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Intervention with Cognitive Behavioral Therapy for subjects with IBS and its effects on visceral perception, abdominal complaints, psychological functioning and gut microbiota

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IBS (Irritable Bowel Syndrome) is a multifaceted condition preferably conceptualized within a biopsychosocial framework that enables understanding of the interactions and the role of stress, pain and fear processing, cognitive-evaluative, sensory-discriminative, motivational-affective, psychosocial, biomedical, physiological and neuroscience factors.

Research suggests that abdominal pain-related fear is a better predictor of disability than is the actual abdominal pain intensity and thus, fear of pain and pain avoidance behaviours are important clinical factors that should be accounted for in the assessment and treatment of chronic abdominal pain and other IBS symptoms. One therapeutic strategy that successfully builds upon this principle is the cognitive behavioural approach that encounters IBS- related fear by confrontation and exposure to the very fear of gut- pain and other IBS- related impairments and results in effective symptom-relief.

The treatment has shown promising results for gastrointestinal symptoms and well-being when delivered over the internet but much remains to be learned about how the treatment can be optimized, its effectiveness when delivered in face-to-face format, and biological markers that are associated with improvement in IBS symptoms.

The aim of the study is to:

- evaluate if an exposure-based CBT treatment leads to improvement (i.e., decrease) visceral perception in subjects with IBS

- evaluate if the results obtained in the several trials of internet-based CBT can be replicated in individual CBT, using the same protocol as in the internet-based trials, with regards to improvement in gastrointestinal symptoms, quality of life, fear and worry about symptoms, avoidance behaviours and psychological wellbeing

- evaluate if CBT can improve biological markers of oxidative stress, barrier function, gene expression as well as gastrointestinal and neuroendocrine hormones in subjects with IBS.


Edebol-Carlman H, Ljótsson B, Linton SJ, Boersma K, Schrooten M, Repsilber D, Brummer RJ. Face-to-Face Cognitive-Behavioral Therapy for Irritable Bowel Syndrome: The Effects on Gastrointestinal and Psychiatric Symptoms. Gastroenterol Res Pract. 2017;2017:8915872.

Boersma K, Ljótsson B, Edebol-Carlman H, Schrooten M, Linton SJ, Brummer RJ Exposure-based cognitive behavioral therapy for irritable bowel syndrome. A single-case experimental design across 13 subjects. Cogn Behav Ther. 2016 Nov;45(6):415-30.

Edebol-Carlman H, Schrooten M, Ljótsson B, Boersma K, Linton S, Brummer RJ. Cognitive behavioral therapy for irritable bowel syndrome: the effects on state and trait anxiety and the autonomic nervous system during induced rectal distensions - An uncontrolled trial. Scand J Pain. 2018 Jan 26;18(1):81-91.

Research groups


  • Brjánn Ljótsson, Dept. of Clinical Neuroscience, Karolinska Institutet