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Overview of
Published Research To Date on Hypnosis for IBS
By Olafur S. Palsson, Psy.D.
Whorwell PJ; Prior A; Faragher EB. Controlled trial of
hypnotherapy in the treatment of severe refractory
irritable-bowel syndrome.The Lancet 1984, 2: 1232-4.
This
study is the earliest and perhaps the best study in this
research area to date, as it was thoroughly placebo-controlled
and showed dramatic contrast in response to hypnosis treatment
above the placebo group. Thirty patients with severe symptoms
unresponsive to other treatment were randomly chosen to receive
7 sessions of hypnotherapy (15 patients) or 7 sessions of
psychotherapy plus placebo pills (15 patients). The
psychotherapy group showed a small but significant improvement
in abdominal pain and distension, and in general well-being but
not bowel activity pattern. The hypnotherapy patients showed a
dramatic improvement in all central symptom. The hypnotherapy
group showed no relapses during the 3-month follow-up period.
Graph
adapted from the above paper, showing group differences in two
of the main IBS symptoms

Whorwell PJ;
Prior A; Colgan SM. Hypnotherapy in severe irritable bowel
syndrome: further experience. Gut, 1987 Apr, 28:4, 423-5.
This
report summed up further experience with 35 patients added to
the 15 treated with hypnotherapy in the 1984 Lancet study. For
the whole 50 patient group, success rate was 95% for classic IBS
cases, but substantially less for IBS patients with atypical
symptom picture or significant psychological problems. The
report also observed that patients over age 50 seemed to have
lower success rate from this treatment.
Harvey RF; Hinton RA; Gunary RM; Barry RE. Individual and group
hypnotherapy in treatment of refractory irritable bowel
syndrome. Lancet, 1989 Feb, 1:8635, 424-5.
This study
employed a shorter hypnosis treatment course than other studies
for IBS, and the success rate was lower, most likely
demonstrating that a larger number of sessions is necessary for
optimal benefit. Twenty out of 33 patients with refractory
irritable bowel syndrome treated with four sessions of
hypnotherapy in this study improved. Improvement was maintained
at a 3-month treatment. These researchers further found that
hypnosis treatment for IBS in groups of up to 8 patients seems
as effective as individual therap
Prior A, Colgan SM, Whorwell PJ. Changes in rectal sensitivity
after hypnotherapy in patients with irritable bowel syndrome.
Gut 1990;31:896.
This
study found IBS patients to be less sensitive to pain and other
sensations induced via balloon inflation in their gut while they
were under hypnosis. Sensitivity to some balloon-induced gut
sensations (although not pain sensitivity) was reduced following
a course of hypnosis treatment.
Houghton LA; Heyman DJ; Whorwell PJ. Symptomatology, quality
of life and economic features of irritable bowel syndrome--the
effect of
hypnotherapy. Aliment Pharmacol Ther, 1996 Feb, 10:1, 91-5.
This
study compared 25 severe IBS patients treated with hypnosis to
25 patients with similar symptom severity treated with other
methods, and demonstrated that in addition to significant
improvement in all central IBS symptoms, hypnotherapy recipients
had fewer visits to doctors, lost less time from work than the
control group and rated their quality of life more improved.
Those patients who had been unable to work prior to treatment
resumed employment in the hypnotherapy group but not in the
control group. The study quantifies the substantial economic
benefits and improvement in health-related quality of life which
result from hypnotherapy for IBS on top of clinical symptom
improvement.
Koutsomanis D. Hypnoanalgesia in the irritable bowel syndrome.
Gastroenterology 1997, 112, A764.
This
French study showed less analgesic medication use required and
less abdominal pain experienced by a group of 12 IBS patients
after a course of 6-8 analgesia-oriented hypnosis sessions
followed by 4 sessions of autogenic training. Patients were
evaluated at 6-month and 12-month follow-up.
Houghton LA, Larder S, Lee R, Gonsalcorale WM, Whelan V,
Randles J, Cooper P, Cruikshanks P, Miller V, Whorwell PJ. Gut
focused hypnotherapy normalises rectal hypersensitivity in
patients with irritable bowel syndrome (IBS). Gastroenterology
1999; 116: A1009.
Twenty-three
patients each received 12 sessions of hypnotherapy. Significant
improvement was seen in the severity and frequency of abdominal
pain, bloating and satisfaction with bowel habit. A subset of
the treated patients who were found to be unusually
pain-sensitive in their intestines prior to treatment (as
evidenced by balloon inflation tests) showed normalization of
pain sensitivity, and this change correlated with their pain
improvement following treatment. Such pain threshold change was
not seen for the treated group as a whole.
Vidakovic Vukic M. Hypnotherapy in the treatment of irritable
bowel syndrome: methods and results in Amsterdam. Scand J
Gastroenterol Suppl, 1999, 230:49-51.Reports
results of treatment of 27patients of gut-directed hypnotherapy
tailored to each individual patient. All of the 24 who completed
treatment were found to be improve.
Galovski TE; Blanchard EB. Appl Psychophysiol Biofeedback, 1998
Dec, 23:4, 219-32.
Eleven patients completed hypnotherapy, with improvement
reported for all central IBS symptoms, as well as improvement in
anxiety. Six of the patients were a waiting-control group for
comparison, and did not show such improvement while waiting for
treatment.
Gonsalkorale WM, Houghton LA, Whorwell PJ. Hypnotherapy in
irritable bowel syndrome: a large-scale audit of a clinical
service with examination of factors influencing responsiveness.
Am J Gastroenterol 2002 Apr;97(4):954-61.
This study is
notable as the largest case series of IBS patients treated with
hypnosis and reported on to date. 250 unselected IBS patients
were treated in a clinic in Manchester, England, using 12
sessions of hypnotherapy over a 3-month period plus home
practice between sessions. Marked improvement was seen in all
IBS symptoms (overall IBS severity was reduced by more than half
on the average after treatment), quality of life, and anxiety
and depression. All subgroups of patients appeared to do equally
well except males with diarrhea, who improved far less than
other patients for unknown reason.
Palsson OS,
Turner MJ, Johnson DA, Burnett CK, Whitehead WE. Hypnosis
treatment for severe irritable bowel syndrome: investigation of
mechanism and effects on symptoms. Dig Dis Sci 2002
Nov;47(11):2605-14.
Possible
physiological and psychological mechanisms of hypnosis treatment
for IBS were investigated in two studies. Patients with severe
IBS received seven biweekly hypnosis sessions and used hypnosis
audiotapes at home. Rectal pain thresholds and smooth muscle
tone were measured with a barostat before and after treatment in
18 patients (study I), and treatment changes in heart rate,
blood pressure, skin conductance, finger temperature, and
forehead electromyographic activity were assessed in 24 patients
(study II). Somatization, anxiety, and depression were also
measured. All central IBS symptoms improved substantially from
treatment in both studies. Rectal pain thresholds, rectal smooth
muscle tone, and autonomic functioning (except sweat gland
reactivity) were unaffected by hypnosis treatment. However,
somatization and psychological distress showed large decreases.
In conclusion, hypnosis improves IBS symptoms through reductions
in psychological distress and somatization. Improvements were
unrelated to changes in the physiological parameters measured.
17 of 18 patients in study 1 and 21 of 24 patients in study 2
were judged substantially improved Improvement was
well-maintained at 10-12 month follow up in study 2.
Lea R, Houghton LA, Calvert EL, Larder S, Gonsalkorale WM,
Whelan V, Randles J,
Cooper P, Cruickshanks P, Miller V, Whorwell PJ.Gut-focused
hypnotherapy normalizes disordered rectal sensitivity in
patients with irritable bowel syndrome.Aliment Pharmacol Ther.
2003 Mar 1;17(5):635-42.
This study evaluated the rectal sensitivity changes in IBS
patients who received hypnotherapy, like a previous study by the
same group (see Houghton et al's study above, but using a
slightly different methodology. Twenty-three IBS patients were
tested before and after 12 weeks of
hypnotherapy. Following the course of hypnotherapy, the mean
pain sensory threshold increased in the hypersensitive subgroup
and tended to decrease in the hyposensitive group,
although the l. Reduction in gut pain sensitivity was associated
with a reduction in abdominal pain. These results suggest that
hypnotherapy may work at least partly by normalizing bowel
perception in those patients who have abnormal gut sensitivity,
while leaving normal sensation unchanged.
Gonsalkorale
WM, Toner BB, Whorwell PJ. J Psychosom Res. 2004
Mar;56(3):271-8. Cognitive change in patients undergoing
hypnotherapy for irritable bowel syndrome.Cognitive
changes were evaluated in 78 IBS patients who completed a
12-session hypnosis treatment course, using the recently
developed Cognitive Scale for Functional Bowel Disorders.
Hypnotherapy resulted in improvement of symptoms, quality of
life, anxiety and depression.
Unhelpful
IBS-related cognitions improved significantly, with reduction in
the
total cognitive score and all component themes related to bowel
function.
Overall symptom reduction correlated with an improvement on the
cognitive scale.
Gonsalkorale WM, Miller V, Afzal A, Whorwell PJ. Long term
benefits of hypnotherapy for irritable bowel syndrome. Gut. 2003
Nov;52(11):1623-9. In this study, 204 IBS patients treated
with a course of hypnotherapy completed questionnaires scoring
symptoms, quality of life, anxiety, and depression before,
immediately after, and up to six years following treatment. 71%
of patients showed improvement in response to treatment
initially, and of those, 81% were still improved years later,
while most of the other 19% only reported slight worsening of
symptoms. Quality of life and anxiety or depression scores were
also still significantly improved at follow-up but showed some
deterioration. Patients also reported fewer doctor visits rates
and less medication use long-term after hypnosis treatment.
These results indicate that for most patients the benefits from
hypnotherapy last at least five years.
Psychosom Med.
2004 Mar-Apr;66(2):233-8
Treatment with hypnotherapy reduces the sensory
and motor component of the gastrocolonic response in irritable
bowel syndrome.
Simren M, Ringstrom G, Bjornsson ES,
Abrahamsson H.
Department of Internal Medicine, Sahlgrenska University
Hospital, Goteborg, Sweden. magnus.simren@medicine.gu.se
OBJECTIVE: Postprandial symptoms in irritable bowel syndrome are
common and relate to an exaggerated motor and sensory component
of the gastro colonic response. We investigated whether this
response can be affected by hypnotherapy. METHODS: We included
28 patients with irritable bowel syndrome refractory to other
treatments. They were randomized to receive gut-directed
hypnotherapy 1 hour per week for 12 weeks (N = 14) or were
provided with supportive therapy (control group; N = 14). Before
randomization and after 3 months, all patients underwent a
colonic distension trial before and after a 1-hour duodenal
lipid infusion. Colonic sensory thresholds and tonic and phasic
motor activity were assessed. RESULTS: Before randomization,
reduced thresholds after vs. before lipid infusion were seen in
both groups for all studied sensations. At 3 months, the colonic
sensitivity before duodenal lipids did not differ between
groups. Controls reduced their thresholds after duodenal lipids
for gas (22 +/- 1.7 mm Hg vs. 16 +/- 1.6 mm Hg, p <.01),
discomfort (29 +/- 2.9 mm Hg vs. 22 +/- 2.6 mm Hg, p <.01), and
pain (33 +/- 2.7 mm Hg vs. 26 +/- 3.3 mm Hg, p <.01), whereas
the hypnotherapy group reduced their thresholds after lipids
only for pain (35 +/- 4.0 mm Hg vs. 29 +/- 4.7 mm Hg, p <.01).
The colonic balloon volumes and tone response at randomization
were similar in both groups. At 3 months, baseline balloon
volumes were lower in the hypnotherapy group than in controls
(83 +/- 14 ml vs. 141 +/- 15 ml, p <.01). In the control group,
reduced balloon volumes during lipid infusion were seen (141 +/-
15 ml vs. 111 +/- 19 ml, p <.05), but not after hypnotherapy (83
+/- 14 ml vs. 80 +/- 16 ml, p >.20). CONCLUSION: Hypnotherapy
reduces the sensory and motor component of the gastro colonic
response in patients with irritable bowel syndrome. These
effects may be involved in the clinical efficacy of hypnotherapy
in IBS.
Am J Clin Hypn. 2005 Jan;47(3):161-78.
Hypnosis and irritable
bowel syndrome: a review of efficacy and mechanism of action.
Tan G, Hammond DC, Joseph G.
Michael E. DeBakey VA Medical Center,
Baylor College of Medicine, Houston, TX 77030, USA. tan.gabriel@med.va.gov
Irritable bowel syndrome (IBS) is a
functional gastrointestinal disorder characterized by abdominal
pain, distension, and an altered bowel habit for which no cause
can be found. Despite its prevalence, there remains a
significant lack of efficacious medical treatments for IBS to
date. In this paper we reviewed a total of 14 published studies
(N=644) on the efficacy of hypnosis in treating IBS (8 with no
control group and 6 with a control group). We concluded that
hypnosis consistently produces significant results and improves
the cardinal symptoms of IBS in the majority of patients, as
well as positively affecting non-colonic symptoms. When
evaluated according to the efficacy guidelines of the Clinical
Psychology Division of American Psychological Association, the
use of hypnosis with IBS qualifies for the highest level of
acceptance as being both efficacious and specific. In reviewing
the research on the mechanism of action as to how hypnosis works
to reduce symptoms of IBS, some evidence was found to support
both physiological and psychological mechanisms of action.
PMID: 15754863 [PubMed - indexed for MEDLINE]
Int J Clin Exp Hypn. 2006 Jan;54(1):7-20.
Hypnosis for irritable
bowel syndrome: the empirical evidence of therapeutic effects.
Whitehead WE.
University of North Carolina at Chapel
Hill, Chapel Hill, North Carolina 27599, USA. William_Whitehead@med.unc.edu
Irritable bowel syndrome (IBS) is a complex and prevalent
functional gastrointestinal disorder that is treated with
limited effectiveness by standard medical care. Hypnosis
treatment is, along with cognitive-behavioral therapy, the
psychological therapy best researched as an intervention for
IBS. Eleven studies, including 5 controlled studies, have
assessed the therapeutic effects of hypnosis for IBS. Although
this literature has significant limitations, such as small
sample sizes and lack of parallel comparisons with other
treatments, this body of research consistently shows hypnosis to
have a substantial therapeutic impact on IBS, even for patients
unresponsive to standard medical interventions. The median
response rate to hypnosis treatment is 87%, bowel symptoms can
generally be expected to improve by about half, psychological
symptoms and life functioning improve after treatment, and
therapeutic gains are well maintained for most patients for
years after the end of treatment.
PMID:
16316880 [PubMed - indexed for MEDLINE]
Gut. 2002 Nov;51(5):701-4.
Visceral sensation and
emotion: a study using hypnosis.
Houghton LA, Calvert EL, Jackson NA, Cooper
P, Whorwell PJ.
Department of Medicine, University
Hospital of South Manchester, Manchester M20 2LR, UK. lahoughton@man.ac.uk
BACKGROUND AND OBJECTIVES: We have previously shown that
hypnosis can be used to study the effect of different emotions
on the motility of the gastrointestinal tract. These studies
demonstrated that both anger and excitement increased colonic
motility while happiness led to a reduction. The purpose of this
study was to investigate the effect of hypnotically induced
emotion on the visceral sensitivity of the gut. METHODS: Sensory
responses to balloon distension of the rectum and compliance
were assessed in 20 patients with irritable bowel syndrome (IBS)
(aged 17-64 years; 17 female) diagnosed by the Rome I criteria.
Patients were studied on four separate occasions in random order
either awake (control) or in hypnosis, during which anger,
happiness, or relaxation (neutral emotion) were induced.
RESULTS: Hypnotic relaxation increased the distension volume
required to induce discomfort (p=0.05) while anger reduced this
threshold compared with relaxation (p<0.05), happiness (p<0.01),
and awake conditions (p<0.001). Happiness did not further alter
sensitivity from that observed during relaxation. There were no
associated changes in rectal compliance or wall tension.
CONCLUSIONS: Further to our previous observations on motility,
this study shows that emotion can also affect an IBS patient's
perception of rectal distension and demonstrates the critical
role of the mind in modulating gastrointestinal physiology.
These results emphasise how awareness of the emotional state of
the patient is important when either measuring visceral
sensitivity or treating IBS.
PMID:
12377810 [PubMed - indexed for MEDLINE]
Gastroenterol Clin North Am. 1991
Jun;20(2):325-33.
Treatment of the
irritable bowel syndrome.
Friedman G.
Department of Medicine, Mt. Sinai School
of Medicine, New York, New York.
Individualization of treatment for patients with IBS is
predicated on a thorough analysis of the patient's symptoms,
consideration of the reasons for seeking health care, evaluation
of symptom-precipitating factors, elimination of confounding
features, and the absolute knowledge of the absence of organic
illness. Collecting and codifying appropriate historical data
allow the physician to educate the patient with respect to the
origin of his symptoms, and to enlist the patient as a partner
in his future health care. There is no single, universally
accepted therapeutic agent available for the treatment of the
IBS patient. As a result, treatment is directed at reducing the
frequency and intensity of triggering factors as well as
ameliorating the symptoms when they arise. Symptoms evoked by
psychologic factors may be effectively reduced by psychotherapy
or hypnotherapy. Situational anxiety may be treated for brief
periods by using antianxiety agents such as diazepam,
chlordiazepoxide, buspirone, or similar agents. Depressive
reactions may be reduced with suitable doses of antidepressant
agents such as amitriptyline. Smooth muscle hyperreactivity may
be dulled with small amounts of selected anticholinergics, which
are usually most effective in reducing meal-induced discomfort.
Peppermint oil may be of additional benefit. Gas-related
symptoms require elimination of contributory dietary factors,
such as lactose-containing foods, sorbitol, or fructose, as well
as certain oligosaccharides. Simethecone, charcoal, or beanase
may be helpful. Functional constipation is best treated with
graded doses of insoluble or soluble fiber. Diarrheal episodes
may be reduced with either loperamide or diphenoxylate. Careful,
continued follow-up assessment of therapeutic endeavors, a
sincere interest in the patient's concerns, and surveillance for
intercurrent organic illness are the cornerstones of complete
ongoing care.
PMID:
2066156 [PubMed - indexed for MEDLINE]
Curr Treat Options Gastroenterol. 1999
Feb;2(1):13-19
Irritable Bowel
Syndrome.
Wald
A.
University of Pittsburgh Medical Center,
Pittsburgh University Hospital, Mezzanine Level, C-Wing, 200
Lothrop Street, Pittsburgh, PA 15213-2582.
I
believe there are four essential elements in the management of
patients with irritable bowel syndrome (IBS): to establish a
good physician-patient relationship; to educate patients about
their condition; to emphasize the excellent prognosis and benign
nature of the illness; and to employ therapeutic interventions
centering on dietary modifications, pharmacotherapy, and
behavioral strategies tailored to the individual. Initially, I
establish the diagnosis, exclude organic causes, educate
patients about the disease, establish realistic expectations and
consistent limits, and involve patients in disease management. I
find it critical to determine why the patient is seeking
assistance (eg, cancer phobia, disability, interpersonal
distress, or exacerbation of symptoms). Most patients can be
treated by their primary care physician. However, specialty
consultations may be needed to reinforce management strategies,
perform additional diagnostic tests, or institute specialized
treatment. Psychological co-morbidities do not cause symptoms
but do affect how patients respond to them and influence health
care-seeking behavior. I find that these issues are best
explored over a series of visits when the physician-patient
relationship has been established. It can be helpful to have
patients fill out a self-administered test to identify
psychological co-morbidities. I often use these tests as a basis
for extended inquiries into this area, resulting in the
initiation of appropriate therapies. I encourage patients to
keep a 2-week diary of food intake and gastrointestinal
symptoms. In this way, patients become actively involved in
management of their disease, and I may be able to obtain
information from the diary that will be valuable in making
treatment decisions. I do not believe that diagnostic studies
for food intolerances are cost-effective or particularly
helpful; however, exclusion diets may be beneficial. I introduce
fiber supplements gradually and monitor them for tolerance and
palatability. Synthetic fiber is often better-tolerated than
natural fiber, but must be individualized. In my experience,
excessive fiber supplementation often is counterproductive, as
abdominal cramps and bloating may worsen. Antidiarrheal agents
are very effective when used correctly, preferably in divided
doses. I use them in patients in anticipation of diarrhea and
especially in those who fear symptoms when engaged in activities
outside the home. I encourage patients to make decisions as to
when and how much to use. However, almost always, a morning dose
before breakfast is used (loperamide, 2 to 6 mg) and, perhaps
again later in the day when symptoms of diarrhea are prominent.
I prefer antispasmodics to be used intermittently in response to
periods of increased abdominal pain, cramps, and urgency. For
patients with daily symptoms, especially after meals, agents
such as dicyclomine before meals are useful. For patients with
infrequent but severe episodes of unpredictable pain, sublingual
hyoscyamine often produces rapid relief and instills confidence.
In general, I recommend that oral antispasmodics be used for a
limited period of time rather than indefinitely, and generally
for periods of time when symptoms are prominent. For chronic
visceral pain syndromes, I recommend small doses of tricyclic
antidepressants. These agents are especially effective in
diarrhea-predominant patients with disturbed sleep patterns but
may be unacceptable to patients with constipation. I educate
patients that side effects occur early and benefits may not be
apparent for 3 to 4 weeks. I consider using SSRIs in low doses
in patients with constipation-predominant IBS; cisapride, 10 to
20 mg three times per day, also may be beneficial. When taken
with drugs that inhibit cytochrome P450, cisapride has been
associated with serious cardiac arrhythmias caused by QT
prolongation, including ventricular arrhythmias and torsades de
pointes. These drugs include the azole fungicides; erythromycin,
clarithromycin, and troleandomycin; some antidepressants; HIV
protease inhibitors; and others. In patients with IBS with mild
to moderate co-morbid depression, I have found that the use of
SSRIs such as paroxetine, fluoxetine, or sertraline may be
beneficial. It is important to tell patients that anxiety and
disturbed sleep may occur during the first 10 days and benefits
may not occur for 3 to 4 weeks. I prescribe a small amount of a
short-acting benzodiazepine such as alprazolam, 0.5 mg two times
per day, to control these symptoms. For generalized anxiety
without depression, buspirone or clonazepam may be useful. I
have found that patients who also have associated panic disorder
may benefit from a benzodiazepine, tricyclic antidepressant, or
an SSRI. However, these patients are best managed in conjunction
with a psychiatrist or psychologist. I consider the use of
alternative therapies in patients who fail to respond to
conventional measures and who are receptive to alternative
strategies. These include general relaxation techniques such as
biofeedback and hypnosis therapies.
PMID: 11096567 [PubMed - as supplied by publishe
J Clin Nurs. 2006
Jun;15(6):678-84
Effect of nurse-led
gut-directed hypnotherapy upon health-related quality of life in
patients with irritable bowel syndrome.
Smith GD.
School of Health in Social Science, University of Edinburgh, Old
Medical School, Edinburgh, UK. graeme.smith@ed.ac.uk
AIMS AND OBJECTIVES: This study quantified health-related
quality of life in a group of irritable bowel syndrome patients
and measures changes following a treatment programme of
nurse-led gut-directed hypnotherapy. BACKGROUND: It is well
recognized that health-related quality of life can be severely
impaired in patients suffering form the irritable bowel
syndrome. Current conventional treatment for irritable bowel
syndrome is often unsatisfactory. In contrast it has been shown
that gut-directed hypnotherapy is an effective treatment of
irritable bowel syndrome with up to three-quarters of patients
reporting symptomatic improvement. DESIGN/METHOD: Seventy-five
patients (55 females/20 males, median age 37.1 years, age range
18-64) comprised the study group. Physical symptoms of irritable
bowel syndrome were recorded using seven-day diary cards. On
presentation the predominant symptoms were abdominal pain (61%),
altered bowel habit (32.5%), and abdominal distension/bloating
(6.5%) in the patient group. An irritable bowel syndrome quality
of life questionnaire was used to define health-related quality
of life. Psychological well-being was measured using the
Hospital Anxiety and Depression Scale. Data analysis was carried
out using MINITAB, Release 12 for Windows. RESULTS: Physical
symptoms statistically improved after hypnotherapy. There were
also significant statistical improvements (P < 0.001) in six of
the eight health-related quality of life domains measured
(emotional, mental health, sleep, physical function, energy and
social role). These improvements were most marked in female
patients who reported abdominal pain as their predominant
physical symptom. Anxiety and depression improved following
treatment. CONCLUSION: Gut-directed hypnotherapy has a very
positive impact on health-related quality of life with
improvements in psychological well-being and physical symptoms.
It appears most effective in patients with abdominal pain and
distension. Relevance to clinical practice. This study
demonstrates that by integrating complementary therapies into
conventional care that gastrointestinal nurses have a potential
role in the management of irritable bowel syndrome.
PMID:
16684163 [PubMed - indexed for MEDLINE]
Gastroenterology.
2007 Nov;133(5):1430-6. Epub 2007 Sep 2
Hypnotherapy for children with functional abdominal pain or
irritable bowel syndrome: a randomized controlled trial.
Vlieger AM,
Menko-Frankenhuis C, Wolfkamp SC,
Tromp E,
Benninga MA.
Department of Pediatrics, St. Antonius Hospital, Nieuwegein, The
Netherlands. a.vlieger@antonius.net
BACKGROUND & AIMS: Functional abdominal pain (FAP) and irritable
bowel syndrome (IBS) are highly prevalent in childhood. A
substantial proportion of patients continues to experience
long-lasting symptoms. Gut-directed hypnotherapy (HT) has been
shown to be highly effective in the treatment of adult IBS
patients. We undertook a randomized controlled trial and
compared clinical effectiveness of HT with standard medical
therapy (SMT) in children with FAP or IBS. METHODS: Fifty-three
pediatric patients, age 8-18 years, with FAP (n = 31) or IBS (n
= 22), were randomized to either HT or SMT. Hypnotherapy
consisted of 6 sessions over a 3-month period. Patients in the
SMT group received standard medical care and 6 sessions of
supportive therapy. Pain intensity, pain frequency, and
associated symptoms were scored in weekly standardized abdominal
pain diaries at baseline, during therapy, and 6 and 12 months
after therapy. RESULTS: Pain scores decreased significantly in
both groups: from baseline to 1 year follow-up, pain intensity
scores decreased in the HT group from 13.5 to 1.3 and in the SMT
group from 14.1 to 8.0. Pain frequency scores decreased from
13.5 to 1.1 in the HT group and from 14.4 to 9.3 in the SMT
group. Hypnotherapy was highly superior, with a significantly
greater reduction in pain scores compared with SMT (P < .001).
At 1 year follow-up, successful treatment was accomplished in
85% of the HT group and 25% of the SMT group (P < .001).
CONCLUSIONS: Gut-directed HT is highly effective in the
treatment of children with longstanding FAP or IBS.
PMID: 17919634 [PubMed - indexed for MEDLINE]
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