The IBS Treatment Most People Are Never Offered

July 26, 2026•6 min read

The IBS Treatment Most People Are Never Offered

You have been managing this on your own for a while now. You know which foods you have quietly stopped eating, you know roughly how long you can be away from a loo, and you know the particular tightening in your stomach that arrives when a plan gets confirmed. You have probably had the tests. You may have had the diagnosis. And somewhere along the way you worked out that the appointments were going to be ten minutes long, the advice was going to be about fibre, and the rest of it was going to be down to you. So you got on with it, and you got good at hiding how much of your week it takes up.

Here is the thing that came out of the research this month. It turns out you are not unusual in thinking there might be more help available than you have been offered. Most people with gut symptoms think so too. Almost none of them have ever been asked.

This week's research: open to it, but never offered it

A team led by Diana Veraza at Indiana University and UCLA ran an online survey of 770 adults in the United States, published in Neurogastroenterology & Motility in March 2026. They wanted to know what people actually think about cognitive behavioural therapy for gut conditions, rather than what clinicians assume they think. Of the 770 people, 268 met the Rome IV criteria for a bowel disorder of gut-brain interaction, which is the group that includes IBS, functional constipation, and functional diarrhoea. The rest were people with other gastrointestinal diseases, or people with no gut condition at all, so the researchers could compare.

Two numbers stand out. Just over 70% of participants said they thought CBT could be helpful. Only 12% had ever been offered it. And among the people who knew someone who had actually done CBT, 90% said it had helped that person. People with IBS and related conditions were more familiar with CBT than the comparison groups, which makes sense given how long many of them have been searching. But being more familiar with it made no difference at all to whether anyone had ever suggested it to them. When the researchers asked what got in the way, the answers were practical: not enough trained professionals, cost, and the time and effort involved.

Why this matters for you. If you have never been offered a psychological approach to your gut symptoms, that is not a comment on how bad your symptoms are, or on whether anyone believes you. It is a supply problem. The treatment exists, it is recommended in the guidelines, and the appetite for it is clearly there. There are simply not enough people trained to deliver it, and most short GP appointments never get near the conversation. We looked at what the UK guidelines actually say about this, and the gap between what is recommended and what is offered is one of the more frustrating things about this condition.

Why a talking therapy does anything to a gut at all

This is the question worth answering properly, because the phrase "psychological treatment" still lands badly for a lot of people with IBS. It sounds like a polite way of being told the problem is imaginary.

It is not. IBS is a disorder of gut-brain interaction, which is a description of mechanism rather than a description of blame. Your gut and your brain are in constant two-way conversation along the gut-brain axis, and in IBS that conversation has become louder and more reactive than it needs to be. Normal gut activity, the kind that would pass unnoticed in someone else, gets amplified on its way to the brain and registered as pain or urgency. That is visceral hypersensitivity, and it is a real, measurable change in how signals are processed. Once that is happening, a maintaining loop sets in. Symptoms create anticipation, anticipation creates vigilance, vigilance sharpens the signal, and the loop tightens.

Psychological therapies for IBS work on that loop, not on your character. That is why they show up in the gastroenterology guidelines rather than only in the mental health ones. The British Society of Gastroenterology gives gut-directed hypnotherapy a strong recommendation, and NICE lists it as an option for IBS that has not responded to first-line treatment after twelve months. In well-designed individual trials, gut-directed hypnotherapy has commonly produced response rates in the region of 70 to 80%, with benefits still present at twelve-month follow-up. Those are trial findings rather than guideline claims, and they are worth knowing when you are deciding whether something is worth your time.

The work I do is cognitive behavioural hypnotherapy, which brings CBT, mindfulness, and gut-directed hypnotherapy together rather than picking one. They are all pulling on the same maintaining loop from different angles: CBT on the thoughts and behaviours that keep the loop fed, mindfulness on the vigilance, and gut-directed hypnotherapy on the sensitivity itself. That is a large part of why an integrated approach tends to outperform any single strand of it.

Your top tip this week

Ask a more specific question at your next appointment. The survey found the biggest barrier was not that people refuse this kind of help, it is that nobody raises it. Ten-minute appointments run on whatever gets asked first, and "my IBS is still bad" tends to get answered with another dietary suggestion. So change the question. Try: "My symptoms have not responded to diet and medication. What gut-brain therapies are available to me, either on the NHS or privately?" Naming the category out loud does two useful things. It signals that you already understand your symptoms are physiologically real and modifiable, and it moves the conversation from what you should cut out to what you could add in. Write it down before you go, because the appointment will move faster than you expect.

The takeaway

If you have spent years assuming there was nothing else on offer, this study suggests something more hopeful and more annoying at the same time. There is something else on offer. Most people just never get told about it. That gap is not a reflection of you, and it is not permanent.

If you are curious about what a gut-brain approach would actually look like for your symptoms, that is a conversation I am always happy to have, with no obligation on either side. You can find out more about working with me on the site, or simply keep reading Mind Your Guts each week and take what is useful.

Kathryn is a cognitive behavioural hypnotherapist specialising in IBS. This blog shares research for general information and is not a substitute for medical advice. If your symptoms are new, changing, or accompanied by warning signs such as bleeding, unexplained weight loss, or persistent pain, please see your GP.