Print Print
CKS is no longer commissioned by the National Institute for Health and Clinical Excellence (NICE). NICE remains committed to providing a replacement service for CKS and is currently reviewing its options. In the meantime, although CKS content is now not being maintained, it still remains relevant and will continue to be made available. CKS content was generated under a programme of topic creation and update. To check if the topic you are viewing is current or out of date, please refer to the topic publication details by clicking on the 'How up-to-date is this topic?' link in the left hand menu on individual topic pages.

Irritable bowel syndrome - Management
When should psychological therapies be considered?

  • Consider referral for psychological interventions for people who do not respond to diet, lifestyle, and drug treatments after 12 months.
    • Cognitive behavioural therapy, hypnotherapy, and/or psychological therapy is recommended.
Basis for recommendation

Basis for psychological interventions

  • This recommendation is from the National Institute for Health and Clinical Excellence (NICE) guidance Irritable bowel syndrome in adults [National Collaborating Centre for Nursing and Supportive Care, 2008; NICE, 2008].
    • There is some evidence in people with long term irritable bowel syndrome (IBS) of a significant global improvement in symptoms after 12 weeks and after 15 months, for dynamic psychotherapy plus medical therapy compared with medical therapy alone. Compared with 'usual treatment', psychotherapy improved global symptoms after 12 weeks, but this improvement was not maintained in the longer term (52 weeks); there was no difference in pain score at 12 weeks, nor at 52 weeks.
    • There is good evidence, mainly in people with psychiatric comorbidities and refractory IBS, of a significant global improvement in symptoms for cognitive behavioural therapy (CBT) compared with no treatment or symptom monitoring. Evidence did not suggest an improvement in individual symptoms with CBT.
    • Evidence on hypnotherapy in the management of irritable bowel syndrome (IBS) is generally poor, making it difficult to draw any conclusions about the efficacy of hypnotherapy for IBS.

© NHS Institute for Innovation and Improvement