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Psychotherapy or paroxetine did not reduce abdominal pain, but may improve quality of life in irritable bowel syndrome

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 QUESTION: In patients with severe irritable bowel syndrome (IBS), is psychotherapy or paroxetine more effective than usual care for reducing abdominal pain, and improving health related quality of life (HRQL), without incurring additional costs?


Cost effectiveness analysis of a randomised (allocation concealed*), blinded (clinicians, {data collectors, data analysts, and data safety and monitoring committee}),* controlled trial with follow up at 3 and 15 months.


7 gastroenterology clinics in the UK.


257 patients 18–65 years of age (mean age 40 y, 80% women) who met Rome I criteria for IBS, had symptoms for >6 months, failed to respond to “usual” medical treatment (antispasmodics and laxatives or antidiarrhoeal medication given for ≥3 mo), had severe abdominal pain (visual analogue scale >59), had no contraindication to psychotherapy or paroxetine, and were able to complete the study questionnaires. …

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  • Sources of funding:Medical Research Council of the UK and North Western Region Health Authority.

  • For correspondence: Dr F Creed, University of Manchester, Manchester, UK. francis.creed{at}

  • * See glossary.

  • Information provided by the author.