Published 6 January 2009, doi:10.1136/bmj.a3148
Cite this as: BMJ 2009;338:a3148

Letters

Irritable bowel syndrome

Why pills more than skills?

The first 150 words of the full text of this article appear below.

The effectiveness of fibre, antispasmodic drugs, and peppermint oil in irritable bowel syndrome should further increase interest in other low cost, low toxicity interventions.^{1 2}

The heavy emphasis on pharmacotherapy found in so many British and US guidelines on irritable bowel syndrome results in continuing monthly expenditures for patients in the United States, as well as generally encouraging ongoing patient passivity and dependence on the medical system.

Hypnotherapy seems to relieve symptoms as well as or better than pharmacotherapy, with no side effects. However, unlike pharmacotherapy, it also improves quality of life and psychological state, including the sense of self empowerment and self control, which correlate with higher motivation for ongoing self care.³ Furthermore, continual professional treatments are not needed: the beneficial effects from the initial treatments seem to be sustained over time, with patients reporting continued relief from symptoms for at least five years.⁴

A meta-analysis of 17 randomised trials . . . [Full text of this article]

¹ Penny George Institute for Health and Healing, Abbott Northwestern Hospital, Minneapolis, MN 55407, USA, ² Minnesota Head and Neck Pain Clinic, St Paul, MN 55114, USA

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