For decades, CBT for IBS has been treated as a psychological add-on — something referred when medications fall short. That framing is now being firmly corrected. With ACG guidelines recommending it as an early-line option and insurers increasingly recognizing it as a frontline treatment, CBT is gaining the clinical standing it has long deserved. The mechanism is biological as much as behavioral: CBT recalibrates brain-gut signaling, and research has demonstrated measurable changes in limbic activity, gut microbial composition, and symptom outcomes — including 61% of patients in a landmark RCT reporting meaningful improvement after just four home-based sessions.
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