Hypnotherapy could help relieve symptoms of irritable bowel syndrome

Hypnotherapy may help relieve symptoms of Irritable Bowel Syndrome (IBS) in some patients up to 9 months after the end of treatment, in a randomized controlled trial of 354 adults with IBS in primary and secondary care. The Lancet Gastroenterology & Hepatology newspaper.

After 3 months of treatment, more patients (40%, 41/102 for which data was available) and hypnotherapy groups (33%; 31/91) reported adequate symptom relief. IBS compared to those receiving education and supportive care. (17%, 6/35), and these benefits persisted at the 9-month follow-up (42% [38/91]50% [40/80]and 22% [7/31]).

Importantly, the results suggest that group hypnotherapy is as effective as individual sessions, which could allow more IBS patients to be treated cheaply.

The study is the largest randomized trial of hypnotherapy for SIB to date and one of the first to be conducted in primary care, where the vast majority of IBS patients are treated.

The study found that IBS patients undergoing hypnotherapy reported a greater overall improvement in their condition and were better able to cope with and be less disrupted by their symptoms compared to those receiving treatment. educational support. However, hypnotherapy does not seem to reduce the severity of symptoms.

Although the results are promising, the authors conclude that more research is needed to test the optimal number of hypnotherapy sessions, the effect that patient expectations may have on treatment outcomes, and the extent to which outcomes hypnotherapy are influenced by the magnitude of the psychological consequences. patient complaints.

"Our study indicates that hypnotherapy could be considered a treatment option for patients with IBS, regardless of the severity of the symptoms and the subtype of IBS," said Dr. Carla Flik of the Medical Center. University of Utrecht, The Netherlands, who led the research. "It is also promising to see that group hypnotherapy is as effective as individual sessions, which could mean that more people could be treated cheaply, should this be confirmed by new studies."

"What is striking with these results is the extent to which the patient's perception of their illness has an effect on their suffering and the fact that their perception of symptoms seems to be as important as the actual severity of symptoms." . "

The SCI affects about 1 in 5 people worldwide. It is a persistent and difficult to treat condition, the symptoms of which can seriously affect the quality of life, including abdominal pain, bloating, diarrhea and constipation. For many people, drug and diet treatments do not work.

Psychological interventions have proven effective, but their use is limited by a shortage of qualified therapists. Hypnotherapy has already shown promising results for IBS, but the majority of studies have been done in highly specialized centers and further research is needed to determine whether hypnotherapy is beneficial for primary and secondary care, where most patients are treated.

The IMAGINE study recruited 354 adults (aged 18 to 65 years) with IBS, who were referred by primary care physicians and hospital specialists to 11 hospitals in the Netherlands between May 2011 and April 2016. Participants were randomly assigned between two 45-minute individual sessions. (150 patients) or group sessions (150) hypnotherapy twice a week for 6 weeks, or education and supportive care (54).

The hypnotherapy treatment was provided by psychologists trained in hypnotherapist. It was a positive visualization technique in which patients received suggestions on how to control their digestive system to reduce feelings of pain and discomfort. Patients also received a CD so that they could practice self-hypnosis exercises at home for 15 to 20 minutes each day.

Participants assessed the severity of their symptoms, their quality of life, their psychological symptoms, their cost in health care and their absence from work at the start of the trial and immediately after treatment (3 months) and again 9 months later, as well as on symptom relief. immediately after treatment and 9 months later.

The results showed that immediately after treatment, participants in both hypnotherapy groups reported satisfactory relief at rates well above those receiving supportive educational care and that these benefits persisted for 9 years. months after the end of treatment (Table 2).

Nevertheless, satisfactory symptom relief did not accompany a significant improvement in the severity of symptoms.

As Dr. Flik explains: "We do not know exactly how the hypnotherapy led by the intestines, but it can change the state of mind and the internal mechanisms of … adaptation of patients, thus allowing them to better control the processes of the autonomous body, such as the treatment of pain and modulation, intestinal activity. "

Improvements in quality of life, psychological complaints, cognitions, reduced medical costs, and ICS-related work absences were similar across groups.

Overall, hypnotherapy was well tolerated. Eight serious and unexpected adverse effects (six in the group of hypnotherapy and two in the hypnotherapy group) have been reported, mainly cancer and inflammatory bowel disease, but no symptoms. were not related to hypnotherapy.

The authors highlight some limitations: for example, 22 patients (15%) from the hypnotherapy group, 22 (15%) from the hypnotherapy group and 11 (20%) from the control group discontinued treatment before or during treatment, and a significant number participants did not complete the questionnaires 3 months and 9 months after treatment, which could have skewed the results (Figure 1). They also point out that the lack of experience of IBS therapists and the low number (six) of hypnotherapy sessions provided (half of the usual number) could have led to an underestimation of the effects of IBS. # 39; hypnotherapy.

Olafur Palsson, professor at the University of North Carolina at Chapel Hill, United States, describes factors that may have contributed to the "modest" impact of hypnosis in the study .

He writes: "The hypnotherapy tested in this study was perhaps suboptimal in terms of amount or implementation.However, as noted by the authors, the lower therapeutic effect of this trial compared Most of the trials of hypnotherapy in tertiary care might be due to the fact that care is different from tertiary care – perhaps of a simpler nature and with fewer psychological factors. An impressive investigation by Flik and his colleagues, it remains to be determined whether gut-directed hypnotherapy is well-suited to treating IBS in primary and secondary care, and future trials are needed to provide definitive answers. . "

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More information:
The Lancet Gastroenterology & Hepatology, www.thelancet.com/journals/lan… (18) 30310-8 / full text