Whorwell 1984: landmark gut-hypnosis RCT for refractory IBS

The 1984 randomised trial by Whorwell, Prior and Faragher is the founding RCT for gut-directed hypnotherapy in refractory IBS. It is why later Manchester-model work exists. It is not, by itself, enough to grade a whole field A.

Key evidence

The trial enrolled people with severe IBS that had not responded to usual medical care. One arm received gut-focused hypnosis; the comparator received psychotherapy. The hypnosis arm showed large improvements in bowel symptoms relative to the control arm. Diagnostic criteria were of that era (not Rome IV).

Later pooled reviews and the Gut psychological-therapies network sit on top of this lineage. The hub grades the programme of evidence, not this single paper.

Limitations

Small sample. Older criteria. No participant blinding (true of all GDH). The original paper did not supply modern 12-month multicentre follow-up.

What we don't know yet

How the same protocol would perform if re-run today with Rome IV and current usual care is a thought experiment, not a new trial.

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