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Irritable Bowel Syndrome

Irritable Bowel Syndrome (26)

10 Sep

Researchers at the University of North Carolina at Chapel Hill reported on their successful hypnosis and guided imagery protocols, using verbatim scripts for treating gastrointestinal disorders - irritable bowel syndrome, ulcerative colitis and functional abdominal pain.

Treatment with these scripted protocols is delivered in a fixed series of sessions over a 2- or 3-month period.

The investigators report these methods have been found to be efficacious for improving bowel symptoms in several clinical trials, even in patients who have been entirely unresponsive to medical treatment.

Response rates in clinical trials have ranged from 53% to 94%, and the therapeutic benefits have been shown to be well maintained at 6-, 10-, or 12-month follow-ups in various studies.

28 Apr

Investigators from the School of Clinical Sciences and Community Health at the University of Edinburgh in the UK compared brief interventions with biofeedback and hypnotherapy in women with refractory Irritable Bowel Syndrome.

Patients were randomized to one of two treatment groups, biofeedback or hypnotherapy, delivered as three one-hour sessions over 12 weeks.

Symptom assessments were undertaken using validated, self-administered questionnaires.
 
Two of the 128 consecutive IBS patients suitable for the study declined to consider nonpharmacological therapy and 29 patients did not attend beyond the first session.

01 Jul

Researchers from the Medical University of Vienna in Vienna, Austria investigated whether gut-directed hypnotherapy (GHT) administered in group sessions is effective for refractory Irritable Bowel Syndrome (IBS), as we know it is when administered in individual sessions.
 
A total of 164 patients with IBS (Rome-III-criteria) were screened, and of those, 100 patients refractory to usual treatment were randomized either to 10 sessions within 12 weeks of either supportive talks with medical treatment as usual (SMT) or to the latter along with gut directed hypnotherapy.

Patients were assessed for clinical improvement on several dimensions of daily life, as assessed by the IBS impact scale, immediately after treatment and again at 12-month follow-up.  In addition, they were also assessed for improvement in general quality of life (using the QOL Medical Outcome Study Short-Form-36); for psychological status (Hospital Anxiety Depression Scale); and for reduction of individual IBS symptoms.  Analysis was by intention to treat.

20 May

Dutch researchers from Emma Children’s Hospital in Amsterdam reviewed the literature to see if gut-directed hypnotherapy was as effective for children as it is for adults suffering from functional abdominal pain (FAP) and irritable bowel syndrome (IBS).

Investigators searched Medline, Embase, PsychINFO, Cumulative Index to Nursing and Allied Health Literature databases and Cochrane Central Register of Controlled Trials for randomized controlled trials (RCT) with child subjects with FAP or IBS. They looked at the efficacy of hypnotherapy on abdominal pain, quality of life, treatment costs and school absenteeism.

17 Dec

Researchers from the University of Gothenburg in Gothenburg, Sweden conducted a retrospective study to evaluate long-term effects 2-7 years after receiving gut-directed hypnotherapy for Irritable Bowel Syndrome.

Subjects who had received gut-directed hypnotherapy (n=208) filled out the Subjective Assessment Questionnaire (SAQ) which measures changes in IBS symptoms. The 208 patients were classified as responders and non-responders were also asked to report changes in health-care seeking, use of drugs for IBS symptoms, use of alternative non-pharmacological treatments, and if they still actively used hypnotherapy.
11 Jun

Investigators from the Department of Gastroenterology at Shaare Zedek Medical Center and the Hebrew University School of Medicine in Jerusalem conducted a randomized, controlled trial with 56 outpatients suffering from Inflammatory Bowel Disease (IBD) to see if relaxation training could improve their quality of life.
 
Subjects were randomly assigned to a treatment group or a waiting-list control group.  Treatment group patients attended three relaxation-training sessions and received an audio disc for home practice.

21 Nov

Researchers from UCLA investigated whether a cognitive-behavioral treatment known as Interoceptive Exposure (originally developed for treating panic disorder) targeting visceral anxiety could alleviate the symptoms of Irritable Bowel Syndrome, a potentially debilitating condition with few efficacious pharmacological or psychosocial treatment options available.

[Ed. Note:  for a fuller explanation of Interoceptive Exposure, click here]

The protocol randomly assigned 110 subjects to receive 10 sessions of either: (a) interoceptive exposure (IE) targeting visceral sensations (b) stress management (SM); or (c) an attention control condition (AC).  They were assessed at baseline, mid-treatment, post-treatment, and follow-up sessions.

31 Jul

Researchers from the Department of Clinical Neuroscience of the Karolinska Institutet in Stockholm, Sweden conducted a follow-up of a previously reported study of internet-delivered cognitive behavior therapy (CBT) for Irritable Bowel Syndrome (IBS), based on exposure and mindfulness exercises (Ljótsson et al. (2010) Internet-delivered exposure and mindfulness based therapy for irritable bowel syndrome - a randomized controlled trial. Behaviour Research and Therapy, 48, 531-539).

25 Oct

In this small pilot study, researchers from the Department of Behavioral Medicine at Tohoku University Graduate School of Medicine in Japan looked at the impact of Autogenic Training (AT) on the symptoms of irritable bowel syndrome (IBS).

Twenty-one patients with IBS were randomly assigned to AT (n = 11, 5 male, 6 female) or a control condition (n = 10, 5 male, 5 female). AT patients were trained intensively, while the control therapy participated in discussions about eating habits and general lifestyle.

All patients answered a question measuring adequate relief (AR) of IBS symptoms and four questionnaires: Self-induced IBS Questionnaire (SIBSQ), Self-reported Depression Scale (SDS), State-Trait Anxiety Inventory (STAI), and Medical Outcome Short Form 36 Health Survey (SF-36).

23 Nov

Researchers from the University of Manchester in the United Kingdom reviewed the literature, looking at the effects of hypnotherapy on functional gastro-intestinal disorders, such as irritable bowel syndrome, functional dyspepsia, and non-cardiac chest pain – conditions which create severe symptoms and erode quality of life.  

Because these conditions are notoriously hard to treat, often impervious to a wide variety of conventional medicines, there has been an unusual openness to exploring hypnosis as a treatment option.

This review concludes that hypnotherapy relieves symptoms and also appears to restore many of the supposed psychological and physiological “abnormalities” that, for better or worse, become  associated with these conditions.  The authors recommend that hypnosis be integrated into the ongoing medical care that patients suffering from these functional gastro-intestinal conditions are receiving.

Citation:  Miller V, Whorwell PJ.  Hypnotherapy for functional gastrointestinal disorders: a reviewInternational Journal of Clinical and Experimental Hypnosis. 2009 July; 57 (3): pages 279-92.