Clin Gastroenterol Hepatol. 2023 Sep 22:S1542-3565(23)00749-8.doi: 10.1016/j.cgh.2023.09.013. Online ahead of print.

Darren M Brenner ¹, Amy M Ladewski ², Sarah Wimberly Kinsinger ³

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Clin Gastroenterol Hepatol. 2023 Sep 22:S1542-3565(23)00749-8.doi: 10.1016/j.cgh.2023.09.013. Online ahead of print.

Darren M Brenner ¹, Amy M Ladewski ², Sarah Wimberly Kinsinger ³

Abstract

Background: Irritable bowel syndrome (IBS) is a common, debilitating disorder characterized by abdominal pain and disordered bowel habits. Current pharmacological treatments often provide incomplete symptom relief and may be poorly tolerated. Furthermore, alleviation of gastrointestinal symptoms does not always translate into improved quality of life (QOL) for IBS patients. Current treatment guidelines recommend brain-gut behavior therapy (BGBT) in conjunction with other IBS therapies, and in randomized controlled trials, BGBT has been shown to improve symptoms, patient satisfaction, functioning, and QOL. Access to BGBT is limited by lack of adequately trained gastrointestinal psychologists, patient time constraints, and cost. Furthermore, clinician knowledge that BGBT is specific, and different from psychotherapy approaches for common mental health disorders may limit referrals even where available.

Aim: This review provides an overview of the pathophysiology of IBS, disease burden, unmet therapeutic needs, evidence base of novel digital therapeutics for IBS, and guidance on the introduction and appropriateness of these interventions for patients.

Methods: We searched the literature for available published data relating to the use of novel digital therapeutics to provide cognitive behavioral therapy (CBT) and gut-directed hypnotherapy in the treatment of irritable bowel syndrome.

Results: Clinical trial data support the development and utility of digital therapeutics designed to deliver self-guided CBT and hypnotherapy for the treatment of IBS.

Conclusion: BGBTs are effective, guideline-recommended treatments for IBS. Digital therapeutic devices offer accessible, cost-effective treatment options for delivery of adjunctive BGBT for the treatment of IBS. The decision to recommend digital BGBTs should be guided by careful patient assessment that includes mental health screening and risk assessment.