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Patient - Irritable Bowel Syndrome (IBS) Hypnotherapy

Forbes A, MacAuley S, Chiotakakou-Faliakou E. "Hypnotherapy and therapeutic audiotape: effective in previously unsuccessfully treated irritable bowel syndrome?" International Journal of Colorectal Disease. 15(5-6):328-34, 2000.
Therapeutic audiotapes were compared with gut-directed hypnotherapy in a randomised controlled trial. Eighty-nine patients with established IBS were recruited to a 12-week study. None had gotten relief from dietary and drug therapy. Most patients had symptoms of approximately 5 years duration. Twenty-five patients had six sessions of hypnotherapy and 27 patients used the audiotape. Symptom scores improved in 76% of hypnotherapy patients and in 59% of tape patients (not significant). Gut-directed hypnotherapy and audiotapes appear valuable in treatment-resistant IBS. Although probably not as effective as hypnotherapy, the ease and affordability of audiotape use may be considered sufficient to recommend it as a second-line option in IBS, reserving hypnotherapy for those who need further intervention.

Gonsalkorale WM, Miller V. Afzal A, Whorwell PJ. "Long term benefits of hypnotherapy for irritable bowel syndrome." Gut. 52:1623-1629, 2003.
There is now good evidence from several sources that hypnotherapy can relieve the symptoms of irritable bowel syndrome in the short term. This study looked at whether there were long term benefits of hypnotherapy for IBS. Questionnaires were completed by 204 patients scoring symptoms, quality of life, anxiety and depression before, immediately after, and up to six years following hypnotherapy. Seventy one percent of patients initially responded to therapy. Of these, 81% maintained their improvement over time while the majority of the remaining 19% claimed that deterioration of symptoms had only been slight. Quality of life and anxiety or depression scores were still significantly improved at follow up but did show some deterioration. Patients also reported a reduction in healthcare visits and medication use following the completion of hypnotherapy. This study demonstrated that the beneficial effects of hypnotherapy appear to last at least five years, making it a viable therapeutic option for the treatment of irritable bowel syndrome.>

Gonsalkorale WM, Toner BB, Whorwell PJ. "Cognitive change in patients undergoing hypnotherapy for irritable bowel syndrome." Journal of Psychosomatic Research. 56(3):271-8, 2004.
Decreased quality of life and psychological distress are common in irritable bowel syndrome (IBS) and may be associated with unhelpful thinking. Hypnotherapy (HT) is effective in improving both symptoms and quality of life in patients with IBS, and this study was designed to determine whether this improvement is reflected in cognitive change. A total of 78 IBS patients were tested before and after 12 sessions of gut-focused HT. HT resulted in improvement of symptoms, quality of life and scores for anxiety and depression. IBS-related cognition (thought processes) also improved, with reduction in the total cognitive score and all component themes related to bowel function. Cognitions were related to symptom severity because the most abnormal cognitive scores were observed in patients with the highest symptom scores. Furthermore, a reduction in symptom score following treatment correlated with an improvement in the cognitive score. This study shows that symptom improvement in IBS with hypnotherapy is associated with cognitive change. It also represents an initial step in unravelling the many possible mechanisms by which treatments such as hypnotherapy might bring about improvement.

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." American Journal of Gastroenterology. 97(4): 954-961, 2002.
Hypnotherapy has been shown to be effective in the treatment of irritable bowel syndrome in a number of previous research studies. This study presents an audit on the first 250 unselected patients treated. Patients underwent 12 sessions of hypnotherapy over a 3-month period and were required to practice techniques in between sessions. At the beginning and end of the course of treatment, patients completed questionnaires to score bowel and extracolonic symptoms, quality of life, and anxiety and depression, allowing comparisons to be made. Marked improvement was seen in all symptom measures, quality of life, and anxiety and depression, in keeping with previous studies. All subgroups of patients appeared to do equally well, with the notable exception of males with diarrhea, who improved far less than other patients.

Harvey RF, Gunary RM, Hinton RA, et al. "Individual and group hypnotherapy in treatment of refractory irritable bowel syndrome." The Lancet. 1(8635):424-5, 1989 Feb 25.
Thirty-three patients with irritable bowel syndrome that was resistant to treatment received four 40-minute sessions of hypnotherapy over 7 weeks. Twenty improved, 11 of whom lost almost all their symptoms. Short-term improvement was maintained for 3 months without further formal treatment. Hypnotherapy in groups of up to 8 patients was as effective as individual therapy.

Houghton LA, Heyman DJ, Whorwell PJ. "Symptomotology, quality of life and economic features of irritable bowel syndrome—the effect of hypnotherapy. Alimentary Pharmacological Therapy. 10(1):91-5, 1996.
The purposes of this study were to quantify the effects of severe irritable bowel syndrome on quality of life and economic functioning, and to assess the impact of hypnotherapy on these features. A quality of life questionnaire including questions on symptoms, employment and health seeking behavior was administered to 25 patients treated with hypnotherapy and to 25 control irritable bowel syndrome patients of comparable severity. Patients treated with hypnotherapy reported less severe abdominal pain, bloating, nausea, flatulence, urinary symptoms, lethargy, backache, and painful sexual intercourse compared with control patients. Quality of life, such as emotional and physical well being, mood, locus of control, and work attitude were also favorably influenced by hypnotherapy. For those patients who were employed, more of the controls were likely to take time off work (79% vs. 32%) and visit their general practitioner (58% vs. 21%) than those treated with hypnotherapy. Three of four hypnotherapy patients out of work prior to treatment resumed employment compared with none of the six in the control group. This study has shown that in addition to relieving the symptoms of irritable bowel syndrome, hypnotherapy profoundly improves patients’ quality of life and reduces absenteeism from work.

Palsson OS, Turner MJ, Johnson DA, et al. "Hypnosis treatment for severe irritable bowel syndrome: investigation of mechanism and effects on symptoms." Digestive Diseases & Sciences. 47(11):2605-14, 2002.
Hypnosis improves irritable bowel syndrome (IBS), but the mechanism is unknown. Possible physiological and psychological mechanisms were investigated in two studies. Patients with severe IBS received 7 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 (conversion of an emotional, mental, or psychosocial problem to physical symptoms), anxiety, and depression were also measured. All central IBS symptoms improved substantially from treatment in both studies. Somatization and psychological distress showed large decreases. In conclusion, hypnosis improves IBS symptoms through reductions in psychological distress and somatization.

Simren M, Ringstrom G, Bjornsson ES, Abrahamsson H. "Treatment with hypnotherapy reduces the sensory and motor component of the gastrocolonic response in irritable bowel syndrome." Psychosomatic Medicine. 66:233-238, 2004.
After-meal 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. Twenty eight patients with irritable bowel syndrome that had not responded to other treatments were randomized to receive gut-directed hypnotherapy 1 hour per week for 12 weeks or were provided with supportive therapy (control group). Hypnotherapy reduced the sensory and motor component of the gastro-colonic response in patients with irritable bowel syndrome. These effects may be involved in the effectiveness of hypnotherapy in IBS.

Whorwell PJ. "Review article: The history of hypnotherapy and its role in the irritable bowel syndrome." Alimentary Pharmacology & Therapeutics. 22(11-12):1061-7, 2005 Dec.
This paper reviews the history of hypnotherapy, its physiological effects, and the accumulating evidence that it is effective in relieving the symptoms of irritable bowel syndrome and improving quality of life.

Whorwell PJ. "Review article: The history of hypnotherapy and its role in the irritable bowel syndrome." Alimentary Pharmacology & Therapeutics. 22(11-12):1061-7, 2005 Dec.


 
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