Which behavioral treatments work best for IBS?

Study details: This systematic review and network meta-analysis assessed the relative efficacy of behavioral therapies for adults with irritable bowel syndrome (IBS). Researchers analyzed 67 randomized trials (N=7,441) comparing various interventions—including IBS-specific cognitive behavioral therapy (CBT), gut-directed hypnotherapy, stress management, and digital approaches—against each other or control conditions. Global IBS symptom improvement was the primary outcome, with efficacy ranked using pooled relative risks and P scores.

Results: Several therapies demonstrated significant benefit vs. waiting list control. Minimal-contact CBT (relative risk [RR], 0.55; P score, 0.78), telephone disease self-management (RR, 0.57; P score, 0.75), dynamic psychotherapy (RR, 0.59; P score, 0.72), and standard CBT (RR, 0.65; P score, 0.64) ranked highest. Gut-directed hypnotherapy also showed efficacy (RR, 0.79; P score, 0.39).

Clinical impact: Behavioral therapies—especially brain-gut approaches like CBT and hypnotherapy—offer clinically meaningful symptom relief for IBS. However, confidence in comparative rankings is limited by publication bias and trial quality, underscoring the need for higher-quality research to guide personalized treatment strategies.

Source:

Thakur ER, et al. (2025, October 9). Lancet Gastroenterol Hepatol. Efficacy of behavioural therapies for irritable bowel syndrome: a systematic review and network meta-analysis. https://pubmed.ncbi.nlm.nih.gov/41077057/