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Review article: gut‐directed hypnotherapy in the management of irritable bowel syndrome and inflammatory bowel disease
Author(s) -
Peters S. L.,
Muir J. G.,
Gibson P. R.
Publication year - 2015
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/apt.13202
Subject(s) - irritable bowel syndrome , medicine , ulcerative colitis , inflammatory bowel disease , clinical trial , disease , gastroenterology , functional gastrointestinal disorder , intensive care medicine
Summary Background Gut‐directed hypnotherapy is being increasingly applied to patients with irritable bowel syndrome ( IBS ) and to a lesser extent, inflammatory bowel disease ( IBD ). Aim To review the technique, mechanisms of action and evidence for efficacy, and to identify gaps in the understanding of gut‐directed hypnotherapy as a treatment for IBS and IBD . Methods A review of published literature and a systematic review of clinical trials in its application to patients with IBS and IBD were performed. Results Gut‐directed hypnotherapy is a clearly described technique. Its potential mechanisms of action on the brain‐gut axis are multiple with evidence spanning psychological effects through to physiological gastrointestinal modifications. Six of seven randomised IBS studies reported a significant reduction (all P < 0.05) in overall gastrointestinal symptoms following treatment usually compared to supportive therapy only. Response rates amongst those who received gut‐directed hypnotherapy ranged between 24% and 73%. Efficacy was maintained long‐term in four of five studies. A therapeutic effect was also observed in the maintenance of clinical remission in patients with ulcerative colitis. Uncontrolled trials supported the efficacy and durability of gut‐directed hypnotherapy in IBS . Gaps in understanding included to whom and when it should be applied, the paucity of adequately trained hypnotherapists, and the difficulties in designing well controlled‐trials. Conclusions Gut‐directed hypnotherapy has durable efficacy in patients with IBS and possibly ulcerative colitis. Whether it sits in the therapeutic arsenal as a primary and/or adjunctive therapy cannot be ascertained on the current evidence base. Further research into efficacy, mechanisms of action and predictors of response is required.