Long term benefits of hypnotherapy for irritable bowel syndrome

Abstract

Background and aims: There is now good evidence from several sources that hypnotherapy can relieve the symptoms of irritable bowel syndrome in the short term. However, there is no long term data on its benefits and this information is essential before the technique can be widely recommended. This study aimed to answer this question.

Patients and methods: 204 patients prospectively completed questionnaires scoring symptoms, quality of life, anxiety, and depression before, immediately after, and up to six years following hypnotherapy. All subjects also subjectively assessed the effects of hypnotherapy retrospectively in order to define their "responder status".

Results: 71% of patients initially responded to therapy. Of these, 81% maintained their improvement over time while the majority of the remaining 19% claimed that deterioration of symptoms had only been slight. With respect to symptom scores, all items at follow up were significantly improved on pre-hypnotherapy levels (p<0.001) and showed little change from post-hypnotherapy values. There were no significant differences in the symptom scores between patients assessed at 1, 2, 3, 4, or 5+ years following treatment. Quality of life and anxiety or depression scores were similarly still significantly improved at follow up (p<0.001) but did show some deterioration. Patients also reported a reduction in consultation rates and medication use following the completion of hypnotherapy.

Conclusion: 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.

Figure 1

Intra-individual differences in IBS symptom scores for all patients (n=204) between the different time points—that is, pre-HT post-HT, pre-HT/follow up, and post-HT/follow up. Data expressed as mean (95% confidence interval (CI)), with positive and negative values denoting reduction (improvement) and increase (deterioration) in score relative to earlier time point. (Mean values of scores at these time points are given in the text.) Overall score treated as the primary outcome and therefore no adjustment is made for multiple comparisons. “Unadjusted” comparisons for individual symptoms significant at the 0.1% level are assumed significant at the 5% level if multiple comparison adjustment is made. *p<0.01, **p<0.001.

Figure 2

Intra-individual differences in IBS symptom scores for responders and non-responders between the different time points shown. Data expressed as mean (95% confidence interval (CI)), with positive and negative values denoting reduction and increase in score relative to earlier time point. (Mean values of scores at these time points are given in table 1 ▶.) Overall score treated as the primary outcome and therefore no adjustment is made for multiple comparisons. “Unadjusted” comparison for individual symptoms significant at the 0.1% level are assumed to be significant at the 5% level if multiple comparison adjustment made. *p<0.05, **p<0.01, ***p<0.001 (intra-individual difference); ^† p<0.005, ^†† p<0.001 (responders v non-responders).