Hypnotherapy in severe irritable bowel syndrome: further experience.

Abstract

In a previous controlled trial we reported that 'gut directed' hypnotherapy appeared to be highly effective in the management of patients with severe refractory irritable bowel syndrome.' A criticism of this study has been that the follow up period of three months was too short to discount a placebo response to hypnosis.2' All 15 patients treated with hypnotherapy in the original study have now been followed up for over one year and these data are reported here together with experience on an additional 35 patients treated in a similar manner. Methods PATIENTSThe 15 patients receiving hypnotherapy in the original study have been followed up at three monthly intervals with an assessment of symptom scores and an additional session of hypnotherapy at each visit. The miean follow up period was 18 months (14-21 months). Patients were asked to telephone if they experienced a relapse so that an additional session of hypnotherapy could be arranged. A further 35 patients (31 women, four men, aged 23-65 years) with intractable irritable bowel syndrome have Address for correspondence: Dr P J Whorwell, Dept of Medicine, University of South Manchester, Nell Lane, West Didsbury, Manchester M20 8LR. Received for publication 11 July 1986. also been treated by hypnotherapy and followed for at least three months. These patients were divided into three groups. Group 1: classical cases of irritable bowel syndrome exhibiting abdominal pain, abdominal distension, and an abnormal bowel habit. Group 2: atypical cases lacking one or two of the three criteria necessary for Group 1. Group 3: patients with classical irritable bowel syndrome with significant psychopathology as judged by a score in excess of 14 on the 28 question general health questionnaire.4 The original study only included patients in Group 1.Hypnotherapy was carried out 1y PJW and consisted of half hour sessions of decreasing frequency over a three month period. Patients were given a tape for daily autohypnosis after the third session. Before hypnosis the patient was given a simple account of intestinal smooth muscle physiology. Hypnosis was induced by an eye fixation and arm levitation technique followed by standard deepening procedures. After general comments about improvement of health and wellbeing, attention was directed to the control of intestinal smooth muscle. The patient was asked to place his/her hand on the abdomen, feel a sense of warmth and relate this to asserting control over gut function. All sessions were concluded with standard ego strengthening suggestions. No subject was unable to be hypnotised. Ten weekly sessions of hypnotherapy were offered before treatment was 423 on 12 May 2018 by guest. Protected by copyright.

The Efficacy of Hypnotherapy in the Treatment of Irritable Bowel Syndrome: A Systematic Review and Meta-analysis

“…11 Several additional studies have also reported benefits of hypnotherapy in treating gastrointestinal symptoms and QOL of IBS patients. [12][13][14][15][16] Previous systematic reviews to prove that there are statistically significant benefits have been based on pooled results of research on the effectiveness of hypnotherapy for IBS patients. 17,18 These reviews concluded that, although a number of studies have shown a beneficial effect of hypnotherapy, insufficient evidence existed to recommend widespread use because of limitations in the sample sizes and methodological flaws.…”

Hypnosis and upper digestive function and disease

“…After the treatment, the patients in the hypnosis group showed substantial improvement in all cardinal IBS symptoms, and were significantly more improved on all outcome variables than the supportive psychotherapy group [15] . In a later paper, the investigators reported that the benefits of hypnotherapy in the same group of patients persisted up to 18 mo [17] . This study, albeit small, was a landmark trial, demonstrating for the first time the substantial possibilities that hypnosis offers for ameliorating gastrointestinal symptoms.…”

Psychosocial Background and Intervention in the Irritable Bowel Syndrome

“…Hopefully, this state of affairs might change in the future as more of the participants in the yearly introductory course that is held in the department offer the treatment at their own institutions. The application of this approach to treatment was started back in the early 1980s, firstly on an empirical basis, but has subsequently been formally evaluated in a number of studies [55, 57, 58]. …”