title: Gut-directed hypnotherapy for irritable bowel syndrome: piloting a primary care-based randomised controlled trial.
abstract: BACKGROUND
  In western populations irritable bowel syndrome (IBS) affects between 10% and 30% of the population and has a significant effect on quality of life. It generates a substantial workload in both primary and secondary care and has significant cost implications. Gut-directed hypnotherapy has been demonstrated to alleviate symptoms and improve quality of life but has not been assessed outside of secondary and tertiary referral centres.
  
  
  OBJECTIVE
  To assess the effectiveness of gut-directed hypnotherapy as a complementary therapy in the management of IBS.
  
  
  METHODS
  Randomised controlled trial.
  
  
  METHODS
  Primary care patients aged 18-65 years inclusive, with a diagnosis of IBS of greater than 6 weeks' duration and having failed conventional management, located in South Staffordshire and North Birmingham, UK.
  
  
  METHODS
  Intervention patients received five sessions of hypnotherapy in addition to their usual management. Control patients received usual management alone. Data regarding symptoms and quality of life were collected at baseline and again 3, 6, and 12 months post-randomisation.
  
  
  RESULTS
  Both groups demonstrated a significant improvement in all symptom dimensions and quality of life over 12 months. At 3 months the intervention group had significantly greater improvements in pain, diarrhoea and overall symptom scores (P<0.05). No significant differences between groups in quality of life were identified. No differences were maintained over time. Intervention patients, however, were significantly less likely to require medication, and the majority described an improvement in their condition.
  
  
  CONCLUSIONS
  Gut-directed hypnotherapy benefits patients via symptom reduction and reduced medication usage, although the lack of significant difference between groups beyond 3 months prohibits its general introduction without additional evidence. A large trial incorporating robust economic analysis is, therefore, urgently recommended.
authors.affiliation: Department of Primary Care and General Practice, Division of Primary Care, Public and Occupational Health, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK. robertslz@adf.bham.ac.uk
authors.forename: Lesley
authors.initials: L
authors.lastname: Roberts
authors.forename: Sue
authors.initials: S
authors.lastname: Wilson
authors.forename: Sukhdev
authors.initials: S
authors.lastname: Singh
authors.forename: Andrea
authors.initials: A
authors.lastname: Roalfe
authors.forename: Sheila
authors.initials: S
authors.lastname: Greenfield
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005194:Family Practice; D005260:Female; D006801:Humans; D006990:Hypnosis / Q000379:methods*; D043183:Irritable Bowel Syndrome / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011788:Quality of Life; D016896:Treatment Outcome