OnMedica – News – Hypnotherapy Could Help Alleviate Irritable Bowel Syndrome

Symptom relief can last up to nine months, clinical trial results indicate

Hypnotherapy may reduce the symptoms of irritable bowel syndrome (IBS) in some patients up to nine months after treatment, according to one of the largest studies of its kind, published today in The Lancet Gastroenterology & Hepatology newspaper.

The study *, a randomized controlled trial of 354 adults with IBS in primary and secondary care, showed that patients treated with hypnotherapy received an overall improvement in their condition and were better able to cope with their symptoms. and less troubled by them. those who have received educational support therapy. However, hypnotherapy does not seem to reduce the severity of symptoms.

IBS affects about one in five people worldwide and is persistent and difficult to treat, with symptoms that can seriously affect quality of life, including abdominal pain, bloating, diarrhea, and constipation.

Psychological interventions have proven effective, but the lack of well-trained therapists prevents their widespread use. Research on hypnotherapy has already produced promising results for IBS, but most studies have been done in highly specialized centers rather than in primary and secondary care where most patients are treated.

The IMAGINE study recruited 354 adults (aged 18 to 65 years old) with IBS, which were referred to 11 hospitals in the Netherlands between May 2011 and April 2016. Participants were divided into between a 45-minute individual session (150 patients) or a group session. (150) twice a week for six weeks, or simply 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 completed the assessment of the severity of their symptoms, quality of life, psychological symptoms, health care costs and sick leave at the start of the trial immediately after treatment ( three months) and nine months later. The level of symptomatic relief was assessed immediately after treatment and nine months later.

Immediately after treatment, participants in both groups of hypnotherapy reported satisfactory relief at rates significantly higher than those receiving educational supportive care alone.

After three months of treatment, more patients (40%, 41/102 for which data was available) and hypnotherapy groups (33%; 31/91) reported adequate symptom relief. SCI, compared to those receiving education and supportive care. (17%, 6/35).

The benefits were still evident nine months later (42% [38/91]50% [40/80]and 22% [7/31]). But this has not been accompanied by a significant improvement in the severity of the symptoms.

"Our study indicates that hypnotherapy could be considered a treatment option for IBS patients, regardless of the severity of the symptoms and the subtype of IBS," says Dr. Carla Flik of the University Medical Center. from Utrecht (The Netherlands), who led the research.

"It is also promising that group hypnotherapy is as effective as individual sessions, which means that more people could be treated at a lower cost, should this be confirmed by new studies."

She adds, "These findings are striking: the impact of patients' perception of their illness on their suffering and their perception of symptoms seems as important as the actual severity of symptoms.

"We do not know exactly how gut-directed hypnotherapy works, but it could alter the mindset and internal coping mechanisms of patients, allowing them to better control organic processes, such as how which they treat the pain and modulate the intestinal activity.

The authors note some limitations in their research, including a relatively high dropout rate of 15 to 22% and the inability of a significant number of participants to complete the questionnaires after three and nine months. The inexperience of therapists in the treatment of IBS and the low number (six) of hypnotherapy sessions provided (half the usual number) might also have underestimated the effects of hypnotherapy.

In a related commentary, Professor Olafur Palsson, of the University of North Carolina at Chapel Hill, United States, examines factors that may have contributed to the "modest" therapeutic impact of hypnosis in the study.

"Hypnotherapy tested in this study may have been suboptimal in quantity or implementation. However, as noted by the authors, the lower therapeutic effect in this trial compared to most trials of hypnotherapy in tertiary care might be due to the fact that SCI in primary and secondary care is different from that in tertiary care – perhaps of a simpler nature and with less psychological involvement. factors.

"Therefore, despite this impressive investigative effort by Flik and his colleagues, it remains to be determined whether intestinal-directed hypnotherapy is well-suited to treating IBS patients with care. primary and secondary education, and future trials are needed to provide definitive answers. "

* Flik CE, et al. Efficacy of Individual and Group Hypnotherapy in Irritable Bowel Syndrome (IMAGINE): Randomized Multicentre Controlled Trial. The Lancet Gastroenterology and Hepatology, November 22, 2018