

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.
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.
Lea R, Houghton LA, Calvert EL, Larder S, Gonsalkorale WM, Whelan V, Randles J,
Cooper P, Cruickshanks P, Miller V, Whorwell PJ.Gut-focused hypnotherapy
normalizes disordered rectal sensitivity in patients with irritable
bowel syndrome.Alimentary Pharmacology& Therapeutics 2003 Mar
1;17(5):635-42.
This study evaluated the rectal
sensitivity changes in IBS patients who received hypnotherapy, like a
previous study by the same group (see Houghton et al's study above, but
using a slightly different methodology. Twenty-three IBS patients were
tested before and after 12 weeks of
hypnotherapy. Following the course of hypnotherapy, the mean pain
sensory threshold increased in the hypersensitive subgroup and tended to
decrease in the hyposensitive group,
although the l. Reduction in gut pain sensitivity was associated with a
reduction in abdominal pain. These results suggest that hypnotherapy may
work at least partly by normalizing bowel perception in those patients
who have abnormal gut sensitivity, while leaving normal sensation
unchanged.
Gonsalkorale WM, Miller V, Afzal A, Whorwell PJ. Long term benefits of hypnotherapy for irritable bowel syndrome.
Gut. 2003 Nov;52(11):1623-9.
In this study, 204 IBS patients treated with a course of hypnotherapy
completed questionnaires scoring symptoms, quality of life, anxiety, and
depression before, immediately after, and up to six years following
treatment. 71% of patients showed improvement in response to treatment
initially, and of those, 81% were still improved years later, while most
of the other 19% only reported slight worsening of symptoms. Quality
of life and anxiety or depression scores were also still significantly
improved at follow-up but showed some deterioration. Patients also
reported fewer doctor visits rates and less medication use long-term
after hypnosis treatment. These results indicate that for most patients
the benefits from hypnotherapy last at least five years.
Gonsalkorale WM, Toner BB, Whorwell PJ. J Psychosom Res. 2004 Mar;56(3):271-8. Cognitive change in patients undergoing hypnotherapy for irritable bowel syndrome.
Cognitive changes were evaluated in 78 IBS patients who completed a
12-session hypnosis treatment course, using the recently developed Cognitive Scale for Functional Bowel Disorders. Hypnotherapy resulted in improvement of symptoms, quality of life, anxiety and depression. Unhelpful IBS-related cognitions improved significantly, with reduction in thetotal cognitive score and all component themes related to bowelfunction. Overall symptom reduction correlated with an improvement on the cognitive scale.
Palsson OS, Turner MJ, Whitehead WE. Hypnosis home treatment for irritable bowel syndrome: a pilot study. Int J Clin Exp Hypn. 2006 Jan;54(1):85-99.
A 3-month home-treatment version of a scripted hypnosis protocol previously shown to improve all central IBS symptoms was completed by 19 IBS patients. Outcomes were compared to those of 57 matched IBS patients from a separate study receiving only standard medical care. Ten of the hypnosis subjects (53%) responded to treatment by 3-month follow-up (response defined as more than 50% reduction in IBS severity) vs. 15 (26%) of controls. Hypnosis subjects improved more in quality of life scores compared to controls. Anxiety predicted poor treatment response. Hypnosis responders remained improved at 6-month follow-up. Although response rate was lower than previously observed in therapist-delivered treatment, hypnosis home treatment may double the proportion of IBS patients improving significantly across 6 months.
Barabasz A, Barabasz M. Effects of
tailored and manualized hypnotic inductions for complicated irritable
bowel syndrome patients. Int J Clin Exp Hypn. 2006 Jan;54(1):100-12.
This small clinical pilot study provided preliminary data on the effects
of hypnotic inductions tailored to an irritable bowel syndrome patient
in each session compared to Palsson's fully scripted (standardized)
protocol. A total of eight IBS patients previously unresponsive to any
treatment were assigned randomly to either the tailored or standardized
induction condition. Other than pre-testing for hypnotizability, the
procedure followed for the standardized group (four subjects) was
exactly as prescribed by O. Palsson (1998). The same scripts were used
for the other (tailored) group of four patients except that the
inductions were individualized. Patients showed favorable treatment
response immediately post-treatment and at 10-month follow-up. Only the
tailored group showed no incapacitating pain at post-treatment but
greater emotional stress than the standardized group. The tailored group
continued to improve and showed better results than the standardized
group at 10-month follow-up, and the post-reatment emotional distress
had decreased significantly
Smith GD. Effect of nurse-led
gut-directed hypnotherapy upon health-related quality of life in
patients with irritable bowel syndrome. J Clin Nurs. 2006
Jun;15(6):678-84.
This study conducted in Edinburgh, UK, measured the effects of a
nurse-led gut-directed hypnotherapy. Seventy-five patients were treated
with 5 to 7 1/2 hours of hypnotherapy, as well as receiving education
and support. Diary results showed that the physical symptoms of
abdominal pain and bloating improved significantly after treatment.
There were also significant statistical improvements in six of the eight
health-related quality of life scales and in anxiety scores after
treatment.
Vlieger AM, Menko-Frankenhuis C, Wolfkamp SC, Tromp E, Benninga MA.
Hypnotherapy for children with functional abdominal pain or irritable
bowel syndrome: a randomized controlled trial. Gastroenterology. 2007
Nov;133(5):1430-6.
This randomized controlled trial compared the effectiveness of six
sessions of hypnotherapy over 12 weeks with results from standard
medical therapy plus six sessions of supportive therapy in children with
functional abdominal pain or IBS. Fifty-three children ranging in age
from 8 to 18 years, with functional abdominal pain (31patients) or IBS
(22 patients), were randomly assigned to either hypnotherapy or the
comparison treatment. Pain scores decreased significantly in both groups
from baseline to 1 year follow-up, but the hypnotherapy group showed
significantly greater reduction in pain compared with the comparison
group. At one-year follow-up, treatment was judged successful for 85% of
the hypnotherapy group and 25% of the comparison group (p< .001).