Three new abstracts show that hypnosis is an effective intervention for Irritable Bowel Syndrome. Principle Investigator W.M. Gonsalkorale of the UK has been particularly prolific in writing about this.. Researchers from University Hospital of South Manchester in the UK review the latest research on the efficacy of hypnotherapy for irritable bowel syndrome, and conclude that the beneficial effects of hypnotherapy are long lasting, with most patients maintaining their improved status and decreasing their need for office visits and medication in the long term.

The review team acknowledges that, while the exact mechanisms of how hypnotherapy brings about these therapeutic effects are not fully known, changes in colonic motility and rectal sensitivity have been demonstrated. In addition, they say, changes in central processing and psychological effects may also play a role.

Citation: Gonsalkorale WM, Whorwell PJ.Hypnotherapy in the treatment of irritable bowel syndrome. European Journal of Gastroenterology and Hepatology. 2005 Jan; 17 (1): Pages 15-20. [email protected]

W. Gonsalkorale of University Hospital of South Manchester enrolled 204 subjects in this study of patients who had received hypnotherapy for IBS (irritable bowel syndrome) over the previous 6 years. Subjects completed questionnaires to help determine if positive results were maintained in the long term. All subjects also subjectively assessed the effects of hypnotherapy retrospectively in order to define their "responder status"

The study found that 71% of patients initially responded to the hypnotherapy intervention. 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 over 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 number of office visits and medication use following the completion of hypnotherapy. This study concludes that the beneficial effects of hypnotherapy appear to last at least five years.

Citation: Gonsalkorale WM, Miller V, Afzal A, Whorwell PJ. Long term benefits of hypnotherapy for irritable bowel syndrome. Gut. 2003 Nov; 52 (11): pages 1623-9. [email protected]

Researchers at Sahlgrenska University Hospital in Goteborg, Sweden, conducted a randomized, controlled clinical trial to see if hypnotherapy could mediate the post-mealtime gastrocolonic symptoms typically suffered by many people with IBS (irritable bowel syndrome).

The study included 28 patients with irritable bowel syndrome refractory to other treatments. They were randomized to receive gut-directed hypnotherapy 1 hour per week for 12 weeks (N = 14) or were provided with supportive therapy (control group; N = 14). Before randomization and after 3 months, all patients underwent a colonic distension trial before and after a 1-hour duodenal lipid infusion. Colonic sensory thresholds and tonic and phasic motor activity were thus assessed.

The study found that at 3 months, the colonic sensitivity before duodenal lipids did not differ between groups. Controls reduced their thresholds after duodenal lipids for gas (22 +/- 1.7 mm Hg vs. 16 +/- 1.6 mm Hg, p <.01), discomfort (29 +/- 2.9 mm Hg vs. 22 +/- 2.6 mm Hg, p <.01), and pain (33 +/- 2.7 mm Hg vs. 26 +/- 3.3 mm Hg, p <.01), whereas the hypnotherapy group reduced their thresholds after lipids only for pain (35 +/- 4.0 mm Hg vs. 29 +/- 4.7 mm Hg, p <.01).

The colonic balloon volumes and tone response at randomization were similar in both groups. At 3 months, baseline balloon volumes were lower in the hypnotherapy group than in controls (83 +/- 14 ml vs. 141 +/- 15 ml, p <.01). In the control group, reduced balloon volumes during lipid infusion were seen (141 +/- 15 ml vs. 111 +/- 19 ml, p <.05), but not after hypnotherapy (83 +/- 14 ml vs. 80 +/- 16 ml, p >.20). The study concludes that hypnotherapy significantly reduces the sensory and motor component of the gastrocolonic response in patients with irritable bowel syndrome.

Citation: Simren M, Ringstrom G, Bjornsson ES, Abrahamsson H. Treatment with hypnotherapy reduces the sensory and motor component of the gastrocolonic response in irritable bowel syndrome. Psychosomatic Medicine. 2004 Mar-Apr; 66 (2): pages 233-8. [email protected]

This study by Gonsalkorale et al investigated whether hypnotherapy improves negative cognitions - thoughts, ideas and assumptions - about IBS, as well as helping with symptoms and quality of life.

A total of 78 irritable bowel syndrome patients completed a validated symptom-scoring questionnaire, the Hospital Anxiety and Depression (HAD) Scale and the Cognitive Scale for Functional Bowel Disorders (FBDs), before and after 12 sessions of gut-focused hypnotherapy.

The hypnotherapy intervention resulted in improvement of symptoms, quality of life and scores for anxiety and depression (all P''s<.001). IBS-related cognitions also improved, with reduction in the total cognitive score (TCS; P<.001) and all component themes related to bowel function (all P<.001).

The study correlated cognitions with symptom severity, because the most abnormal cognitive scores were observed in patients with the highest symptom scores (P<.001). Furthermore, a reduction in symptom score following treatment correlated with an improvement in the cognitive score (P<.001). Regression analysis confirmed that the cognitive score had independence from the other scores and did not serve solely as a proxy for symptom improvement.

The researchers conclude that symptom improvement in IBS with hypnotherapy is associated with cognitive change. It also represents an initial step in unravelling the many possible mechanisms by which treatments such as hypnotherapy bring about improvement in IBS.

Citation: Gonsalkorale WM, Toner BB, Whorwell PJ.Cognitive change in patients undergoing hypnotherapy for irritable bowel syndrome.Journal of Psychosomatic Research. 2004 Mar; 56 (3): pages 271-8. [email protected]