Six vs 12 Sessions of Gut-focused Hypnotherapy for Irritable Bowel Syndrome: A Randomized Trial

Hasan, Syed; Whorwell, Peter J.; Miller, Vivien; Morris, Julie; Vasant, Dipesh H.

doi:10.1053/j.gastro.2021.02.058

Cited by 17 publications

(48 citation statements)

References 13 publications

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“…The review concluded that GDH was significantly more effective when delivered as ≥8 sessions with at least 6 hours of contact time. This contrasts with the previously mentioned RCT 30 which reported that six sessions of IH were at least as effective as 12. Future studies should also provide more robust reporting about homework compliance to determine the effect of daily GDH practice on outcomes.…”

Section: Impli C Ati On S For Future Re S E Arch Educ Ati On and Pr Ac Ti Cecontrasting

confidence: 88%

“…Whilst IH has been found to be an effective treatment for patients with severe, refractory IBS, 19,27,30,31,42,95 the current evidence for GGDH is not robust enough to support its implementation into practice for this patient population. The most compelling evidence for GGDH is provided by Flik et al, 49 however, patients were from primary and secondary care settings and had milder symptom severity than those typically seen in tertiary care settings.…”

Section: Impli C Ati On S For Future Re S E Arch Educ Ati On and Pr Ac Ti Cementioning

confidence: 99%

“…Highly significant improvements were also reported in non-colonic symptoms, quality of life and anxiety or depression scores (P s < 0.001). In the largest RCT 30 of IH to date, with 448 patients to test the non-inferiority of six sessions of IH compared with 12 sessions, clinically significant improvements of ≥50-points reduction were achieved by 78% of patients after 6 sessions and 73.9% after 12 sessions. IH has also been reported to be effective in 65% of patients when delivered at a distance using video consultation.…”

Section: Hypnotherapy For Ibsmentioning

confidence: 99%

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Review article: the effectiveness of group and self‐help hypnotherapy for irritable bowel syndrome and the implications for improving patients’ choice and access to treatment

Gillan

2021

Aliment Pharmacol Ther

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Background: Individual hypnotherapy (IH) is a recognised treatment for irritable bowel syndrome (IBS). However, it is not widely available to patients due to its resource-intensive nature, lack of adequately trained therapists, and scepticism about hypnosis. Non-individualised hypnotherapy approaches, such as group and self-help hypnotherapy, could maximise existing therapist resources by treating more patients at the same time, thus widening patient access to treatment without incurring additional expenditure. Aims:To investigate the research literature for non-individualised approaches to hypnotherapy for IBS and to determine their effectiveness for reducing symptom severity and/or providing adequate relief. Methods:A literature review of published peer-reviewed studies was conducted. Quantitative research was selected to determine the effectiveness of the interventions.Results: Ten studies were eligible for inclusion. Three delivered group hypnotherapy, three integrated hypnosis within a group concept, and four utilised a self-help home hypnotherapy treatment using audio recordings. Both group hypnotherapy for adults and the self-help home hypnotherapy treatment for children were effective interventions that may be non-inferior to IH for patients with mild-to-moderate symptoms.Treatment benefits were long-lasting. The evidence for the integrative group concept and home treatment for adults was less compelling.Conclusions: Group hypnotherapy for adults, and self-help hypnotherapy for children, may be cost-effective treatments that can widen access for patients with milder IBS in primary care settings. Further research is needed to determine the effectiveness of group hypnotherapy for patients with severe, refractory IBS.

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Section: Impli C Ati On S For Future Re S E Arch Educ Ati On and Pr Ac Ti Cecontrasting

confidence: 88%

Section: Impli C Ati On S For Future Re S E Arch Educ Ati On and Pr Ac Ti Cementioning

confidence: 99%

Section: Hypnotherapy For Ibsmentioning

confidence: 99%

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Review article: the effectiveness of group and self‐help hypnotherapy for irritable bowel syndrome and the implications for improving patients’ choice and access to treatment

Gillan

2021

Aliment Pharmacol Ther

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“… 12 This questionnaire has been routinely used to evaluate extra‐intestinal symptom outcomes in patients with IBS in a number of our studies. 10 , 12 , 13 , 14 , 15 …”

Section: Methodsmentioning

confidence: 99%

The symptom burden of Irritable Bowel Syndrome in tertiary care during the COVID‐19 pandemic

Noble

Hasan

Whorwell

et al. 2022

Neurogastroenterology Motil

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Background The COVID‐19 pandemic caused unprecedented disruption to healthcare services worldwide with well‐documented detrimental effects on mental health. Patients with refractory disorders of gut‐brain interaction such as Irritable Bowel Syndrome (IBS) seen in tertiary care tend to exhibit higher levels of psychological comorbidity, but the impact of the pandemic on IBS symptom severity in tertiary care is unknown. Methods As part of routine clinical care, consecutive tertiary referrals with refractory IBS patients prospectively completed a series of baseline questionnaires including IBS symptom severity score (IBS‐SSS), non‐colonic symptom score, Hospital Anxiety and Depression (HAD), and Illness impact scores. The symptom severity questionnaire data were compared for consecutive patients seen in tertiary care 12 months before and after the onset of COVID‐19 pandemic restrictions. Key Results Of 190 consecutive tertiary referrals with IBS, those seen during the pandemic had greater IBS severity (IBS‐SSS: 352 vs. 318, p = 0.03), more severe extra‐intestinal symptoms (non‐colonic score: 269 vs. 225, p = 0.03), sleep difficulties ( p = 0.03), helplessness and loss of control ( p = 0.02), but similar HAD‐Anxiety ( p = 0.96) and HAD‐Depression ( p = 0.84) scores. During the pandemic, unmarried patients ( p = 0.03), and keyworkers ( p = 0.0038) had greater IBS severity. Conclusions and Inferences This study has shown for the first time that patients seen in tertiary care with refractory IBS during the COVID‐19 pandemic had a significantly higher symptom burden emphasizing the importance of gut‐brain axis in IBS. Furthermore, lack of support and perceived loss of control appear to be contributory factors.

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“…Some patients do not seem to require 12 sessions of treatment to achieve significant improvement and we have recently published a paper showing that six sessions may be just as effective as 12 although some of the more severe cases do need additional sessions. 26 …”

Section: Methodsmentioning

confidence: 99%

Hypnotherapy for irritable bowel syndrome: patient expectations and perceptions

Donnet

Hasan

Whorwell

2022

Therap Adv Gastroenterol

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Introduction: Numerous studies have shown that hypnotherapy (HT) is effective in irritable bowel syndrome (IBS) using traditional symptom severity end points. However, there is now interest in capturing the patient’s perception of their illness and treatment because what patients expect from their treatment may differ from that of their healthcare provider. Objective: To record patient perceptions and expectations of hypnotherapy as well as their symptom response. Methods: 150 consecutive IBS patients (116 females, 34 males, aged 16–81 years) receiving hypnotherapy completed questionnaires recording IBS symptom severity, quality of life, noncolonic symptoms, anxiety and depression levels before and after treatment. Their expectations and perceptions of HT were also recorded, including a free text reflection. Results: 121 patients (81%) responded to treatment consistent with our previous experience. Symptom severity scores, noncolonic symptoms, quality of life, anxiety and depression significantly all improved after HT ( p < 0.001). Expectancy of an improvement with hypnotherapy was greater in those who did not respond to treatment (63%) than those who did (57%, p < 0.001). Scepticism and apprehension were common before treatment and replaced with enthusiasm afterwards. Free text responses after treatment were overwhelmingly positive. Patients also reported a variety of other benefits and even 20 of 29 symptom nonresponders (70%) still considered treatment worthwhile. Conclusion: Although initially perceived negatively, hypnotherapy improved symptoms and resulted in a wide range of additional benefits. Expectation did not necessarily influence outcome. Recording IBS symptoms alone does not fully capture the patient’s experience of treatment and needs to be considered in future research.

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Six vs 12 Sessions of Gut-focused Hypnotherapy for Irritable Bowel Syndrome: A Randomized Trial

Cited by 17 publications

References 13 publications

Review article: the effectiveness of group and self‐help hypnotherapy for irritable bowel syndrome and the implications for improving patients’ choice and access to treatment

Review article: the effectiveness of group and self‐help hypnotherapy for irritable bowel syndrome and the implications for improving patients’ choice and access to treatment

The symptom burden of Irritable Bowel Syndrome in tertiary care during the COVID‐19 pandemic

Hypnotherapy for irritable bowel syndrome: patient expectations and perceptions

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