Irritable Bowel Syndrome, or IBS, is one of the most researched areas in the application of clinical hypnotherapy.
And for good reason. The multiple session hypnosis protocol has proven to be one of the best approaches to create positive results for IBS. We at ChangeWorks have IBS clients referred to us frequently, of all ages.
Take a look through just a few of the research studies we’re aware of (and there are many more to be found with a simple google search).
Study 1: Hypnosis for IBS – Especially for clients under age 50 (and describes sessions and suggestions given)
Results: This study followed up on 15 patients with intractable irritable bowel syndrome (IBS) who previously reported having been successfully treated with hypnotherapy. At a mean follow up period of 18-months, all remain free of IBS. (Two experience a single relapse – that was overcome was an additional session of hypnotherapy).
More Results: The study then combined these 15 patients with 35 more patients. Those below the age of 50 years exhibited a 100% response rate to hypnosis.
Notes: Hypnotherapy consisted of half hour sessions of decreasing frequency over a three month period. Patients were given a tape for daily autohypnosis after the third session. Before hypnosis the patient was given a simple account of intestinal smooth muscle physiology. Hypnosis was induced by an eye fixation and arm levitation technique followed by standard deepening procedures.
After general comments about improvement of health and wellbeing, attention was directed to the control of intestinal smooth muscle. The patient was asked to place his/her hand on the abdomen, feel a sense of warmth and relate this to asserting control over gut function. All sessions were concluded with standard ego strengthening suggestions. No subject was unable to be hypnotized.
Patients were judged as having ‘improved’ only if their symptoms became mild or absent and they required no medication for irritable bowel syndrome with the exception of bulking agents.
Gut, 1987, 28, 423-425
By: P. J. Whorwell, Alison Prior and S. M. Colgan, The Department of Medicine, University Hospital of South Manchester, Manchester
Study 2: Hypnosis for IBS – Helps both Diarrhea-Predominant IBS and Constipation-Predominant IBS
Results: In comparison with a control group of 15 patients who received no hypnotherapy significant changes in rectal sensitivity were found in patients with diarrhea-predominant irritable bowel syndrome both after a course of hypnotherapy and during a session of hypnosis (p<O0O5). Although patient numbers were small, a trend towards normalization of rectal sensitivity was also observed in patients with constipation-predominant irritable bowel syndrome. No changes in rectal compliance or distension-induced motor activity occurred in either subgroup nor were any changes in somatic pain thresholds observed. The results suggest that symptomatic improvement in irritable bowel syndrome after hypnotherapy may in part be due to changes in visceral sensitivity.
Notes: Fifteen patients with the irritable bowel syndrome were studied to assess the effect of hypnotherapy on anorectal physiology.
Gut, 1990, 31, 896-898
By: Alison Prior, S. M. Colgan, P. J. Whorwell, Department of Medicine, University Hospital of South Manchester, Manchester M20 8LR
Study 3: Hypnosis for IBS Symptoms, Quality of Life and Anxiety
Hypnotherapy in irritable bowel syndrome: a large-scale audit of a clinical service with examination of factors influencing responsiveness
Results: Marked improvement was seen with hypnosis 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). Study’s conclusion: “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.”
Notes: 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. 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.
American Journal of Gastroenterology (2002) 97, 954-961; doi:10.1111/j.1572-0241.2002.05615.x
By: Wendy M. Gonsalkorale Ph.D., Lesley A. Houghton Ph.D. and Peter J. Whorwell M.D. FRCP, Department of Medicine, University Hospital of South Manchester, Manchester, United Kingdom
Study 4: Hypnosis and Refractory IBS (I.E., Remains unresponsive to pharmacological treatments) – For Abdominal Pain, Abdominal Distension, General Well-Being, and Bowel Habit
Controlled Trial of Hypnotherapy in the Treatment of Severe Refractory Irritable-Bowel Syndrome
Results: The psychotherapy patients showed a small but significant improvement in abdominal pain, abdominal distension, and general well-being but not in bowel habit. The hypnotherapy patients showed a dramatic improvement in all features, the difference between the two groups being highly significant. In the hypnotherapy group no relapses were recorded during the 3-month follow-up period, and no substitution symptoms were observed.
Notes: 30 patients with severe refractory irritable-bowel syndrome were randomly allocated to treatment with either hypnotherapy or psychotherapy and placebo.
The Lancet, Volume 324, Issue 8414, Pages 1232-1234, 1 December 1984
By: P. J. Whorwell, Alison Prior, E. B. Faragher, Department of Medicine, University Hospital of South Manchester, Manchester M20 8LR, United Kingdom
Study 5: Long-Term Benefits of Hypnosis for IBS (Beneficial effects of Hypnotherapy appear to last at least five years or more)
Long term benefits of hypnotherapy for irritable bowel syndrome
Results: 71% of patients initially responded to hypnotherapy. 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.
Notes: 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”. Gut directed hypnotherapy comprises a course of up to 12 weekly 1 hour sessions. Each session consists of induction of the hypnotic state and deepening procedures, followed by “ego strengthening” suggestions relevant to the individual. These are accompanied by further suggestions and interventions, such as inducing warmth in the abdomen using the hands and imagery, directed towards controlling and normalizing gut function.
This study presents the first long term follow up of a large number of patients who have undergone hypnotherapy for IBS symptoms.
Gut 2003;52:1623-1629 doi:10.1136/gut.52.11.1623
By: W. M. Gonsalkorale, V. Miller, A. Afzal, P. J. Whorwell, Department of Medicine, University Hospital of South Manchester, Manchester, UK Correspondence to: Dr. W. M. Gonsalkorale Hypnotherapy Unit, Withington Hospital, Nell Lane, Manchester M20 2LR, UK
Study 6: Hypnosis for Children with IBS or Functional Abdominal Pain
Hypnotherapy for Children With Functional Abdominal Pain or Irritable Bowel Syndrome: A Randomized Controlled Trial
Results: Pain scores decreased significantly in both groups: from baseline to 1 year follow-up, pain intensity scores decreased in the hypnotherapy (HT) group from 13.5 to 1.3 and in the standard medical therapy (SMT) group from 14.1 to 8.0. Pain frequency scores decreased from 13.5 to 1.1 in the HT group and from 14.4 to 9.3 in the SMT group. Hypnotherapy was highly superior, with a significantly greater reduction in pain scores compared with SMT (P<.001). At 1 year follow-up, successful treatment was accomplished in 85% of the HT group and 25% of the SMT group (P < .001). Conclusions: Gut-directed HT is highly effective in the treatment of children with longstanding FAP or IBS.
Notes: This study undertook a randomized controlled trial and compared clinical effectiveness of “gut directed hypnotherapy” (“HT”) with standard medical therapy (“SMT”) in children with FAP (functional abdominal pain) or IBS. Fifty-three pediatric patients, age 8–18 years, with FAP (n 31) or IBS (n 22), were randomized to either HT or SMT. Hypnotherapy consisted of 6 sessions over a 3-month period. Patients in the SMT group received standard medical care and 6 sessions of supportive therapy. Pain intensity, pain frequency, and associated symptoms were scored in weekly standardized abdominal pain diaries at baseline, during therapy, and 6 and 12 months after therapy. Hypnotherapy consisted of general relaxation, control of abdominal pain and gut functions, and ego-strengthening suggestions. Hypnosis was not used to analyze the existence of causal or compounding psychologic factors. The first session was always used to have the participant become familiar with hypnosis and the therapist. In addition, the participant was given information on the body-mind connection” and the mind’s ability to regulate bodily functions. Specific techniques aiming at control of the abdominal pain, and if necessary normalization of gut functions, were then introduced. For example, after a hypnotic\induction, the participant was invited to create visualizations of a normal working gut, using metaphors adapted to the child’s interests, such as a car running at a normal speed. In another session, the participant was asked to place both hands on the belly and was given suggestions for positive effects on abdominal discomfort. No fixed hypnotic scripts were used, and subsequent sessions were often modified on the basis of feedback from the participant. Apart from gut-directed suggestions, treatment also included a variety of nonanalgesic suggestions for relaxation, sleep improvement, and ego-strengthening suggestions to increase self-confidence and well-being. Every participant received a compact disc with a standardized hypnosis session and was encouraged to listen to it on a daily basis or to practice self-hypnosis.
Gastroenterology, 2007: 133: 1430-1436, Nov. 2007
By: Arine M. Vlieger,* Carla Menko – Frankenhuis,‡ Simone C. S. Wolfkamp,‡ Ellen Tromp, § and Marc A. Benning‡
Author Affiliations: *Department of Pediatrics, St. Antonius Hospital, Nieuwegein, The Netherlands; ‡Department of Pediatric Gastroenterology, Academic Medical Centre, Amsterdam, The Netherlands; §Department of Statistics, St. Antonius Hospital, Nieuwegein, The Netherlands
Study 7: Research Consistently Shows Hypnosis has Substantial Beneficial Effect on IBS – even for patients unresponsive to standard medical interventions
Hypnosis for Irritable Bowel Syndrome: The Empirical Evidence of Therapeutic Effects
Notes: Eleven studies, including 5 controlled studies, have assessed the therapeutic effects of hypnosis for IBS. Although this literature has significant limitations, such as small sample sizes and lack of parallel comparisons with other treatments, this body of research consistently shows hypnosis to have a substantial therapeutic impact on IBS, even for patients unresponsive to standard medical interventions. The median response rate to hypnosis treatment is 87%, bowel symptoms can generally be expected to improve by about half, psychological symptoms and life functioning improve after treatment, and therapeutic gains are well maintained for most patients for years after the end of treatment.
International Journal of Clinical and Experimental Hypnosis, Volume 54, Issue 1, 2006
Special Issue: Irritable Bowel Syndrome, pages 7-20
By: William E. Whitehead, Ph.D., Division of Gastroenterology and Hepatology, University of North Carolina at Chapel Hill
Study 8: Hypnosis and IBS – Overview and Review – Hypnosis consistently improves symptoms of IBS possibly in physiological and psychological ways
Hypnosis and Irritable Bowel Syndrome: A Review of Efficacy and Mechanism of Action
Results: This study concluded that hypnosis consistently produces significant results and improves the cardinal symptoms of IBS in the majority of patients, as well as positively affecting non-colonic symptoms. When evaluated according to the efficacy guidelines of the Clinical Psychology Division of American Psychological Association, the use of hypnosis with IBS qualifies for the highest level of acceptance as being both efficacious and specific. In reviewing the research on the mechanism of action as to how hypnosis works to reduce symptoms of IBS, some evidence was found to support both physiological and psychological mechanisms of action.
Notes: In this paper, the authors reviewed a total of 14 published studies (N = 644) on the efficacy of hypnosis in treating IBS (8 with no control group and 6 with a control group.
American Journal of Clinical Hypnosis, Volume 47, Issue 3, 2005, pages 161-178
By: Gabriel Tan Ph.D., D. Corydon Hammond and Joseph Gurrala
Author Affiliations: Michael E. DeBakey VA Medical Center Baylor College of Medicine, USA, University of Utah School of Medicine, USA