A new study shows that hypnotherapy might help relieve irritable bowel syndrome (IBS) complaints for some patients for as long as nine months after the end of treatment.
The study, a randomized controlled trial of 354 adults with IBS in primary and secondary care, found that after three months of treatment, adequate relief of IBS symptoms was reported by 40 percent of the patients who received individual hypnotherapy and 33 percent of those in group hypnotherapy.
That is compared to 17 percent of patients who were give education and supportive care. The study also found that these benefits persisted at a follow-up nine months later.
Importantly, the researchers say, the findings suggest that group hypnotherapy is as effective as individual sessions, which could enable many more patients with IBS to be treated at reduced cost.
According to the study’s findings, IBS patients undergoing hypnotherapy reported a greater overall improvement in their condition and were more able to cope with, and were less troubled by, their symptoms compared with those who received educational supportive therapy. However, hypnotherapy did not appear to reduce the severity of symptoms, the researchers noted.
While the findings are promising, the researchers noted that more research will be needed to test the optimum number of hypnotherapy sessions, the effect that patient expectations may have on treatment outcome, and the extent to which hypnotherapy outcomes are influenced by the magnitude of the psychological complaints of the patient.
“Our study indicates that hypnotherapy could be considered as a treatment option for patients with IBS, irrespective of symptom severity and IBS subtype,” said Dr. Carla Flik from the University Medical Center Utrecht in the Netherlands, who led the research.
“It is also promising to see that group hypnotherapy is as effective as individual sessions, which may mean that more people could be treated with it at lower cost, should it be confirmed in further studies.”
“What’s striking about these findings is the extent to which patient’s perception of their illness has an effect on their suffering, and that their perception of symptoms appears to be as important as actual symptom severity,” she added.
IBS affects around one in five people worldwide and is a persistent and difficult-to-treat condition, with symptoms that can seriously affect quality of life, including abdominal pain, bloating, diarrhea, and constipation. For many sufferers, drug and dietary treatments are not successful.
Psychological interventions have proven effective, but their use is limited by a shortage of trained therapists, the researchers said. Hypnotherapy has previously shown promising results for IBS, but the majority of studies have been done in highly specialized centers, and more research is needed into whether hypnotherapy is beneficial in primary and secondary care where most patients are treated, the researchers said.
The IMAGINE study recruited 354 adults between the ages of 18 and 65 with IBS who were referred by primary care physicians and hospital specialists to 11 hospitals across the Netherlands between May 2011 and April 2016. Participants were randomly assigned to receive either 45-minute individual sessions (150 patients) or group sessions (150) of hypnotherapy twice weekly for six weeks, or education and supportive care (54).
Hypnotherapy treatment was provided by psychologists who were trained as hypnotherapists and involved a technique of positive visualization during which patients were given suggestions about how they could gain control over their digestive system to reduce feelings of pain and discomfort. Patients were also given a CD so they could practice self-hypnosis exercises at home for 15 to 20 minutes every day.
Participants completed assessments on their level of symptom severity, quality of life, psychological symptoms, health-care costs, and work absence at the start of the trial and immediately after the three-month treatment and again nine months later, as well as symptom relief immediately after treatment and nine months later.
Results showed that immediately after treatment, participants in the two hypnotherapy groups reported satisfactory relief at substantially higher rates than those who received educational supportive care, and these benefits persisted for nine months after the treatment ended.
Satisfactory relief of symptoms, however, was not accompanied by a significant improvement in symptom severity, the researchers discovered.
“We do not know exactly how gut-directed hypnotherapy works, but it may change patients’ mindsets and internal coping mechanisms, enabling them to increase their control over autonomic body processes, such as how they process pain and modulate gut activity,” Flik said.
Improvements in quality of life, psychological complaints, cognition, and reductions in medical costs and IBS-related work absence were similar between groups, she noted.
The researchers point out some limitations to the study. For instance, 22 patients in the individual hypnotherapy group, 22 in the group hypnotherapy group, and 11 in the control group dropped out before or during therapy.
Additionally, a substantial number of participants did not complete questionnaires at three months and nine months after treatment, which might have biased the results. They also point out that the inexperience of therapists in dealing with IBS, and the low number — six — of hypnotherapy sessions provided (half the usual number), might have led to underestimations of the effects of hypnotherapy.
The study was published in The Lancet Gastroenterology & Hepatology journal.
Source: The Lancet