Gut-directed hypnotherapy delivered by psychologists appears as effective in group or individual sessions, potentially offering a new treatment option for…
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 may help relieve irritable bowel syndrome (IBS) complaints for some patients for as long as 9 months after the end of treatment, according to a randomized 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 %; 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 majority of IBS patients were 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 med dem som fick pedagogisk støttende terapi. Hos hypnoterapi blev det ikke vist at reducere sværhedsgraden af symptomer.
Mens de resultater er lovende, forfatterne konkluderer, at flere undersøgelser vil være nødvendige for at teste det optimale antal hypnoterapi sessioner, den effekt at patientens forventninger kan have på behandlingsresultatet , en de mate waarin hypnotherapie-uitkomsten zijn beïnvloed door de omvang van de psychologische klachten van de patiënt.
“Onze studie geeft aan dat hypnotherapie kan worden beschouwd als een behandelingsoptie voor patiënten met IBS, ongeacht symptomen ernst en 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 IBS affects around 1 in 5 people worldwide and is a persistent and unusual symptom severity. moeilijk te behandelen toestand, met symptomen die ernstig kunnen beïnvloeden de kwaliteit van leven waaronder abdominale pijn, bloating, diarree, en constipatie.
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 the majority of patients are treated.
The IMAGINE study recruited 354 adults (aged 18-65 years) with IBS who were referenced 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) Hypnotherapy treatment was provided by psychologists who were trained as hypnotherapists and involved a technique of positive visualization during which patients were given suggestions (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 over hoe ze kunnen krijgen controle over hun spijsvertering systeem om te verminderen gevoelens van pijn en ongemak. 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
Resultater viste at umiddelbart efter behandlingen, deltagerne i de to hypnoterapi-behandlinger (3 måneder) og igen 9 måneder senere, samt symptomlindring umiddelbart efter behandlingen og 9 måneder senere. 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 (Table 2).
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. “
Overall, hypnotherapy was well tolerated.
Improvements in quality of life, psychological complaints, cognitions and reductions in medical costs and IBS-related work absence were similar between groups. Eight serious unexpected adverse reactions were reported, mostly cancer and inflammatory bowel disease, but were not related to hypnotherapy.
The authors note some limitations-for example that 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 may have biased the results (figure 1). De har også påpekt at de inexperience of therapists in dealing with IBS, and the low number (six) of hypnotherapy sessions provided (half the usual number) may 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 of implementation. Men som den forfatterens notat, den mindre terapeutiske effekten i denne undersøgelsen sammenlignet med de fleste hypnoterapiske forsøg i tertiær pleje kunne have været fordi IBS i primær og sekundær pleje er forskellig fra det i tertiær pleje-måske enklere i naturen og med mindre involvering af psykologiske faktorer. Derfor, på trods af denne imponerende undersøgelsesindsats hos Flik og kollegaer, er det fortsat uklart om gut-directed hypnoterapi is goed geschikt voor de behandeling van patiënten met IBS in primaire en secundaire zorg, en toekomstige proeven zijn nodig om definitieve antwoorden te geven. “
Researcher: Hypnosis should be offered to patients with IBS
The Lancet Gastroenterology & Hepatology www.thelancet.com/journals/lan … (18) 30310-8 / fulltext