Efficacy of psychological therapies for irritable bowel syndrome: systematic review and network meta-analysis

Black et al Gut BMJ 2021
Key finding: CBT-based interventions and gut-directed hypnotherapy had the largest evidence base and were the most efficacious long term.

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¹ Hypnotherapy for irritable bowel syndrome: an audit of one thousand adult patients

V Miller 1, H R Carruthers, J Morris, S S Hasan, S Archbold, P J Whorwell

Aliment Pharmacol Ther. 2015 May; 41(9):844-55) 2015 May;41(9):844-55.

Key finding: Significant reductions in IBS Symptoms and anxiety were observed in the IBS group 

https://pubmed.ncbi.nlm.nih.gov/25736234/

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¹ Patient satisfaction after gut-directed hypnotherapy in irritable bowel syndrome

Perjohan Lindfors et al

Key finding: Patient satisfaction with gut-directed hypnotherapy in IBS is associated with improvement of quality of life and gastrointestinal (GI) symptoms.

https://www.researchgate.net/publication/232228297_Patient_satisfaction_after_gut-directed_hypnotherapy_in_irritable_bowel_syndrome

 

¹ The Efficacy of Hypnotherapy in the Treatment of Irritable Bowel Syndrome: A Systematic Review and Meta-analysis

Han Hee Lee, Yoon Young Choi, Myung-Gyu Choi
Key finding: Significant reductions were achieved in abdominal pain and overall gastrointestinal symptoms. This study provides clearer evidence that hypnotherapy has beneficial short-term effects in improving gastrointestinal symptoms of patients with IBS.

https://pubmed.ncbi.nlm.nih.gov/24840368/ 

 

¹ Long term benefits of hypnotherapy for irritable bowel syndrome

W M Gonsalkorale, V Miller, A Afzal, and P J Whorwell

Key finding:  This study demonstrates that the beneficial effects of hypnotherapy appear to last at least five years. Thus it is a viable therapeutic option for the treatment of irritable bowel syndrome
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1773844/pdf/gut05201623.pdf

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¹ Long-term effects of hypnotherapy in patients with refractory irritable bowel syndrome
Perjohan Lindfors, Peter Unge, Henry Nyhlin, Brjánn Ljótsson, Einar S. Björnsson, Hasse Abrahamsson & Magnus Simrén

Key Finding: This long-term follow-up study indicates that gut-directed hypnotherapy in refractory IBS is an effective treatment option with long-lasting effects, also when given outside highly specialized hypnotherapy centers. Apart from the clinical benefits, the reduction in health-care utilization has the potential to reduce the health-care costs.

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² Randomised clinical trial: the efficacy of gut‐directed hypnotherapy is similar to that of the low FODMAP diet for the treatment of irritable bowel syndrome

S. L. Peters, et al

Alimentary Pharmacology and Therapeutics Volume44, Issue5, September 2016 Pages 447-459

Key finding: Durable effects of gut‐directed hypnotherapy are similar to those of the low FODMAP diet for relief of gastrointestinal symptoms. Hypnotherapy has superior efficacy to the diet on psychological indices. No additive effects were observed.

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​­³ Systematic review, meta-analysis with subgroup analysis of hypnotherapy for irritable bowel syndrome, effect of intervention characteristics.

Matthew Krouwel *, Amanda Farley, Sheila Greenfield, Tariq Ismail, Kate Jolly

Key finding: This review suggests that high volume hypnotherapy is more beneficial than low and should be adopted for GDH. Both high frequency and group interventions are effective in reducing GGS in IBS.

Systematic review, meta-analysis with subgroup analysis of hypnotherapy for irritable bowel syndrome, effect of intervention characteristics - ScienceDirect

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Gut-focused hypnotherapy for children and adolescents with irritable bowel syndrome

Dipesh H Vasant et al. 

Keyfindings: GDH is highly effective in children and adolescents with IBS (88% response). Early intervention with GFH in childhood IBS may reduce the subsequent burden of this problem in adults.

Vasant DH, et al. Frontline Gastroenterology 2021;12:570–577. doi:10.1136/flgastro-2020-101679

 

² Home-Based Hypnotherapy Self-exercises vs Individual Hypnotherapy With a Therapist for Treatment of Pediatric Irritable Bowel Syndrome, Functional Abdominal Pain, or Functional Abdominal Pain Syndrome A Randomized Clinical Trial

Juliette M. T. M. Rutten, MD, PhD; Arine M. Vlieger, PhD; Carla Frankenhuis  JAMA Pediatr. 2017;171(5):470-477. 

Key finding: Long-term effectiveness of home-based HT with a CD is noninferior to iHT performed by therapists in pediatric IBS or FAP(S). Treatment with hypnosis using a CD provides an attractive treatment option for these children.

https://jamanetwork.com/journals/jamapediatrics/fullarticle/2613403

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Hypnotherapy for Children With Functional Abdominal Pain or Irritable Bowel Syndrome: A Randomized Controlled Trial

ARINE M. VLIEGER,* CARLA MENKO–FRANKENHUIS,‡ SIMONE C. S. WOLFKAMP,‡ ELLEN TROMP,§ and MARC A. BENNINGA‡

GASTROENTEROLOGY 2007;133:1430 –1436

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Return on investment of internet delivered exposure therapy for irritable bowel syndrome: a randomized controlled trial.
Hugo Wallén et al.

Key finding: Including exposure in Cognitive Behavior Treatment for IBS is more cost-efective from a societal perspective than not including it, even though it may demand more therapist and patient time in the short term.

Return on investment of internet delivered exposure therapy for irritable bowel syndrome: a randomized controlled trial | BMC Gastroenterology | Full Text (biomedcentral.com)

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² Cognitive-behavioral therapy for patients with irritable bowel syndrome: current insights

Sarah W Kinsinger et al. Psychological Research and Behavior Management

Key finding: IBS involves dysregulation of the brain–gut axis and psychological processes play an important role in the development and maintenance of the disorder. This is a chronic, difficult-to-treat condition and patients often feel dismissed and frustrated because of the lack of effective medical interventions. Psychological interventions are well-established, effective treatments for IBS, and CBT in particular has been rigorously tested in clinical trials and consistently demonstrates significant and long-lasting symptom improvement. Despite the clear benefits of CBT for IBS, very few patients have access to this specialized approach.

Cognitive-behavioral therapy for patients with irritable bowel syndrome: current insights (nih.gov)

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² Cognitive Behavioral Therapy for IBS and Other Functional Gastrointestinal Disorders

Alyse Bedell, PhD., Assistant Professor of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, and Laurie Keefer, Ph.D., Associate Professor of Gastroenterology and Psychiatry, Icahn School of Medicine, Mount Sinai, New York, NY

Key finding: Cognitive behavioral therapy (CBT) can help relieve pain from IBS CBT can be used to stop the harmful effects of the fight or flight response by instead turning on the “rest and digest” response. Practicing deep breathing, muscle relaxation, and using guided imagery can all help move the body into this relaxed state.

Iffgd.org/resources/publication-library/cognitive-behavioral-therapy-for-ibs-and-other-fgids/

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⁴ Emergency upscaling of video consultation during the COVID-19 pandemic: Contrasting user experience with data insights from the electronic health record in a large academic hospital.

E.Z. Barsom a , H.A.W. Meijer a , J. Blom a , M.J. Schuuring

Key finding: This study strongly signals that VC is an important modality in futureproofing outpatient care during and beyond pandemic times.

Emergency upscaling of video consultation during the COVID-19 pandemic: Contrasting user experience with data insights from the electronic health record in a large academic hospital - ScienceDirect

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PDS bij IBD in remissie

Treatment of inflammatory bowel disease: a role for hypnotherapy?
Miller et al 2008

Key finding: Hypnotherapy appears to be a promising adjunctive treatment for inflammatory bowel disease and has steroid sparing effects.

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The Effect of Hypnosis on Systemic and Rectal Mucosal Measures of Inflammation in Ulcerative Colitis
Mawdsley, Joel E.  et al American Journal of Gastroenterology 
Key finding: Hypnosis reduced several components of the systemic and mucosal inflammatory response in active ulcerative colitis toward levels found previously in the inactive disease. Some of these effects may contribute to the anecdotally reported benefits of hypnotherapy and provide a rationale for controlled trials of hypnotherapy in UC.

 

Prevalence of irritable bowel syndrome-type symptoms in patients with inflammatory bowel disease in remission: a systematic review and meta-analysis

Keeley M Fairbrass et al Lancet G&H 2020
Key finding: In conclusion, the prevalence of IBS-type symptom reporting in patients with IBD in remission in this meta-analysis was as high as 35%. Even when more objective measures of remission were used, one-in-four patients reported these symptoms.

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Hypnotherapy for Irritable Bowel Syndrome - Type Symptoms in Patients with Quiescent Inflammatory Bowel Disease: A Randomized, Controlled Trial
Hoekman et al Journal of Crohn's and Colitis 2021

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Gut-directed hypnotherapy significantly augments clinical remission in quiescent ulcerative colitis

L Keefer et al AP&T 2013

Key finding: This is the first prospective study that has demonstrated a significant effect of a psychological intervention on prolonging clinical remission in patients with quiescent ulcerative colitis (Clinical Trial # NCT00798642)

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Hypnotherapy for Inflammatory Bowel Disease Across the Lifespan
Eva Szigeth et al Am Journal of Clinical Hypnosis 2015

Finding: In children and adolescents with IBD, hypnotherapy could have a protective effect in training the brain to better cope with the psychological and physical consequences of this life-long inflammatory disease, which to date, remains without a cure.
 

Functionele dyspepsie

Long-term improvement in functional dyspepsia using hypnotherapy

This study aimed to assess the efficacy of HT in functional dyspepsia (FD). 

Emma Louise Calvert;  Gastroenterology Volume 123 Issue 6 Pages 1778-1785 (December 2002) DOI:10.1053/gast.2002.37071

Key finding: HT is highly effective in the long-term management of FD. Furthermore, the dramatic reduction in medication use and consultation rate provide major economic advantages.

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Pilot Study of a Self‑Administered Hypnosis Intervention or Functional Dyspepsia

Sarah W. Kinsinger et al.

Key finding: The fully automated hypnosis audio treatment program, which requires no therapist or clinician involvement, demonstrated excellent feasibility and resulted in significant improvement in FD symptoms, quality of life and emotional well-being. The results indicate that the intervention has high potential as adjunctive therapy for FD.

Kinsinger et al 2021. Pilot Study of a Self‑Administered Hypnosis Intervention for Functional Dyspepsia.

Prokinetic effect of gut-oriented hypnosis on gastric emptying
G. Chiaroni et al: Alimentary Pharmacology & Therapeutics 2006
Key finding: Gut-oriented hypnosis is effective in shortening gastric emptying both in dyspeptic and in healthy subjects.


Beyond Rome IV
The feasibility and acceptability of esophageal-directed hypnotherapy for functional heartburn
Rielh et al Dis Esophagus. 2016
Key finding: We suggest that this is an acceptable and effective intervention for patients who have failed traditional pharmaco-therapy or are interested in less invasive treatment alternatives for their symptoms.

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Treatment of non-cardiac chest pain: a controlled trial of hypnotherapy
Jones et al Gut 2006

Key finding: Hypnotherapy appears to have use in this highly selected group of NCCP patients and warrants further assessment in the broader context of this disorder.