Hypnotherapy for treatment of irritable bowel syndrome

Webb, Annette; Kukuruzovic, Renata H; Catto‐Smith, Anthony G.; Sawyer, Susan Μ

doi:10.1002/14651858.cd005110.pub2

Cited by 82 publications

(53 citation statements)

References 41 publications

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“…The previous reviews included insufficient evidences because of the small number of RCTs and methodological flaws. 17,18 Our study provides more reliable evidence by including 3 recent well-designed RCTs. Randomization is especially important in trials of fluctuating diseases such as IBS, since recruitment of patients to a trial usually occurs during a period of increased symptomatology.…”

Section: Discussionmentioning

confidence: 85%

“…[12][13][14][15][16] Previous systematic reviews to prove that there are statistically significant benefits have been based on pooled results of research on the effectiveness of hypnotherapy for IBS patients. 17,18 These reviews concluded that, although a number of studies have shown a beneficial effect of hypnotherapy, insufficient evidence existed to recommend widespread use because of limitations in the sample sizes and methodological flaws. From these conclusions, the National Institute for Health and Clinical Excellence guidelines noted that hypnotherapy is a promising intervention for IBS but the evidence remains to be limited.…”

Section: Introductionmentioning

confidence: 99%

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The Efficacy of Hypnotherapy in the Treatment of Irritable Bowel Syndrome: A Systematic Review and Meta-analysis

Lee

Choi

2014

J Neurogastroenterol Motil

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Background/AimsHypnotherapy is considered as a promising intervention for irritable bowel syndrome (IBS), but the evidence is still limited. The aims of this study were to conduct a systematic review and meta-analysis to estimate the efficacy of hypnotherapy for the treatment of IBS. MethodsA literature search was performed using MEDLINE (PubMed), Embase, PsycINFO and the Cochrane Central Register of Controlled Trials (CENTRAL database). Only randomized controlled trials that compared hypnotherapy with any other conventional treatment or no treatment in patients with IBS were included. Studies had to report outcomes as IBS symptom score or quality of life. The mean change in outcome score was used to pool these outcomes for the meta-analysis. Data were synthesized using the standardized mean difference for continuous data. ResultsSeven randomized controlled trials (6 papers) involving 374 patients with IBS were identified. Performance bias was high in all trials because it was impossible to blind participants and therapists in this type of intervention. The outcomes in this meta-analysis were evaluated at 3 months for short-term effects and at 1 year for long-term effects. The change in abdominal pain score at 3 months was significant in the hypnotherapy group (standardized mean difference, -0.83; 95% CI, -1.65 to -0.01). Three of the 4 trials showed greater improvement in overall gastrointestinal symptoms in the hypnotherapy group. ConclusionsThis study provides clearer evidence that hypnotherapy has beneficial short-term effects in improving gastrointestinal symptoms of patients with IBS.

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Section: Discussionmentioning

confidence: 85%

Section: Introductionmentioning

confidence: 99%

The Efficacy of Hypnotherapy in the Treatment of Irritable Bowel Syndrome: A Systematic Review and Meta-analysis

Lee

Choi

2014

J Neurogastroenterol Motil

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“…30 Results are in accordance with adult IBS trials showing that HT is superior to a variety of control treatments, with long-lasting effects. [63][64][65][66] Working mechanisms of HT are still poorly understood, but outcomes of adult studies hypothesize that HT affects both physiologic processes, such as colonic motility and pain-processing brain regions, and psychological factors, such as stress and dysfunctional cognitions. [67][68][69] CBT aims to change attitudes, cognitions, and behavior that may play a role in generating or maintaining symptoms and is effective in improving pain and other IBS symptoms in adults.…”

Section: Alternative Medicinementioning

confidence: 99%

Nonpharmacologic Treatment of Functional Abdominal Pain Disorders: A Systematic Review

et al. 2015

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BACKGROUND AND OBJECTIVE: Various nonpharmacologic treatments are available for pediatric abdominal pain-related functional gastrointestinal disorders (AP-FGIDs). Data on efficacy and safety are scarce. The goal of this study was to summarize the evidence regarding nonpharmacologic interventions for pediatric AP-FGIDs: lifestyle interventions, dietary interventions, behavioral interventions, prebiotics and probiotics, and alternative medicine.METHODS: Searches were conducted of the Medline and Cochrane Library databases. Systematic reviews and randomized controlled trials (RCTs) concerning nonpharmacologic therapies in children (aged 3-18 years) with AP-FGIDs were included, and data were extracted on participants, interventions, and outcomes. The quality of evidence was assessed by using the GRADE approach.RESULTS: Twenty-four RCTs were found that included 1390 children. Significant improvement of abdominal pain was reported after hypnotherapy compared with standard care/wait-list approaches and after cognitive behavioral therapy compared with a variety of control treatments/wait-list approaches. Written self-disclosure improved pain frequency at the 6-month follow-up only. Compared with placebo, Lactobacillus rhamnosus GG (LGG) and VSL#3 were associated with significantly more treatment responders (LGG relative risk: 1.31 [95% confidence interval: 1.08 to 1.59]; VSL#3: P , .05). Guar gum significantly improved irritable bowel syndrome symptom frequency; however, no effect was found for other fiber supplements (relative risk: 1.17 [95% confidence interval: 0.75 to 1.81]) or a lactose-free diet. Functional disability was not significantly decreased after yoga compared with a wait-list approach. No studies were found concerning lifestyle interventions; gluten-, histamine-, or carbonic acid-free diets; fluid intake; or prebiotics. No serious adverse effects were reported. The quality of evidence was found to be very low to moderate. CONCLUSIONS:Although high-quality studies are lacking, some evidence shows efficacy of hypnotherapy, cognitive behavioral therapy, and probiotics (LGG and VSL#3) in pediatric AP-FGIDs. Data on fiber supplements are inconclusive.

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“…Eighteen IBS patients had a maximum tolerable pressure of 40 mmHg or higher (median 45, range 40-65), and were therefore considered to be normosensitive to visceral stimuli. Fifteen IBS patients had a maximum tolerable rectal pressure of less than 40 mmHg (median 30, range [25][26][27][28][29][30][31][32][33][34][35], and were considered to be hypersensitive to visceral stimuli. The hypersensitive IBS patients had significantly lower thresholds for first sensation and urgency than the normosensitive IBS patients and the healthy controls.…”

Section: Classification Of Visceral Sensitivity and Clinical Charactementioning

confidence: 99%

Irritable Bowel Syndrome : Studies of central pathophysiological mechanisms and effects of treatment

Lowén¹

2015

Linköping University Medical Dissertations

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Background and aims Irritable bowel syndrome (IBS) is a common gastrointestinal disorder characterized by abdominal pain and altered bowel habits. The societal costs of the disorder are significant, as are its negative effects on quality of life. Medical treatment options are limited, but psychological treatments such as hypnotherapy have proven to be effective. Important pathophysiological mechanisms include disturbances in brain processing of visceral sensation and expectation of visceral sensation. Increased sensation of stimuli (hypersensitivity) is present in a subset of IBS patients to distensions in the lower part of the gastrointestinal tract, indicating a probable important pathophysiological mechanism in IBS. The overall aim of the thesis was to further study the central pathophysiological mechanisms involved in IBS. Specifically, we aimed to identify differences in brain response to standardized repeated rectal distensions and expectation of these stimuli between IBS patients (with or without perceptual rectal hypersensitivity), and healthy controls. Furthermore, we aimed to investigate IBS patients´ brain responses to standardized rectal distensions and expectation of these stimuli after either a successful course hypnotherapy or educational intervention. Methods Functional magnetic resonance imaging (fMRI) data were acquired and analyzed from 15 IBS patients with visceral hypersensitivity, and 18 IBS patients with normal visceral sensitivity (papers I and II). In paper III, fMRI data were analyzed from IBS patients who reported significant symptom reduction after either a course of hypnotherapy, or an educational intervention. FMRI data from IBS patients and healthy controls were also compared. Results The findings reported in papers I and II suggest, that the differences in brain response between IBS patients with and without rectal hypersensitivity, can be explained by changes in brain response during the course of the experiment. Even though the brain responses were similar between groups during the early phase of the experiment, they became substantially different during the late phase. The IBS patients with rectal hypersensitivity demonstrated increased brain response in several brain regions and networks involved in visceral sensation and processing. In contrast, IBS patients with normal rectal sensitivity exhibited reduced brain response during the late phase of the experiment. As reported in paper III, similar symptom reduction was achieved for both treatments. The symptomatic improvement was associated with a reduction of response in the anterior insula, indicating an attenuated awareness of the stimuli. The hypnotherapy group had a reduction of response in the posterior insula, indicating less input to the brain, possibly due to changed activity in endogenous pain modulatory systems. In patients who reported significant symptom reduction following treatment, the brain response to rectal distension got more similar to that observed in healthy controls. Conclusions The results from papers I a...

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Hypnotherapy for treatment of irritable bowel syndrome

Abstract: Analysis 2.4. Comparison 2 Hypnotherapy versus wait list control, Outcome 4 Proportion of subjects with bloating. Analysis 2.5. Comparison 2 Hypnotherapy versus wait list control, Outcome 5 Frequency of bowel motions. .

Cited by 82 publications

References 41 publications

The Efficacy of Hypnotherapy in the Treatment of Irritable Bowel Syndrome: A Systematic Review and Meta-analysis

The Efficacy of Hypnotherapy in the Treatment of Irritable Bowel Syndrome: A Systematic Review and Meta-analysis

Nonpharmacologic Treatment of Functional Abdominal Pain Disorders: A Systematic Review

Irritable Bowel Syndrome : Studies of central pathophysiological mechanisms and effects of treatment

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