Skip to content

Digital App-based Cognitive Behavioral Therapy Significantly Improves IBS Symptoms

In This Article

  • Irritable bowel syndrome (IBS) is a stress-sensitive disorder, making it an ideal candidate for cognitive behavioral therapy (CBT)
  • In a real-world study, Massachusetts General Hospital researchers and colleagues tested the effectiveness of a 10-session, app-delivered CBT course for patients with IBS
  • They report a significant reduction in IBS symptom severity and perceived stress in patients who completed the digital therapy
  • Lead investigator Mythili Pathipati, MD, presented the findings at this year's American College of Gastroenterology Annual Scientific Meeting

Irritable bowel syndrome (IBS) is a stress-sensitive disorder often associated with early adverse life events, which makes it an ideal candidate for cognitive behavioral therapy (CBT). With a shortage of gastrointestinal-specialized psychologists, digital CBT offers strong potential.

Massachusetts General Hospital researchers recently investigated an app-delivered CBT course for patients with IBS, reporting a significant reduction in IBS symptom severity and perceived stress. Mythili Pathipati, MD, clinical fellow at Mass General and lead investigator on the study, presented their findings at the 2023 American College of Gastroenterology (ACG) Annual Scientific Meeting. The findings were featured in HCPLive.

About the Study

Dr. Pathipati and colleagues conducted a real-world study where patients underwent a 10-session course of app-delivered CBT using the digital therapeutic Mahana IBS. Patients were required to have baseline IBS symptom severity scores (IBS-SSS) available and to have received a prescription for the Mahana IBS digital therapeutic. 324 patients were adherent to the app and completed at least five sessions. 162 individuals finished all 10 sessions.

Analysis revealed IBS-SSS and perceived stress scores (PSS) decreased significantly by week 5 and week 10. IBS-SSS improved from a mean of 266 (standard deviation [SD], ±103) at baseline to 162 (SD, ±112), and PSS improved from a baseline of 22 (SD, ±7) to 17 (SD, ±6) after 10 sessions on the app.

The researchers note some limitations to the study, as sex and ethnicity data were missing from the start of data collection due to user privacy reasons.

Clinical Implications

In IBS clinical trials, an IBS-SSS reduction of 50 points is considered clinically significant. In this analysis, IBS-SSS was reduced by 104 points by week 10, indicating that, on average, patients improved from moderate severity IBS to mild severity IBS upon completion of the therapy. Even partial adherence could produce significant results; in patients who only completed five sessions, IBS-SSS scores improved from 266 (SD, ±103) at baseline to 185 (SD, ±107).

Using further multivariate analyses, the researchers report that patients with higher IBS-SSS at baseline were more likely to have a reduction in symptom severity with CBT. Additionally, they identified three factors that correlated with adherence to the therapy: older age, healthcare provider referral, and payment for the app. Older patients who received a prescription from their healthcare provider and paid for the application were more likely to complete the app-based therapy, reinforcing that the adoption of digital technology is increasing in older adults.

Although in-person CBT is ideal, app-delivered CBT can still prove highly effective and is more accessible for a broader range of patients.

Visit the Division of Gastroenterology

Refer a patient to the Division of Gastroenterology


Ashwin N. Ananthakrishnan, MBBS, MPH, director of the Crohn's and Colitis Center, helped direct the International Organization for the Study of Inflammatory Bowel Diseases (IBD) in issuing guidance about the role of lifestyle and behavior modification in managing Crohn's disease and ulcerative colitis.


Kyle D. Staller, MD, MPH, Braden Kuo, MD, and colleagues created a virtual, group-based Tai Chi program adapted for patients who have irritable bowel syndrome with constipation. In a proof-of-concept study, feasibility of recruitment was excellent, and 67% of 27 participants attended at least seven of eight sessions.