Gut-directed hypnotherapy delivers benefits for patients with irritable bowel syndrome (IBS) after six weekly sessions without the need for longer term therapy, UK research has shown.
Led by gastroenterologist Dr Dipesh Vasant of Manchester University, the largest randomised study of gut-directed hypnotherapy to date, involving 448 patients found that six and 12 sessions of hypnotherapy offered similar levels of improvement in IBS symptoms, non-colonic symptoms, anxiety, depression and quality-of-life.
The findings, published in Gastroenterology, could help improve access to the emerging therapy by halving the cost and doubling the output of individual hypnotherapists, as well as the shorter duration making hypnotherapy more acceptable to patients, the investigators said.
In the study, the primary outcome of a ≥50 point reduction in IBS symptom scores was seen by 78.8% of the 226 patients who finished six sessions of hypnotherapy, and by 73.9% of the 222 patients who completed twelve sessions.
Outcomes were also similar for a ≥30% reduction in abdominal pain (63.4% vs 57.0%).
Secondary outcomes were also similar (non-colonic symptom score; improvement in quality-of-life scores; EQ-5D health state scores and HAD-depression) or marginally better (EQ-5D VAS and HAD-anxiety) following six compared to twelve sessions.
Dr Jim Kantidakis, a clinical psychologist and hypnotherapist at St Vincents Hospital Functional Gut Clinic, Melbourne, said the research validated the practices already being used in Australia’s emerging gut-directed hypnotherapy sector.
“We’ve been doing the six sessions for years,” he said.
“What I found was we weren’t seeing much difference between 12 and 10, then 10 and eight sessions, so we reduced the number.”
Dr Kantidakis, who is also founder of The Gut Centre, said he believed the shorter duration of hypnotherapy was effective because patients with IBS knew they would have a positive outcome sooner, and they spent less time thinking about their condition.
“A big part of the problem is that people who have this condition have a lot of anxiety about it,” he said.
The UK investigators speculated that a ‘fast track’ course of gut-directed hypnotherapy would help improve motivation and engagement among both patients and practitioners, with the time pressure helping maintain momentum and avoid disruptions.
Fast-track #hypnotherapy for #IBS?
Large (448 pts) study by @DipeshVasant in @AGA_Gastro shows that 6⃣🆚1⃣2⃣ sessions of gut-focused hypnotherapy are just as effective in alleviating symptomshttps://t.co/08qg6lr31w @DrPalssonUNC @DrvanTilburg @DrTiffTaft @RomeFoundation pic.twitter.com/4zSWUwppB8
— Daniel Keszthelyi MD PhD (@IBS_Maastricht) March 2, 2021
Dr Kantidakis said gut-directed hypnotherapy for IBS was still not widely offered in Australia but was now accessible via telehealth for patients on a mental health or allied healthcare plan.
He said psycho-gastroenterologists — a US term for psychologists trained in gut-directed hypnotherapy — largely worked through private clinics, but some hospitals now offered the service, such as the St Vincent’s Hospital Functional Gut Clinic and the Alfred Hospital’s Functional Gastrointestinal Disorders Clinic.
Commenting on social media, Professor Olafur Palsson a clinical psychologist at University of North Carolina at Chapel Hill, who specialises in functional GI disorders, noted that study co-investigator Professor Peter Whorwell had been a pioneer of IBS hypnosis treatment and the standard treatment course for many years had been 12 weekly sessions.
He added that the benefits of hypnotherapy on IBS appeared to be durable, being fully maintained at 18 months follow-up.