Literature review - scientific studies on the effectiveness of hypnosis for irritable bowel syndrome (IBS) - for the science nerds out there (or anyone else interested).
The following abstracts represent just a few of the many peer-reviewed scientific journal articles on clinical hypnotherapy for IBS. Our program is based largely the research of Palsson and Whorwell, mentioned below.
Tan, G., Hammond, D. C., & Gurrala, J. (2005). Hypnosis and Irritable Bowel Syndrome: A Review of Efficacy and Mechanism of Action. American Journal of Clinical Hypnosis, 47(3), 161–178. doi:10.1080/00029157.2005.1040 Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder characterized by abdominal pain, distension, and an altered bowel habit for which no cause can be found. Despite its prevalence, there remains a significant lack of efficacious medical treatments for IBS to date. In this paper we 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). We 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.
Palsson, O. S., Turner, M. J., Johnson, D. A., Burnett, C. K., & Whitehead, W. E. (2002). Hypnosis Treatment for Severe Irritable Bowel Syndrome Investigation of Mechanism and Effects on Symptoms. Digestive Diseases and Sciences, 47(11), 2605–2614. doi:10.1023/a:1020545017390 Hypnosis improves irritable bowel syndrome (IBS), but the mechanism is unknown. Possible physiological and psychological mechanisms were investigated in two studies. Patients with severe irritable bowel syndrome received seven biweekly hypnosis sessions and used hypnosis audiotapes at home. Rectal pain thresholds and smooth muscle tone were measured with a barostat before and after treatment in 18 patients (study I), and treatment changes in heart rate, blood pressure, skin conductance, finger temperature, and forehead electromyographic activity were assessed in 24 patients (study II). Somatization, anxiety, and depression were also measured. All central IBS symptoms improved substantially from treatment in both studies. Rectal pain thresholds, rectal smooth muscle tone, and autonomic functioning (except sweat gland reactivity) were unaffected by hypnosis treatment. However, somatization and psychological distress showed large decreases. In conclusion, hypnosis improves IBS symptoms through reductions in psychological distress and somatization. Improvements were unrelated to changes in the physiological parameters measured.
Palsson, O. S., & Whitehead, W. E. (2002). The growing case for hypnosis as adjunctive therapy for functional gastrointestinal disorders. Gastroenterology, 123(6), 2132–2135. doi:10.1053/gast.2002.37286 The availability and affordability of this therapy would be vastly increased if the same kind of face-toface hypnosis treatment found effective for FD and IBS would also help patients when administered exclusively in a home-treatment audio format. No data have been presented to date to make it possible to conclude whether this is feasible. In conclusion, although some of the studies to date on hypnotherapy for functional GI disorders have been small and lacking in methodological rigor, and many research questions remain unanswered, the cumulative and consistent evidence for efficacy of hypnotherapy for these disorders seems to warrant serious consideration of its use as a regular adjunct in primary care and gastroenterology treatment of patients with FD and IBS.
Review of the Empirical Evidence. American Journal of Clinical Hypnosis, 58(2), 134– 158. doi:10.1080/00029157.2015.1039 Hypnotherapy has been investigated for 30 years as a treatment for gastrointestinal (GI) disorders. There are presently 35 studies in the published empirical literature, including 17 randomized controlled trials (RCTs) that have assessed clinical outcomes of such treatment. This body of research is reviewed comprehensively in this article. Twenty-four of the studies have tested hypnotherapy for adult irritable bowel syndrome (IBS) and 5 have focused on IBS or abdominal pain in children. All IBS hypnotherapy studies have reported significant improvement in gastrointestinal symptoms, and 7 out of 10 RCTs in adults and all 3 RCTs in pediatric patient samples found superior outcomes for hypnosis compared to control groups. Collectively this body of research shows unequivocally that for both adults and children with IBS, hypnosis treatment is highly efficacious in reducing bowel symptoms and can offer lasting and substantial symptom relief for a large proportion of patients who do not respond adequately to usual medical treatment approaches. For other GI disorders the evidence is more limited, but preliminary indications of therapeutic potential can be seen in the single randomized controlled trials published to date on hypnotherapy for functional dyspepsia, functional chest pain, and ulcerative colitis. Further controlled hypnotherapy trials in those three disorders should be a high priority. The mechanisms underlying the impact of hypnosis on GI problems are still unclear, but findings from a number of studies suggest that they involve both modulation of gut functioning and changes in the brain’s handling of sensory signals from the GI tract.
Whitehead, W. E. (2006). Hypnosis for Irritable Bowel Syndrome:The Empirical Evidence of Therapeutic Effects. International Journal of Clinical and Experimental Hypnosis, 54(1), 7–20. doi:10.1080/00207140500328708 Abstract: Irritable bowel syndrome (IBS) is a complex and prevalent functional gastrointestinal disorder that is treated with limited effectiveness by standard medical care. Hypnosis treatment is, along with cognitive-behavioral therapy, the psychological therapy best researched as an intervention for IBS. 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.
Whorwell, P. J., Prior, A., & Faragher, E. B. (1984). CONTROLLED TRIAL OF HYPNOTHERAPY IN THE TREATMENT OF SEVERE REFRACTORY IRRITABLE-BOWEL SYNDROME. The Lancet, 324(8414), 1232–1234. doi:10.1016/s0140-6736(84)92793-4 30 patients with severe refractory irritable bowel syndrome were randomly allocated to treatment with either hypnotherapy or psychotherapy and placebo. 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.
A new 7-session private-pay Gut-Directed Hypnotherapy program is being offered via Telemedicine by Dr. David Bowler. Chiefly intended for irritable bowel syndrome, it can be adapted for GERD and for symptom reduction as an adjunct to conventional therapy for inflammatory bowel disorders, using the validated peer-reviewed North Carolina protocol. Patients must have been appropriately evaluated and referral must include all relevant investigations and GI consults if available. Initial session is 60-90 minutes, subsequent ones 30-45 minutes, at approximately 2-week intervals.
A medical consultation, online or in person, to review the history and provide information will be arranged prior to the first hypnotherapy session.
Physicians and nurse practitioners can fax referrals to 1-844-820-7073.
David is a fan of books and no doubt will be sharing some good reads here.