A Pilot Study of Cognitive-Behaviour Therapy for Irritable Bowel Syndrome and the Gut Microbiome
试验速览
- 阶段
- 不适用
- 状态
- 终止
- 入组人数
- 6
- 试验地点
- 2
- 主要终点
- IBS Quality of Life
研究概览
简要总结
This study evaluates the effectiveness of a group cognitive behaviour therapy for Irritable Bowel Syndrome (IBS) in decreasing symptoms of IBS, improving quality of life, and normalizing the gut microbiome. Patients will complete an 11-week group cognitive behaviour therapy for IBS within 1 month of being deemed eligible for the study.
详细描述
Irritable bowel syndrome (IBS) is a chronic, disabling functional gastrointestinal disorder that is characterized by abdominal pain or discomfort and a disturbance in bowel habit. Approximately five million Canadians currently suffer with this chronic illness, which can have a significant impact on work and school absenteeism, productivity, social functioning and quality of life (Fedorak et al., 2012). Although the etiology of IBS is still unclear, there is increased interest in the role of the gut-brain axis in the development and maintenance of IBS. A growing body of evidence has identified changes in the composition, temporal stability and metabolic activity of the gut microbiome in IBS (Bolino & Bercik, 2010). Moreover, there is evidence for bidirectional communication between the gut and the brain, such that the gut microbiota appear to influence as well as be modulated by brain activity through neurohumoral mechanisms (Collins, Surette, & Bercik, 2012).
Currently, medications are the most widely used treatment for IBS (Ford et al., 2009; Ford et al., 2014). Although there is good evidence for the effectiveness of medications in reducing IBS symptomatology and improving quality of life, these medications are also often associated with unpleasant side effects. As a result, there is a growing interest in the utilization of psychological treatments, including cognitive behaviour therapy, for IBS. Cognitive behaviour therapy is a psychotherapeutic approach that addresses maladaptive cognitive processes and behaviours in a systematic, explicit fashion. Although there is good evidence for the effectiveness of cognitive behaviour therapy for the treatment of IBS (Ford et al., 2009; Ford et al., 2014), there is a lack of research examining the mechanisms through which cognitive behaviour therapy influences symptoms of IBS.
Accordingly, the current study has three aims: 1) to evaluate the effectiveness of group cognitive behaviour therapy for IBS on IBS symptomatology and quality of life; 2) to examine whether there are any changes in the gut microbiome from pre to posttreatment; and 3) to examine whether changes in the gut microbiome following cognitive behaviour therapy mediate changes in IBS symptomatology and quality of life. The current study has the potential of increasing knowledge about the role of the gut microbiome in IBS as well as the mechanisms of cognitive behaviour therapy for IBS.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 70 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Diagnosed with irritable bowel syndrome
- •Able to commit to attending weekly 2-hour group sessions for 12 weeks
排除标准
- •Use of antibiotics, or probiotics during the 4-week period prior to enrolling in the study
- •Changes in medications during the 4-week period prior to enrolling in the study
- •Presence of a major medical illness that may change the gut microbiome (e.g., any comorbid gastroenterological, rheumatological, or immunological disorder)
- •Diagnosis of a major psychiatric disorder that is likely to impede participation in group therapy (e.g., depression with active suicidality, psychosis, or gross cognitive impairment)
- •Received psychotherapy for IBS within the past 5 years
- •Inability to read or complete symptom diaries or questionnaires
- •Inability or unwillingness to provide or sign informed consent
结局指标
主要结局
IBS Quality of Life
时间窗: Baseline to 11 weeks
Changes in gut microbiome as assessed through analyzing fecal samples
时间窗: Baseline to 11 weeks
Birmingham IBS Symptom Scale
时间窗: baseline to 11 weeks
次要结局
- Hospital Anxiety and Depression Scale(Baseline to 11 weeks)
- Anxiety Sensitivity Index(Baseline to 11 weeks)
- GI-Cognitions Questionnaire(Baseline to 11 weeks)
- Visceral Sensitivity Index(11 weeks to 15 weeks)
- Penn State Worry Questionnaire(Baseline to 11 weeks)
- UCLA Symptom Severity Scale(11 weeks to 15 weeks)
- Irritable Bowel Syndrome Symptom Severity Scale(Weekly for 11 weeks)
- Birmingham IBS Severity Scale(11 weeks to 15 weeks)
- IBS Quality of Life(11 weeks to 15 weeks)