Research Done Using Clinical Hypnotherapy for IBS Treatment

I thought it may be helpful to have research and background summary information on this forum in addition to the other listing locations, so that newbies can refer to it all in one place.

Here is the link and some excerpts from background information for the IBS Audio Program 100 developed by Mike Mahoney of England - the program is available through this site.

http://www.helpforibs.com/hypnosis/selfhyp1.asp

Mahoney's 80 - 90% + success rate statistics arise from studies with patients who were given no relief whatsoever from conventional medical therapy – people who were, in fact, referred by gastroenterologists who had exhausted all other potential avenues of help. The incomparable success rates for the tapes are likely due to Mahoney's in-depth study and understanding of both IBS and hypnotherapy, which results in reducing anxiety, stress and fears directly related to IBS attacks, and increasing patient confidence, self esteem, and management of IBS-specific symptoms.
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After several years of exclusive IBS practice, the dramatic reduction in symptom severity and frequency of Mahoney's patients became well-known locally, and he began receiving numerous referrals from gastroenterologists as well as family physicians. In 1996 he was asked to participate in a medical research study of IBS hypnotherapy funded by the UK National Health Service through a gastroenterology practice at his Local Primary Care Medical Centre, to be monitored and audited by the local Health Authority Audit Commission. For this project, 20 patients were screened by the gastroenterologists and presented various symptoms of IBS. All patients were long-term sufferers, had undergone all medical diagnostic tests, and had taken prescription medications without attaining significant relief from their symptoms. Each patient underwent Mahoney's introductory and five subsequent hypnotherapy sessions. The patients were split into groups, and the hypnotherapy sessions for all groups were staggered over 12 months. At the end of the project, feedback sheets from the patients indicated an overall reduction of 80% in symptom severity and frequency of presentation.

The success of this independent research project, to Mahoney's delight, confirmed his informal findings from earlier patient treatments in private practice. However, he now had additional patient feedback to work with, and this allowed him to further refine various aspects of the hypnotherapy delivery methods and processes.

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This success rate was based on reduction of symptom severity, and the frequency of symptom presentation (how often symptoms occur). Pain, diarrhea, constipation, bloating, and other symptoms were quantified by the patients and individually measured, as was the perceived improvement in overall quality of life. Patients were asked to mark as a percentage the improvement they felt during the program period, immediately after the program had finished, and to commit to three follow up periods of assessment at 12 months, 24 months, and 36 months after therapy ended. The treatment group included 11 females and 4 males; average age 34.

For females: Average frequency of symptom presentation: 3.4 times daily. Average length of time IBS symptoms present: 8.63 years Average length of time on medications: 5.5 years. Average reduction in medications over group: 96%.

For males: Average frequency of symptom presentation: 2.5 times daily. Average length of time IBS symptoms present: 4.75 years. Average length of time on medications: 3.8 years. Average reduction in medications: 94%. (1991 patient trials, per Michael Mahoney interviews and private documents, February-April 2001).

Here is an overview of some of the research done using clinical hypnotherapy in the treatment of IBS - this is only a partial listing - more may be found via the link:

http://www.helpforibs.com/messageboards/ubbthreads/showflat.php?Cat=&Board=library&Number=13951&page=0&view=collapsed&sb=5&o=&fpart=all&vc=1

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Gut. 2003 Nov;52(11):1623-9.

Long term benefits of hypnotherapy for irritable bowel syndrome.

Gonsalkorale WM, Miller V, Afzal A, Whorwell PJ.

Department of Medicine, University Hospital of South Manchester, Manchester, UK.

BACKGROUND: and aims: There is now good evidence from several sources that hypnotherapy can relieve the symptoms of irritable bowel syndrome in the short term. However, there is no long term data on its benefits and this information is essential before the technique can be widely recommended. This study aimed to answer this question.

PATIENTS AND METHODS: 204 patients prospectively completed questionnaires scoring symptoms, quality of life, anxiety, and depression before, immediately after, and up to six years following hypnotherapy. All subjects also subjectively assessed the effects of hypnotherapy retrospectively in order to define their "responder status".

RESULTS: 71% 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. With respect to symptom scores, all items at follow up were significantly improved on pre-hypnotherapy levels (p<0.001) and showed little change from post-hypnotherapy values. There were no significant differences in the symptom scores between patients assessed at 1, 2, 3, 4, or 5+ years following treatment. Quality of life and anxiety or depression scores were similarly still significantly improved at follow up (p<0.001) but did show some deterioration. Patients also reported a reduction in consultation rates and medication use following the completion of hypnotherapy.

CONCLUSION: This study demonstrates that the beneficial effects of hypnotherapy appear to last at least five years. Thus it is a viable therapeutic option for the treatment of irritable bowel syndrome.

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Overview of Published Research To Date on Hypnosis for IBS
By Olafur S. Palsson, Psy.D.

Whorwell PJ; Prior A; Colgan SM. Hypnotherapy in severe irritable bowel syndrome: further experience. Gut, 1987 Apr, 28:4, 423-5. This report summed up further experience with 35 patients added to the 15 treated with hypnotherapy in the 1984 Lancet study. For the whole 50 patient group, success rate was 95% for classic IBS cases, but substantially less for IBS patients with atypical symptom picture or significant psychological problems. The report also observed that patients over age 50 seemed to have lower success rate from this treatment.

Harvey RF; Hinton RA; Gunary RM; Barry RE. Individual and group hypnotherapy in treatment of refractory irritable bowel syndrome. Lancet, 1989 Feb, 1:8635, 424-5. This study employed a shorter hypnosis treatment course than other studies for IBS, and the success rate was lower, most likely demonstrating that a larger number of sessions is necessary for optimal benefit. Twenty out of 33 patients with refractory irritable bowel syndrome treated with four sessions of hypnotherapy in this study improved. Improvement was maintained at a 3-month treatment. These researchers further found that hypnosis treatment for IBS in groups of up to 8 patients seems as effective as individual therap

Prior A, Colgan SM, Whorwell PJ. Changes in rectal sensitivity after hypnotherapy in patients with irritable bowel syndrome. Gut 1990;31:896. This study found IBS patients to be less sensitive to pain and other sensations induced via balloon inflation in their gut while they were under hypnosis. Sensitivity to some balloon-induced gut sensations (although not pain sensitivity) was reduced following a course of hypnosis treatment.

Houghton LA; Heyman DJ; Whorwell PJ. Symptomatology, quality of life and economic features of irritable bowel syndrome--the effect of hypnotherapy. Aliment Pharmacol Ther, 1996 Feb, 10:1, 91-5. This study compared 25 severe IBS patients treated with hypnosis to 25 patients with similar symptom severity treated with other methods, and demonstrated that in addition to significant improvement in all central IBS symptoms, hypnotherapy recipients had fewer visits to doctors, lost less time from work than the control group and rated their quality of life more improved. Those patients who had been unable to work prior to treatment resumed employment in the hypnotherapy group but not in the control group. The study quantifies the substantial economic benefits and improvement in health-related quality of life which result from hypnotherapy for IBS on top of clinical symptom improvement.

Koutsomanis D. Hypnoanalgesia in the irritable bowel syndrome. Gastroenterology 1997, 112, A764. This French study showed less analgesic medication use required and less abdominal pain experienced by a group of 12 IBS patients after a course of 6-8 analgesia-oriented hypnosis sessions followed by 4 sessions of autogenic training. Patients were evaluated at 6-month and 12-month follow-up.

Houghton LA, Larder S, Lee R, Gonsalcorale WM, Whelan V, Randles J, Cooper P, Cruikshanks P, Miller V, Whorwell PJ. Gut focused hypnotherapy normalises rectal hypersensitivity in patients with irritable bowel syndrome (IBS). Gastroenterology 1999; 116: A1009. Twenty-three patients each received 12 sessions of hypnotherapy. Significant improvement was seen in the severity and frequency of abdominal pain, bloating and satisfaction with bowel habit. A subset of the treated patients who were found to be unusually pain-sensitive in their intestines prior to treatment (as evidenced by balloon inflation tests) showed normalization of pain sensitivity, and this change correlated with their pain improvement following treatment. Such pain threshold change was not seen for the treated group as a whole.

Palsson, OS, Burnett CK, Meyer K, and Whitehead WE. Hypnosis treatment for irritable bowel syndrome. Effects on symptoms, pain threshold and muscle tone. Gastroenterology 1997;112:A803. Seventeen out of 18 patients with severe and treatment-refractory IBS who completed a 7-session standardized course of hypnosis treatment improved substantially. All central symptoms of IBS responded to treatment, including abdominal pain, diarrhea/constipation, and bloating. Psychological well-being also increased after treatment, with overall psychological symptoms, anxiety and somatization markedly decreased. Gut pain thresholds and smooth muscle tone, measured with a barostat and balloon inflation tests, were unchanged following treatment.

Vidakovic Vukic M. Hypnotherapy in the treatment of irritable bowel syndrome: methods and results in Amsterdam. Scand J Gastroenterol Suppl, 1999, 230:49-51.Reports results of treatment of 27patients of gut-directed hypnotherapy tailored to each individual patient. All of the 24 who completed treatment were found to be improve.

Galovski TE; Blanchard EB. Appl Psychophysiol Biofeedback, 1998 Dec, 23:4, 219-32. Eleven patients completed hypnotherapy, with improvement reported for all central IBS symptoms, as well as improvement in anxiety. Six of the patients were a waiting-control group for comparison, and did not show such improvement while waiting for treatment.

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. Am J Gastroenterol 2002 Apr;97(4):954-61.

This study is notable as the largest case series of IBS patients treated with hypnosis and reported on to date. 250 unselected IBS patients were treated in a clinic in Manchester, England, using 12 sessions of hypnotherapy over a 3-month period plus home practice between sessions. Marked improvement was seen in all IBS symptoms (overall IBS severity was reduced by more than half on the average after treatment), quality of life, and anxiety and depression. All subgroups of patients appeared to do equally well except males with diarrhea, who improved far less than other patients for unknown reason.

Palsson OS, Turner MJ, Johnson DA, Burnett CK, Whitehead WE. Hypnosis treatment for severe irritable bowel syndrome: investigation of mechanism and effects on symptoms. Dig Dis Sci 2002 Nov;47(11):2605-14.

Possible physiological and psychological mechanisms of hypnosis treatment for IBS were investigated in two studies. Patients with severe IBS received seven 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, anxiety, and depression were also measured. All central IBS symptoms improved substantially from treatment in both studies. Rectal pain thresholds, rectal smooth muscle tone, and autonomic functioning (except sweat gland reactivity) were unaffected by hypnosis treatment. However, somatization and psychological distress showed large decreases. In conclusion, hypnosis improves IBS symptoms through reductions in psychological distress and somatization. Improvements were unrelated to changes in the physiological parameters measured. 17 of 18 patients in study 1 and 21 of 24 patients in study 2 were judged substantially improved Improvement was well-maintained at 10-12 month follow up in study 2.

© Copyright 2000-2003, Olafur S. Palsson, Psy.D. All Rights Reserved.

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Am J Gastroenterol. 2002 Apr;97(4):954-61.

Hypnotherapy in irritable bowel syndrome: a large-scale audit of a clinical service with examination of factors influencing responsiveness.

Gonsalkorale WM, Houghton LA, Whorwell PJ.

Department of Medicine, University Hospital of South Manchester, United Kingdom.

OBJECTIVES: Hypnotherapy has been shown to be effective in the treatment of irritable bowel syndrome in a number of previous research studies. This has led to the establishment of the first unit in the United Kingdom staffed by six therapists that provides this treatment as a clinical service. This study presents an audit on the first 250 unselected patients treated, and these large numbers have also allowed analysis of data in terms of a variety of other factors, such as gender and bowel habit type, that might affect outcome. METHODS: 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. RESULTS: Marked improvement was seen in all symptom measures, quality of life, and anxiety and depression (all ps < 0.001), 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 (p < 0.001). No factors, such as anxiety and depression or other prehypnotherapy variables, could explain this lack of improvement. CONCLUSIONS: This study clearly demonstrates that hypnotherapy remains an extremely effective treatment for irritable bowel syndrome and should prove more cost-effective as new, more expensive drugs come on to the market. It may be less useful in males with diarrhea-predominant bowel habit, a finding that may have pathophysiological implications.

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Hypnotherapy an effective treatment for IBS

Contact: Jo Nightingale
University of Manchester

Medics at The University of Manchester have discovered a way to treat Irritable Bowel Syndrome (IBS) using hypnotherapy.
Up to eight million people in Britain suffer from IBS, with symptoms including diarrhoea, pain and bloating. The condition can seriously affect sufferers' quality of life and finding treatment can be difficult, leading many doctors to feel they can do little to help.

Research by Peter Whorwell, Professor of Medicine and Gastroenterology in the University's Medical School and Director of the South Manchester Functional Bowel Service, has been researching the use of gut-directed hypnosis for over 20 years. Most recently, two hundred and fifty patients who have suffered from IBS for over two years were given twelve one-hour sessions, during which they were given an explanation of how the gut works and what causes their symptoms.

"IBS is ideal for treatment with hypnosis, as there is no structural damage to the body," explained Professor Whorwell. "During the hypnotherapy, sufferers learn how to influence and gain control of their gut function, and then seem to be able to change the way the brain modulates their gut activity."

With a success-rate of about 70% Professor Whorwell believes that, although labour-intensive, hypnotherapy could be an extremely effective treatment for the condition; and a less expensive alternative to new, costly drugs coming onto the market.

"We've found it to help all the symptoms, whereas some of the drugs available reduce only a few," he said. "As IBS can be a life-long condition it could clearly be a very valuable option for patients; however it is not suitable for everyone and women tend to respond better than men."

Professor Whorwell has founded a dedicated unit at Wythenshawe Hospital which treats patients from all over the UK, as the treatment can only be carried out by a practitioner trained in gut-directed hypnotherapy and is not yet widely available on the NHS.

Former patient Sonia Pinnock said, "I suffered from IBS and was on medication for nearly 20 years, but could get little relief from my symptoms. Since visiting the clinic for 12 hypnotherapy sessions last year however they've disappeared completely – the difference it's made to my quality of life is indescribable."

Another happy patient Christine Walsh continued, "After my hysterectomy I suffered from IBS for about five years, and it totally ruined my quality of life. I couldn't plan holidays or leisure activities and at work I was often doubled-up in pain. But since having weekly hypnotherapy sessions for three months I've now been free from IBS for five and a half years - the treatment has totally changed my life."

Professor Whorwell concludes, "The term hypnosis was coined by a Manchester surgeon, James Braid, early in the nineteenth century, and it's been in and out of fashion ever since. I'd like to think that our Unit has brought hypnotherapy back to Manchester, and helped improve its legitimacy."

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For complete information, rather than just these excerpts, please refer to the links! Also take a peek at the featured threads on this forum for more info as well.

Also, feel free to post any questions - we are all here to support!

Be well.

~ Marilyn

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My Journey and Success with the IBS Audio Program Hypnotherapy Program: www.helpforibs.com/messageboards/ubbthreads/showflat.php?Cat=&Board=hypnotherapy&Number=224850

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Hypnosis for IBS

Hypnosis for IBS