Introduction

Surprisingly, the irritable bowel syndrome (IBS) takes up to 50% of the gastroenterologist's workload, according to British researchers. Symptoms - abdominal pain, bloating, and constipation or diarrhea - can be sufficiently severe to impair the patient's quality of life. Although specific medications have recently become available to address the condition (see related links below), treatment remains unsatisfactory for many patients.

Hypnotherapy has been shown in earlier studies to be an effective form of therapy, at least in the short term. Now a study has been reported in the British journal Gut that describes the long-term benefits of this form of treatment.

What was done

A gut-directed hypnotherapy unit was established in the UK some years ago. Recently, questionnaires were mailed to 273 patients with IBS who had completed a course of gut-directed hypnotherapy at least one year previously. A full course comprised up to 12 one-hour weekly sessions. The patients had already completed such questionnaires immediately before and after their course of hypnotherapy. The aim of the study was to see if the apparent benefits of hypnotherapy persisted for at least a year.

The questionnaire covered IBS symptoms, an anxiety and depression scale, a subjective assessment of symptoms (how the patients themselves felt about their condition), doctor's visits, and medications used.

What was found

Of the 273 questionnaires sent out, 204 were returned - a 73% return rate. The time between treatment and the return of questionnaires ranged evenly between 1 and 6 years.

Immediately after completing the course of hypnotherapy, 52% of the patients reported they were "very much better", 19% were "moderately better", and 15% as "slightly better", while 13% reported "no change".

The questionnaires collected at varying interval greater than one year (and up to 6 years) after finishing hypnotherapy showed that 81% of the original responders had maintained their improvement; 29% had "improved much more", 24% "improved moderately more", 11% "improved slightly more", and 17% were "about the same as at the end of hypnotherapy". The remaining 19% had experienced deterioration, mostly described as "slight worsening".

The specific IBS symptoms (pain severity, pain frequency, bloating, bowel habit dissatisfaction, life interference) showed a similar response. All of them were significantly improved immediately after hypnotherapy, and showed little change at the follow up survey, whether this was after 1, 2, 3, 4, or 5 years.

Quality of life, anxiety, and depression scores were significantly improved immediately after hypnotherapy, but were more likely to show some deterioration by the time of final follow up; however, they were still significantly better than those before the hypnosis therapy. Visits to the doctor and the amount of medication taken showed similar changes after treatment.

Comment

This is the first report of the long-term benefits of gut hypnotherapy for IBS. The results are quite favorable - 71% of patients were improved by hypnotherapy, and 81% of these responders maintained the benefit, or reported further improvement, for periods up to 6 years.

As many as 85% of the people who returned questionnaires had continued to practice hypnotherapeutic techniques on their own, after the end of the hypnotherapy course. It wasn't possible to say whether this was associated with a better result over the follow-up period.

Gut-directed hypnotherapy, first developed in the UK in 1984, is a technique that clearly requires specific experience, and is unlikely to be successful in untrained hands. IBS patients considering such an approach should consult with their physicians and find a center that is able to provide this particular service.