April 6, 2012 — Hypnotherapy appears to reduce irritable bowel syndrome (IBS) symptoms, and a recent study suggests that this improvement may last as long as 7 years after completion of the therapy. The study was published in the April issue of the Scandinavian Journal of Gastroenterology.
Perjohan Lindfors, MD, PhD, from Sahlgrenska Academy at the University of Gothenberg in Sweden, and colleagues conducted a retrospective assessment of patients with severe refractory IBS from 3 hospitals or clinics in Sweden who were treated with gut-directed hypnotherapy between 2000 and 2006. Two of the hospitals, Sahlgrenska University Hospital in Gothenburg and Ersta Hospital in Stockholm, Sweden, were specialized in the treatment of patients with functional gastrointestinal (GI) disorders. The third hospital, Gävle Hospital in Sweden, was a midsized county hospital with a small gastroenterology department.
Patients from Gothenburg and Gävle received their treatment as part of randomized controlled trials. The patients from Gävle were treated at the gastroenterology clinic, the patients from Gothenburg were recruited from the university but received hypnotherapy at private psychology practices outside the hospital, and the patients from Stockholm were treated at the unit according to clinic routine.
Patients who had received treatment for more than 12 weeks were excluded from the study. All patients met the Rome II criteria for IBS and had organic GI disease ruled out.
All patients in the current analysis were treated with 12 weekly individual hypnotherapy sessions by psychologists with experience in hypnotherapy for medical conditions and specialized training in gut-directed hypnotherapy. The psychologists in Stockholm also had clinical experience in gut-directed hypnotherapy. All psychologists used the Manchester approach, which has been described by a hypnotherapy group in the United Kingdom .
At the end of treatment, of 244 patients (Gothenburg, n = 80; Gävle, n = 30; Stockholm, n = 134) 208 completed the Subjective Assessment Questionnaire, also developed by the Manchester group. A patient responder was defined as "a patient who reported that his or her IBS symptoms at the end of the course of hypnotherapy compared with before the treatment started were 'very much better' or 'moderately better.' "
Of the 208 evaluable participants, 103 (49%) were considered responders and 105 (51%) were considered nonresponders. Of the responders, 75 patients (73%) said they experienced further improvement at long-term follow-up, conducted 2 to 7 years after completion of hypnotherapy.
More than two thirds of responders (69%) reported a decrease in visits to their general practitioner for GI symptoms at the end of hypnotherapy compared with 31% of the nonresponders (P < .0001). A total of 64% of responders had a reduction in the number gastroenterologist visits after completion of hypnotherapy compared with 32% of the nonresponders (P < .0001).
At the time of follow-up, 54 (54%) of the responders and 54 (51%) of the nonresponders were using medications for their IBS symptoms. Responders reported less medication use after treatment, and nonresponders reported more medication use after treatment, but these numbers were not statistically significant.
At follow-up, 75 (73%) of responders reported that they continued to use hypnotherapy techniques regularly compared with 51 (47%) of the nonresponders (P < .0001).
"The majority of the patients in the responder group (73%) still used the hypnotherapy technique actively at follow-up, which is perhaps easy to understand, but this was also true for 47% of the nonresponders, and in this group it was more common to actively use the technique every day," write the authors in the journal.
"This may reflect that gut-directed hypnotherapy affects the ability to cope with symptoms, even if the severity of the symptoms is unchanged. Only three-fourths of the responders still used the hypnotherapy technique actively at follow-up, which may suggest that the effect is sustained and the need for active use of hypnotherapy has ceased over time," the authors write.
Long-term prospective studies are needed to validate the findings in this study, report the authors.
The authors have disclosed no relevant financial relationships.
Scand J Gastroenterol. 2012;47:414-421. Abstract
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