RCT of VR Therapy for IBS

Inclusion Criteria:

• Has been diagnosed by a physician with Rome IV IBS; all subtypes will be included

• Has clinically significant abdominal pain as defined as an NIH PROMIS abdominal painT-score ≥ 55 (0.5 standard deviation [SD] above the normalized population mean of

• Able to read/write English (SynerGI is currently only available in English)

• Owns a compatible android or iOS smartphone, or personal laptop or desktop computer (excluding tablets) to complete surveys and has access to internet and email

Exclusion Criteria:

• Presents with a condition that interferes with VR usage, including history ofseizure, facial injury precluding safe placement of headset, significant visual orhearing impairment that impacts ability to see the VR images or follow audioinstructions

• Has cognitive impairment that would affect protocol participation

• Has a comorbid disorder that may confound the diagnosis of IBS, including celiacdisease, inflammatory bowel disease, autoimmune disorders that affect the GI system,history of bowel resection, HIV/AIDS, diabetes with HgA1c >=7.0, neuroendocrinetumors, microscopic colitis, eosinophilic bowel disease, acute intermittentporphyria, or any other condition that a physician believes can mimic IBS symptomsand undermine diagnostic certitude

• Takes standing doses of opioid medications given the often severe impact of opioidson GI motility and potential for pharmacological visceral hyperalgesia

• Previously participated in a VR clinical trial

• Previously participated in talk therapy

• Previously used a VR program to treat their IBS