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Hypnotherapy Can Help Bowel Patients

They treat themselves and effects last, study finds

WEDNESDAY, Oct. 22, 2003 (HealthDayNews) -- Hypnotherapy can help relieve symptoms of irritable bowel syndrome over the long term, says a new British study that followed patients for up to six years after they learned the technique.

Nearly three quarters of the more than 200 irritable bowel syndrome (IBS) patients responded well after being given hypnotherapy instruction, reporting fewer symptoms and needing less medication.

Sessions were one hour for up to 12 weeks, and then patients got a tape so they could perform it themselves.

The study appears in the November issue of Gut.

Those who responded had significant improvement in symptoms (such as abdominal pain, bloating and bowel problems) compared to the severity before they learned hypnotherapy, says Wendy Gonsalkorale, a researcher at the University Hospital of South Manchester in the United Kingdom. And for 81 percent of the initial responders, the relief lasted.

IBS is a very common gastrointestinal disorder, accounting for half the patient load of gastroenterologists, the specialists who treat such disorders. IBS symptoms also include constipation or diarrhea.

Symptoms don't always respond to conventional treatment, which can include special diets, agents to bulk up the stool, antispasmodic agents to relax the intestines, and even antidepressants, which may work by boosting the hormone serotonin in the gut and reducing abdominal pain.

Hypnotherapy does seem to work, although Gonsalkorale can't pinpoint how it does. "Certainly, we have shown in lab studies that hypnosis alters motility or muscle movement in the gut and the sensitivity of the gut lining, both of which are implicated in producing IBS symptoms," she says. "So there is a real physical effect here [from the hypnotherapy]."

It can also produce alteration in the immune response, she says. And pain relief can occur at the level of the brain, with the brain learning to ignore incoming pain messages.

"We also emphasize that the patient is developing control over the gut [rather than the other way around], and this is probably also a crucial factor in how the patient improves," she says.

Other studies have shown similar benefits of hypnotherapy.

In the current study, those who responded to the hypnotherapy also reported lower levels of anxiety and depression, Gonsalkorale found, although the improvement tailed off over time.

Patients who responded said they took fewer drugs and did not need to see their doctors as frequently after getting the hypnotherapy instruction. Before instruction, about 67 percent of patients were on medication, but during the follow-up only about 37 percent of responders were on medication, but nearly 56 percent of nonresponders were.

The continued improvement in symptoms wasn't associated with whether the responders continued to practice the hypnotherapy at home, as suggested. But 85 percent of the responders said they did continue the sessions on their own.

Experts in the United States say gastroenterologists are generally open to the suggestion of using hypnotherapy. Some suggest it to patients.

"I thought the study was very interesting," says Dr. Lucinda Harris, an associate professor of medicine at New York Weill Cornell Medical Center. The findings, she says, may demonstrate that "patients probably need a multifaceted approach."

"The only shortcoming really is there is no control group," says Dr. Steven Field, a clinical assistant professor of medicine at New York University School of Medicine and a private practice gastroenterologist in New York City.

"It's no surprise that patients who responded are still responding," he says. "Some are practicing the technique on a conscious or subconscious level."

The study shows, he adds, that hypnotherapy is "another mode for a condition that's frustrating for both the patient and the physician."

More information

To learn more about irritable bowel syndrome, go to the American College of Gastroenterology or the National Library of Medicine.

SOURCES: Wendy Gonsalkorale, Ph.D., researcher, Department of Medicine, University Hospital of South Manchester, Manchester, U.K.; Steven Field, M.D., gastroenterologist and clinical assistant professor, medicine, New York University School of Medicine, New York City; Lucinda Harris, M.D, associate professor, clinical medicine, New York Weill Cornell Medical Center, New York City; November 2003 Gut
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