Original Contribution | Published:

Hypnotherapy in irritable bowel syndrome: a large-scale audit of a clinical service with examination of factors influencing responsiveness

American Journal of Gastroenterology volume 97, pages 954961 (2002) | Download Citation

Subjects

Abstract

OBJECTIVES:

Hypnotherapy has been shown to be effective in the treatment of irritable bowel syndrome in a number of previous research studies. This has led to the establishment of the first unit in the United Kingdom staffed by six therapists that provides this treatment as a clinical service. This study presents an audit on the first 250 unselected patients treated, and these large numbers have also allowed analysis of data in terms of a variety of other factors, such as gender and bowel habit type, that might affect outcome.

METHODS:

Patients underwent 12 sessions of hypnotherapy over a 3-month period and were required to practice techniques in between sessions. At the beginning and end of the course of treatment, patients completed questionnaires to score bowel and extracolonic symptoms, quality of life, and anxiety and depression, allowing comparisons to be made.

RESULTS:

Marked improvement was seen in all symptom measures, quality of life, and anxiety and depression (all ps < 0.001), in keeping with previous studies. All subgroups of patients appeared to do equally well, with the notable exception of males with diarrhea, who improved far less than other patients (p < 0.001). No factors, such as anxiety and depression or other prehypnotherapy variables, could explain this lack of improvement.

CONCLUSIONS:

This study clearly demonstrates that hypnotherapy remains an extremely effective treatment for irritable bowel syndrome and should prove more cost-effective as new, more expensive drugs come on to the market. It may be less useful in males with diarrhea-predominant bowel habit, a finding that may have pathophysiological implications.

Access optionsAccess options

Rent or Buy article

Get time limited or full article access on ReadCube.

from$8.99

All prices are NET prices.

References

  1. 1.

    ., ., ., et al. Non-colonic features of irritable bowel syndrome. Gut 1986;27:37–40.

  2. 2.

    . Irritable bowel syndrome: Prevalence, prognosis and consequences. CMAJ 1986;134:111–113.

  3. 3.

    ., ., ., et al. Irritable bowel syndrome: The view from general practice. Eur J Gastroenterol Hepatol 1997;9:689–692.

  4. 4.

    . What the gastroenterologist does all day. A survey of a state society's practice. Gastroenterology 1976;70:1048–1050.

  5. 5.

    ., ., . Organic and functional disorders in 2000 gastroenterology outpatients. Lancet 1983;i:632–634.

  6. 6.

    ., ., ., et al. U.S. householder survey of functional gastrointestinal disorders: Prevalence, sociodemography and health impact. Dig Dis Sci 1993;38:1569–1580.

  7. 7.

    ., . Irritable bowel syndrome—a safe diagnosis. Br Med J 1982;285:1533–1534.

  8. 8.

    ., . Use of medical resources and attitudes to health care of patients with “chronic abdominal pain”. Br J Med Econ 1992;2:75–79.

  9. 9.

    ., ., ., et al. Medical costs in community subjects with irritable bowel syndrome. Gastroenterology 1995;109:1736–1741.

  10. 10.

    ., ., . Controlled trial of hypnotherapy in the treatment of severe refractory irritable bowel syndrome. Lancet 1984;ii:1232–1234.

  11. 11.

    ., ., . Hypnotherapy in severe irritable bowel syndrome: Further experience. Gut 1987;28:423–425.

  12. 12.

    ., ., . Symptomatology, quality of life and economic features of irritable bowel syndrome—the effect of hypnotherapy. Aliment Pharmacol Ther 1996;10:91–95.

  13. 13.

    ., ., ., et al. Individual and group hypnotherapy in the treatment of refractory irritable bowel syndrome. Lancet 1989;i:424–425.

  14. 14.

    ., . The treatment of irritable bowel syndrome with hypnotherapy. Appl Psychophysiol Biofeedback 1998;23:219–232.

  15. 15.

    ., ., ., et al. Functional bowel disorders and functional abdominal pain. Gastroenterol Int 1992;5:75–91.

  16. 16.

    ., ., . The irritable bowel severity scoring system: A simple method of monitoring irritable bowel syndrome and its progress. Aliment Pharmacol Ther 1997;11:395–402.

  17. 17.

    ., . The Hospital Anxiety and Depression Scale. Acta Psychiatr Scand 1983;67:361–370.

  18. 18.

    ., ., ., et al. Symptom differences in moderate to severe IBS patients based on predominant bowel habit. Am J Gastroenterol 1999;94:2929–2935.

  19. 19.

    : An introduction to the practice of clinical hypnosis, 2nd ed. Brunner/Mazel: New York, 1990.

  20. 20.

    ., ., ., et al. Improvement in pain and bowel function in female irritable bowel patients with alosetron, a 5-HT3 receptor antagonist. Aliment Pharmacol Ther 1999;13:1149–1159.

  21. 21.

    ., ., ., et al. A double-blind, randomised placebo-controlled dose-ranging study to evaluate the efficacy of alosetron in the treatment of irritable bowel syndrome. Aliment Pharmacol Ther 2000;14:23–24.

  22. 22.

    ., ., ., et al. Alosetron relieves pain and improves bowel function compared with mebeverine in female nonconstipated irritable bowel syndrome patients. Aliment Pharmacol Ther 1999;13:1419–1427.

  23. 23.

    ., ., ., et al. Efficacy and safety of alosetron in women with irritable bowel syndrome: A randomised, placebo-controlled trial. Lancet 2000;355:1035–1040.

Download references

Acknowledgements

We thank the other Hypnotherapy Unit staff who treated some of the patients used in this study: Mrs. P. Cooper, Mrs. P. Cruickshanks, Mrs. V. Miller, Mrs. J. Randles, and Mrs. V. Whelan. We also thank Mrs. Julie Morris, Head of Medical Statistics, University Hospital of South Manchester, for help with statistical analysis.

Author information

Affiliations

  1. Department of Medicine, University Hospital of South Manchester, Manchester, United Kingdom

    • Wendy M Gonsalkorale
    • , Lesley A Houghton
    •  & Peter J Whorwell

Authors

  1. Search for Wendy M Gonsalkorale in:

  2. Search for Lesley A Houghton in:

  3. Search for Peter J Whorwell in:

Corresponding author

Correspondence to Wendy M Gonsalkorale.

About this article

Publication history

Received

Accepted

Published

DOI

https://doi.org/10.1111/j.1572-0241.2002.05615.x

Further reading