Abstract

Irritable bowel syndrome (IBS) is not always readily responsive to conventional therapy. Hypnotherapy is effective but time consuming and labour intensive. Preliminary data suggested equivalent value from a specially devised audiotape. Tape use is now compared with gut-directed hyponotherapy in a randomised controlled trial. Consenting patients (n = 52; 37 women) with established IBS were recruited to a 12-week study. All had failed dietary and pharmacological therapy. The median age was 37 years (range 19-71); median symptom duration was 60 months (8-480). Randomisation was to six sessions of individual hypnotherapy, or to the tape, with stratification according to predominant symptom. Symptom scores and validated psychological questionnaires were utilised. Twenty-five patients (18 women) received hypnotherapy, 27 the tape. Successful trance was induced in all hypnotherapy patients. By intention to treat, symptom scores improved in 76% of hypnotherapy patients and in 59% of tape patients (not significant). Amongst 45 patients providing a full set of symptom scores there was advantage to hypnotherapy, with a reduction in median score from 14 to 8.5 compared to an unchanged score of 13 in audiotape patients (P < 0.05). The assessor considered 52% in each group to have improved. Those with greater initial anxiety tended to be more compliant and more likely to respond. Gut-directed hypnotherapy and audiotapes appear valuable in resistant IBS. Although probably inferior to hypnotherapy, the ease and economy of tape use may be considered sufficient to recommend it as a second-line option in IBS, reserving hypnotherapy for failures.