Irritable bowel syndrome (IBS) is a common disorder associated with profoundly impaired quality of life and emotional distress. The management of refractory IBS symptoms remains challenging and non-pharmacological therapeutic approaches have been shown to be effective. We compared brief interventions with
biofeedback and
hypnotherapy in women referred by their GP with refractory IBS symptoms. Patients were randomised to one of two treatment groups,
biofeedback or
hypnotherapy, delivered as three one-hour sessions over 12 weeks. Symptom assessments were undertaken using validated, self-administered questionnaires. Two of the 128 consecutive IBS patients suitable for the study declined to consider nonpharmacological
therapy and 29 patients did not attend beyond the first session. Of the 97 patients randomised into the study, 21 failed to attend the
therapy session; 15 of 76 patients who attended for
therapy dropped out before week 12 post-
therapy. The mean (SD) change in IBS symptom severity score 12 weeks post-treatment in the
biofeedback group was -116.8 (99.3) and in the
hypnotherapy group -58.0 (101.1), a statistically significant difference between groups (difference=-58.8, 95% confidence interval [CI] for difference [-111.6, -6.1], p=0.029). In 61 patients with refractory IBS,
biofeedback and
hypnotherapy were equally effective at improving IBS symptom severity scores, total non-gastrointestinal symptom scores and anxiety and depression ratings during 24 weeks follow-up.
Biofeedback may prove to be the more cost-effective option as it requires less expertise.