognitive–behaviour therapy. Throughout treatment, participants maintained daily records of symptom severity and completed homework assignments to ensure treatment compliance. The pretreatment assessment measures were repeated 1 week post-treatment.

Results: After treatment, five of the eight patients no longer met the Rome diagnostic criteria for IBS. There was no significant reduction in bowel symptom frequency. There were, however, significant improvements in the distress and disability associated with bowel symptoms. Anxiety and depression were also significantly reduced.

Conclusions: Cognitive–behaviour therapy reduced the distress and disability associated with IBS, but not the frequency of bowel symptoms. This supports the proposed cognitive model for IBS, and cognitive–behaviour therapy appears to have its effect by altering the cognitive response to visceral hypersensitivity.