Pain is a common symptom of inflammatory bowel disease (IBD) and has a significant impact on patient quality of life. Up to 70% of patients experience pain in active disease, and up to half (20-50%) of patients will experience pain in remission. Pain in IBD is widely recognised as a biopsychosocial construct, with visceral hypersensitivity, as well as depressive symptoms, anxiety, stress and fear-avoidance, correlating positively with IBD pain. There is an increasing understanding of the psychological interaction and the need for psychological management within IBD. Although ACT (Acceptance and Commitment Therapy) has not been used specifically for pain in IBD, it has become a regular therapy in the management of chronic pain, particularly in relation to improving functioning, quality of life and physical wellbeing and decreasing distress.

This study is a crossover randomised controlled trial of ACT versus treatment-as-usual (TAU) in people with Crohn’s disease (CD) and chronic abdominal pain to assess the feasibility of ACT for reducing the impact of abdominal pain and its associated psychological burden in people with CD. We will investigate the acceptability of ACT to people with CD and chronic pain, specifically testing issues of eligibility, recruitment, retention rates, patient experience and performance of proposed outcome measures. This will inform the design of a subsequent large multi-centre randomised controlled trial (RCT) with long-term follow-up.