A patient’s story
Tim, a 41-year-old professional living and working in Canary Wharf, came to see us at LSDC Clinic after years of fluctuating bowel symptoms. Some weeks he struggled with abdominal pain and bloating, other weeks with diarrhoea or constipation. Multiple tests came back normal. Several clinicians reassured him, yet his symptoms continued to disrupt meetings, travel, and social plans.
What frustrated James most was hearing phrases like “stress-related” without any explanation of what that actually meant. He did not feel anxious by nature, and he certainly did not imagine his symptoms. This confusion represents a common experience for people living with irritable bowel syndrome (IBS) and it often opens the door to conversations about cognitive behavioural therapy (CBT).
What is IBS and what it is not
IBS is a functional gastrointestinal condition. That means the bowel looks structurally normal on scans and tests, but it does not function normally.
IBS involves:
Altered gut sensitivity
Disrupted bowel motility
Changes in gut-brain communication
IBS is not:
Inflammatory bowel disease
A psychological illness
Something you cause by worrying
At LSDC Clinic, we explain IBS as a condition of how the gut and nervous system communicate, not a failure of resilience or mindset.
What is cognitive behavioural therapy in IBS?
Cognitive behavioural therapy is a structured psychological therapy that focuses on how thoughts, behaviours, and physical sensations interact.
In IBS, CBT does not aim to convince you that symptoms are imaginary. Instead, it addresses how the brain-gut axis processes pain, urgency, and discomfort.
In simple terms, CBT for IBS helps patients:
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Understand how the nervous system influences gut symptoms
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Reduce symptom amplification
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Develop healthier responses to flare-ups
We view CBT as a way to calm an overactive gut signalling system, not as a replacement for medical care.
Clinical insight from practice at LSDC Clinic
In our clinical work at LSDC Clinic, we see many patients with IBS who feel dismissed before anyone clearly explains the physiology behind their symptoms. This lack of explanation often leads to frustration, fear around eating, and constant monitoring of bowel habits.
Over time, this pattern can increase gut sensitivity. The bowel begins to react more strongly to normal stimuli. Pain thresholds reduce, and symptoms start to feel unpredictable and intrusive.
Cognitive behavioural therapy helps interrupt this cycle by addressing how the nervous system processes gut signals.
Patients who respond well often tell us:
“I understand my symptoms better now”
“Flare-ups feel less overwhelming”
“I feel more in control, even when symptoms appear”
This level of insight rarely appears in generic IBS blogs, yet in real-world clinical care, it often makes a meaningful difference to how patients experience and manage their condition.
IBS, anxiety, and common misunderstandings
IBS vs anxiety disorders
IBS can exist with or without anxiety. Some patients feel calm emotionally but still experience severe gut symptoms.
CBT in IBS does not mean:
You have a mental health diagnosis
Your symptoms are psychological
Medical assessment no longer matters
Instead, CBT recognises that the gut has its own nervous system and that repeated symptoms can train it to overreact.
Why symptoms overlap
IBS symptoms overlap with stress responses because:
The gut contains extensive nerve networks
Stress hormones influence bowel movement and pain perception
Past flare-ups condition future responses
This overlap explains the benefit of CBT without invalidating physical symptoms.
A structured, assessment-led approach
At LSDC Clinic in central London, we always prioritise accurate diagnosis before considering supportive therapies like CBT.
Structured assessment allows us to:
Confirm an IBS diagnosis
Exclude inflammatory, infectious, or hormonal causes
Identify contributing factors such as diet, gut sensitivity, or previous illness
Correct diagnosis matters. Without it, patients often feel blamed rather than supported.
CBT fits best when we use it as part of a broader, evidence-based plan, guided by clinical judgment.
When CBT may be appropriate in IBS
CBT may be worth considering if:
IBS symptoms persist despite reassurance and normal tests
Pain or urgency feels unpredictable or overwhelming
Fear of symptoms limits daily activities
Flare-ups feel worse during periods of stress, even when stress feels manageable
A specialist discussion helps determine whether CBT adds value in your individual case.