Hypnotherapy for irritable bowel syndrome: patient expectations and perceptions

Abstract

Introduction: Numerous studies have shown that hypnotherapy (HT) is effective in irritable bowel syndrome (IBS) using traditional symptom severity end points. However, there is now interest in capturing the patient’s perception of their illness and treatment because what patients expect from their treatment may differ from that of their healthcare provider. Objective: To record patient perceptions and expectations of hypnotherapy as well as their symptom response. Methods: 150 consecutive IBS patients (116 females, 34 males, aged 16–81 years) receiving hypnotherapy completed questionnaires recording IBS symptom severity, quality of life, noncolonic symptoms, anxiety and depression levels before and after treatment. Their expectations and perceptions of HT were also recorded, including a free text reflection. Results: 121 patients (81%) responded to treatment consistent with our previous experience. Symptom severity scores, noncolonic symptoms, quality of life, anxiety and depression significantly all improved after HT ( p < 0.001). Expectancy of an improvement with hypnotherapy was greater in those who did not respond to treatment (63%) than those who did (57%, p < 0.001). Scepticism and apprehension were common before treatment and replaced with enthusiasm afterwards. Free text responses after treatment were overwhelmingly positive. Patients also reported a variety of other benefits and even 20 of 29 symptom nonresponders (70%) still considered treatment worthwhile. Conclusion: Although initially perceived negatively, hypnotherapy improved symptoms and resulted in a wide range of additional benefits. Expectation did not necessarily influence outcome. Recording IBS symptoms alone does not fully capture the patient’s experience of treatment and needs to be considered in future research.

Patient satisfaction after remotely delivered gut-directed hypnotherapy for irritable bowel syndrome during the COVID-19 era: implications for future practice

“…21 Interestingly, symptom responses did not differ according to patient preferences for mode of delivery. While it would be worth confirming these findings in future studies with larger sample sizes, this is consistent with the literature on patient perceptions 22 and satisfaction 23 with face-to-face GDH, which have suggested that focusing on symptom responses only does not fully capture the patients experience of treatment. Based on our findings and the existing literature, it is not possible to know whether those who felt they would have had additional benefit from face to face would have had a greater symptomatic benefit.…”

“…Based on our findings and the existing literature, it is not possible to know whether those who felt they would have had additional benefit from face to face would have had a greater symptomatic benefit. Indeed, the aforementioned studies on face-to-face GDH have shown that patient expectations of a positive outcome 22 and patient satisfaction 23 do not necessarily influence symptom responses.…”

Hypnotherapy and IBS: Implicit, long-term stress memory in the ENS?

“…Gut-focused hypnotherapy (GFH) can not only improve the primary symptoms of IBS but also reduce noncolon symptoms, anxiety, and depression and improve quality of life and cognitive function [ 194 , 195 ]. Hypnotherapy is particularly effective in children with IBS [ 189 , 196 , 197 ].…”

“…However, the main limitation of this randomized study was the lack of long-term follow-up data to determine the persistence of the effects of abbreviated hypnotherapy, which should be examined in the future. The relevant studies supporting the utility of hypnotherapy in IBS treatment are shown in Table 1 [ 85 , [182] , [183] , [184] , [185] , [186] , [187] , [188] , [189] , 191 , [193] , [194] , [195] , [196] , [197] , 199 , 202 ].…”

“…The hypnotherapy presented a dramatic improvement in all features and no relapses were recorded during the 3-month follow-up period. Donnet et al [ 194 ] Recorded 150 IBS patients' perceptions and expectations of hypnotherapy as well as their symptom response. Hypnotherapy improved symptoms and resulted in a wide range of additional benefits.…”