Breaking News
December 18, 2018 - Artificial intelligence and the future of medicine
December 18, 2018 - Montana State doctoral student receives grant for her work to improve neuroscience tool
December 18, 2018 - Early postpartum initiation of opioids associated with persistent use
December 18, 2018 - Russian scientists identify molecular ‘switch’ that could be target for treatment of allergic asthma
December 18, 2018 - Surgeons make more mistakes in the operating room during stressful moments, shows study
December 18, 2018 - Immune cells explode themselves to inform about the danger of invading bacteria
December 18, 2018 - Malnutrition in children with Crohn’s disease linked with increased risk of surgical complications
December 18, 2018 - FDA Approves Motegrity (prucalopride) for Adults with Chronic Idiopathic Constipation (CIC)
December 18, 2018 - The long and short of CDK12
December 18, 2018 - CMR Surgical partners with Nicholson Center to launch U.S.-based training program for Versius
December 18, 2018 - Findings reinforce guidelines for cautious use of antipsychotics in younger populations
December 18, 2018 - Study finds new strains of hepatitis C virus in sub-Saharan Africa
December 18, 2018 - New battery-free, implantable device aids weight loss
December 18, 2018 - Parental alcohol use disorder associated with offspring marital outcomes
December 18, 2018 - Novel Breast Imaging Technique Might Cut Unnecessary Biopsies
December 18, 2018 - What can a snowflake teach us about how cancer spreads in the body?
December 18, 2018 - Management of nausea and vomiting in pregnancy costs the NHS more than previously thought
December 18, 2018 - Green leafy vegetables may reduce risk of developing liver steatosis
December 18, 2018 - Veganism linked to nutrient deficiencies and malnutrition if not planned correctly
December 18, 2018 - Coming Soon: A Tiny Robot You Swallow to Help You Stay Healthy
December 18, 2018 - Modified malaria drug proven effective at inhibiting Ebola
December 18, 2018 - Study finds epigenetic differences in the brains of individuals with schizophrenia
December 18, 2018 - Fitness instructors’ motivational comments influence women’s body satisfaction
December 18, 2018 - Study focuses on modification of lipid nanoparticles for successful brain cell targeting
December 18, 2018 - New gut bacteria may be effective against obesity, metabolic and mental disorders
December 18, 2018 - New two-in-one powder aerosol to upgrade fight against deadly superbugs in lungs
December 18, 2018 - Biofilms feed with swirling flows
December 17, 2018 - Study identifies specific neurological changes related to traumatic brain injury
December 17, 2018 - New study confirms geographic bias in lung allocation for transplant
December 17, 2018 - Research focuses on optimization of solid lipid nanoparticle that encapsulates Vinorelbine bitartrate
December 17, 2018 - Carpal tunnel syndrome – Genetics Home Reference
December 17, 2018 - A novel insulin accelerant
December 17, 2018 - Tips for caring for patients with disabilities, from a mother and physician
December 17, 2018 - Menopause-related sexual, urinary problems tied to worse quality of life
December 17, 2018 - In-school nutrition programs among students limit increases in BMI, finds study
December 17, 2018 - Risk for Hospitalization for Heart Failure Greater With Diabetes
December 17, 2018 - Food assistance may help older adults adhere to diabetes meds
December 17, 2018 - Supporting a family’s goals during a difficult pregnancy
December 17, 2018 - Neurons with Good Housekeeping Are Protected from Alzheimer’s
December 17, 2018 - New approach to tumor analysis could improve prognosis for bowel cancer patients
December 17, 2018 - New ‘epigenetics-based’ cervical cancer test outperforms Pap smear and HPV tests
December 17, 2018 - Ten year follow-up after negative colonoscopy related to reduced risk of colorectal cancer
December 17, 2018 - CTF along with NTAP and Sage announce first-ever open data portal for neurofibromatosis
December 17, 2018 - Intimacy: The Elusive Fountain of Youth?
December 17, 2018 - Will saliva translate to a real diagnostic tool?
December 17, 2018 - DFG establishes nine new Research Units and one new Clinical Research Unit
December 17, 2018 - Assisted living’s breakneck growth leaves patient safety behind
December 17, 2018 - America’s teens report dramatic increase in their use of vaping devices in just one year
December 17, 2018 - Enlarged heart linked to a higher risk of dementia
December 17, 2018 - Prostate cancer detection using MRI now first-line investigation tool
December 17, 2018 - Loughborough academics part of new project investigating effectiveness of personalized breast cancer screening
December 17, 2018 - Adolescents who use cognitive reappraisal had better metabolic measures, shows study
December 17, 2018 - Probiotics may offer therapeutic benefits for biopolar patients
December 17, 2018 - Stealth BioTherapeutics Granted Fast Track Designation for Elamipretide for the Treatment of Dry Age-Related Macular Degeneration with Geographic Atrophy
December 17, 2018 - Studies reveal role of red meat in gut bacteria, heart disease development
December 17, 2018 - Eisai enters into agreement with Eurofarma for its anti-obesity agent lorcaserin
December 17, 2018 - Researchers use brain connectome to reassess neuroimaging findings of Alzheimer’s disease
December 17, 2018 - “Miracle” baby survives Ebola in Congo and rapid a new Ebola detection device
December 17, 2018 - Mechanisms behind neonatal diabetes uncovered
December 17, 2018 - AHF urges the WHO to expedite approval process for vaccine effective against Ebola
December 17, 2018 - Study finds misuse of benzodiazepines to be highest among young adults
December 17, 2018 - TGen receives PayPal grant to underwrite costs of genetic tests for children with rare disorders
December 17, 2018 - New research highlights why HIV-infected patients suffer higher rates of cancer
December 17, 2018 - Antibiotic-resistant bacteria could soon be targeted with Alzheimer’s drug
December 17, 2018 - Rutgers scientists take an important step in making diseased hearts heal themselves
December 17, 2018 - Tailored Feedback at CRC Screen Improves Lifestyle Behaviors
December 17, 2018 - Loss of two genes drives a deadly form of colorectal cancer, reveals a potential treatment
December 17, 2018 - How the Mediterranean Diet Can Help Women’s Hearts
December 17, 2018 - Sustained connections associated with symptoms of autism
December 17, 2018 - Concussion rates among young football players were higher than previously reported
December 17, 2018 - Cresco Labs granted approval to operate marijuana dispensary in Ohio
December 17, 2018 - Study provides insight into health risks facing new mothers
December 17, 2018 - AMSBIO expands Wnt signaling pathway product range to aid research
December 16, 2018 - Surgical treatment unnecessary for many prostate cancer patients
December 16, 2018 - Excess weight responsible for cancers globally finds report
December 16, 2018 - Regular sex associated with greater enjoyment of life in seniors
December 16, 2018 - Social stigma contributes to poor mental health in the autistic community
December 16, 2018 - Multidisciplinary team successfully performs complex surgery on patient suffering from enlarged skull
December 16, 2018 - Experts analyze data that can guide antidepressant discontinuation
December 16, 2018 - Menlo Therapeutics’ Successful Phase 2 Clinical Trial of Serlopitant Demonstrates Reduction of Pruritus Associated with Psoriasis
Gut-directed hypnotherapy may offer new treatment option for IBS patients

Gut-directed hypnotherapy may offer new treatment option for IBS patients

image_pdfDownload PDFimage_print

Gut-directed hypnotherapy delivered by psychologists appears as effective in group or individual sessions, potentially offering a new treatment option for irritable bowel syndrome in primary and secondary care.

Hypnotherapy might help relieve irritable bowel syndrome (IBS) complaints for some patients for as long as 9 months after the end of treatment, according to a randomised controlled trial of 354 adults with IBS in primary and secondary care published in The Lancet Gastroenterology & Hepatology journal.

After 3 months of treatment, adequate relief of IBS symptoms was reported by more patients who received individual (40%; 41/102 for whom data were available) and group hypnotherapy (33%; 31/91) than those given education and supportive care (17%; 6/35), and these benefits persisted at 9 months follow-up (42% [38/91], 50% [40/80], and 22% [7/31]).

Importantly, 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.

The study is the largest randomized trial of hypnotherapy for IBS to date, and one of the first conducted in primary care, where the vast majority of IBS patients are treated.

The study found that 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.

While the findings are promising, the authors conclude 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,” says Dr Carla Flik from the University Medical Center Utrecht, 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.”

IBS affects around 1 in 5 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. 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 IMAGINE study recruited 354 adults (aged 18-65 years) 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 6 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 15-20 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 treatment (3 months) and again 9 months later, as well as symptom relief immediately after treatment and 9 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 9 months after the treatment ended.

Nevertheless, satisfactory relief of symptoms was not accompanied by a significant improvement in symptom severity.

As Dr Flik explains: “We do not know exactly how gut-directed hypnotherapy works, but it may change patients’ mindset and internal coping mechanisms, enabling them to increase their control over autonomic body processes, such as how they process pain and modulate gut activity.” Improvements in quality of life, psychological complaints, cognitions and reductions in medical costs and IBS-related work absence were similar between groups.

Overall, hypnotherapy was well tolerated. Eight serious unexpected adverse reactions (six in the individual hypnotherapy group and two in the group hypnotherapy group) were reported, mostly cancer and inflammatory bowel disease, but were not related to hypnotherapy.

The authors note some limitations–for instance, that 22 (15%) patients in the individual hypnotherapy group, 22 (15%) in the group hypnotherapy group, and 11 (20%) in the control group dropped out before or during therapy, and a substantial number of participants did not complete questionnaires at 3 months and 9 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.

Writing in a linked Comment, Professor Olafur Palsson, University of North Carolina at Chapel Hill, USA discusses factors that may have contributed to the “modest” therapeutic impact of hypnosis in the study.

He writes: “The hypnotherapy tested in this study might have been suboptimal in amount or implementation. However, as the authors note, the smaller therapeutic effect in this trial compared with most hypnotherapy trials in tertiary care might have been because IBS in primary and secondary care is different to that in tertiary care–perhaps simpler in nature and with less involvement of psychological factors. Therefore, despite this impressive investigative effort by Flik and colleagues, it remains unclear whether gut-directed hypnotherapy is well suited for the treatment of patients with IBS in primary and secondary care, and future trials are needed to provide definitive answers.”

Source:

http://www.thelancet.com/

Tagged with:

About author

Related Articles