Psychological treatment essential for children with gut disease, new study shows

New research carried out at Cambridge University Hospitals (CUH) highlights the urgent need for more NHS clinical psychology appointments to treat growing numbers of bowel conditions in children.

Traditionally, bowel disorders would have been treated by medical doctors specialising in physical health, but there is a growing understanding of the critical importance of treating these conditions psychologically.

The latest study, published in the European Journal of Paediatrics was carried out by a team led by Dr Matthias Zilbauer, University Lecturer and Honorary Consultant in Paediatric Gastroenterology at Cambridge University. 

The report highlights an “urgent need” to offer both physical and mental health services when treating children with gastrointestinal diseases.

It’s a pioneering concept that doctors at CUH hope will be addressed by the new Cambridge Children’s Hospital. 

Planned for completion on the CUH site in 2026, Cambridge Children’s will be the first hospital of its kind to combine mental and physical healthcare, treating the whole child, not just their illness or condition. 

This in turn will help the increasing number of children referred to CUH from across the east of England who require psychological support to help them cope with abdominal pain, vomiting, constipation and indigestion, with most referrals made for functional gastrointestinal disorders (FGIDs) or Inflammatory Bowel Disease (IBD). 

A combination of psychological, social, environmental factors have led CUH along with other Paediatric Gastroenterology Centres across the UK and Germany to witness a substantial rise in the number of children needing clinical support for bowel complaints.

According to the study, of the many thousands referred to hospital every year, an estimated 13 per cent will require psychological support.

While the link between altered gut function and mental health has long been recognised – increasing numbers mean there is now an urgent need for strategic action to be taken to help hospitals address this issue.

Dr Sally Benson, Paediatric Psychological Medicine Service lead at CUH and co-author of the report, said: “Recognising this link – and providing the dedicated mental health support our children and young people need – is vital if we are in any way going to address this issue. 

“At CUH nearly 1000 children have been identified as needing mental health support to help manage their conditions over the last eight years. This went from just 30/year in 2010 to a peak of 169/year in 2016.

“While it’s easy to understand how these debilitating conditions cause mental health problems, because of pain or embarrassment, few people realise such clear physical symptoms can also be caused by mental health problems, such as anxiety or depression.”

Offering children dedicated psychological support to help them understand their conditions and manage their symptoms with coping strategies can have a dramatic impact on their health.

Researchers found that when a small group of children and young people at CUH were able to access the mental health support they needed, 95 per cent saw an improvement in their physical symptoms after only 2-3 appointments with a psychologist.

But sadly the research also highlights that the importance of providing psychological services is “insufficiently recognised.” And it concludes that in many cases an increase in the number of referrals is not being matched by sufficient increase in availability of clinical psychology, which in many cases is leading to longer waiting times.  

University lecturer and honorary consultant paediatric gastroenterologist at CUH, Dr Matthias Zilbauer, added: “There is a real opportunity to better educate paediatric gastroenterologists to deliver more psychologically informed care and prioritise the funding of mental health support in children with chronic symptoms. Without this, children will continue to receive medical interventions and treatment for symptoms that may well have psychological origins.”

Dr Rob Heuschkel, Consultant Paediatric Gastroenterologist at CUH, is heading up a plan to address these issues in his role as clinical director for the new Cambridge Children’s hospital. The new hospital is a unique collaboration between Cambridge University Hospitals, the University of Cambridge and the Cambridgeshire and Peterborough NHS Foundation Trust.

Together they will combine their expertise, experience and shared vision for the future with the support of visionary philanthropists to create a visionary new children’s hospital. 

Rob explained: “Cambridge Children’s will be the first of its kind to fully integrate mental and physical healthcare for all children, regardless of their illness or condition. For children with gastrointestinal disorders it means we will be able to combine the very best medical knowledge and scientific research with the psychological support that children so desperately need, enabling us to treat the whole child, and ultimately improve outcomes for the rest of their life.”To find out more visit cambridgechildrens.org.uk or access the full report here: The growing gap between demand and availability of clinical psychology in Paediatric Gastroenterology: a retrospective analysis of clinical routine care