Psychological approaches have been used for years to treat GI issues. The particular psychological approach used in the MetaMe program is hypnotherapy. More than anything else, hypnosis involves changes in a person's attention and concentration- you can read more about it here. For over 40 years, hypnotherapy has been proposed and tested as a treatment for gastrointestinal disorders (35 scientific reports), and IBS specifically (25 scientific reports). All 25 studies that used hypnotherapy to treat IBS reported improvement in gastrointestinal symptoms. Among these studies, 11 were conducted in adults with IBS as randomized controlled trials (RCTs), which are the gold standard in assessing clinical outcomes. Taken together, the research shows that for a large proportion of patients that do not respond to standard medical approaches, hypnotherapy is very effective in reducing IBS symptoms for an extended period of time.
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Hypnosis Treatment of Irritable Bowel Syndrome:
Effects on Bowel Symptoms and Well Being.
Olafur S. Palsson, PsyD
How Well Does Hypnosis for IBS Work?
Based on more than two dozen published research studies, there is now extensive documentation of the outcomes following hypnosis interventions for IBS. Although outcome measures and definitions of success have varied, the following general conclusions can be made:
Success Rates Tend to Be 70% or Better, Even for Patients Unresponsive to Standard Medical Care
In IBS hypnosis treatment studies that follow carefully developed, standardized treatment protocols, the great majority of patients typically improve following the hypnosis course. In our two studies that tested the exact seven-session treatment course offered through the MetaMe Connect platform in individual face-to-face treatment with therapists, 85% and 93% of patients could be classified as treatment responders based on diary symptom ratings, or on a set of global health improvement ratings, respectively (Palsson et al., 2002). A research team in New York using our treatment protocol in a group format reported that 60% of the treated individuals improved significantly (Gerson et al., 2013).
High success rates have also been reported by the Manchester group, a British research team that has done more hypnosis research than anybody else. The Manchester group’s early work showed a 95% success rate for patients with classic IBS symptoms. A large case series recently published by the Manchester group showing the treatment outcomes for 1000 patients found that 76% of patients to respond to treatment (Miller et al., 2015).
This high rate of favorable response to treatment seen in the studies discussed above is all the more remarkable because the studies have generally involved only IBS sufferers who have already failed to get better from conventional medical care. Therefore, being unresponsive to the usual medical care approaches for IBS does not seem to prevent gaining benefit from hypnosis treatment.
Hypnosis Treatment Substantially Reduces All of the Central Symptoms of IBS
Abdominal pain, bloating or distention, and bowel activity dysfunction (diarrhea or constipation) are all improved through hypnosis treatment. The greatest improvement is commonly seen in abdominal pain, which is reduced by an average of 50% or more in many studies (for example, in our studies, as seen in the Figure).
Therapeutic Benefits Include Enhanced Psychological Well-being, Physical Well-being, and Quality of Life Improvement
Hypnosis treatment is associated with a significant reduction in symptoms of depression and anxiety, and quality-of-life scores improve after treatment (Gonsalkorale et al., 2002; Palsson et al., 2002). Interestingly, multiple studies have also found that IBS patients treated with hypnosis experience fewer non-gastrointestinal body symptoms (like headache or muscle pain) after the treatment course.
Treatment Benefits Generally Last for Years
Gonsalkorale and colleagues completed long-term follow-up on 204 patients treated with hypnosis (Gonsalkorale et al., 2003). They found that 81% of those who initially improved from treatment fully maintained their therapeutic effect in the long term—for up to 5 years post-treatment—and many of the remaining 19% reported only a partial return of symptoms rather than full relapse. Studies using our seven-session protocol have shown excellent maintenance of improvement at 10-month and 12-month follow-up (Palsson et al., 2002; Gerson et al., 2013).
Treatment Leads to Lasting Reduction in Disability and Reduced Health Care and Medication Needs
Houghton, Heyman, & Whorwell (1996) compared 25 patients treated with hypnosis to 25 patients with equivalent IBS severity who only received standard medical care. In addition to better symptom improvement, those in the hypnosis group took less time off work if they were employed, and were more likely to return to work if they had not been able to work. Gonsalkorale et al., (2002) also found reduced doctor visits and medication use in their long-term follow-up of 204 patients.
1. Gerson, C.D., Gerson, J., Gerson, M.J. (2013). Group hypnotherapy for irritable bowel syndrome with long-term follow-up. International Journal of Clinical and Experimental Hypnosis 61(1):38-54.
This study tested whether group gut-focused hypnotherapy would improve irritable bowel syndrome (IBS) symptoms. The authors found significant symptom reduction immediately after treatment, and 3, 6, and 12 months later. Overall, sixty percent of patients reached the threshold indicative of clinical improvement. The authors concluded that group hypnotherapy is effective in patients with IBS.
2. Gonsalkorale W. M., Miller, V., Afzal A., Whorwell P. J. (2003) Long term benefits of hypnotherapy for irritable bowel syndrome. Gut, 52(11), 1623-9.
In this study, 204 IBS patients treated with a course of hypnotherapy completed questionnaires about symptoms, quality of life, anxiety, and depression before, immediately after, and up to six years following the treatment. Of all the treated patients, 71% showed improvement in response to treatment initially, and of those, 81% were still fully improved when re-contacted up to five years later. Quality of life and anxiety or depression scores were also still significantly improved at follow-up but showed some deterioration. Patients also reported fewer doctor visits rates and less medication use long-term after hypnosis treatment. These results indicate that for most patients the benefits from hypnotherapy last at least five years.
3. Gonsalkorale W. M., Houghton L. A., Whorwell P. J. (2002). Hypnotherapy in irritable bowel syndrome: a large-scale audit of a clinical service with examination of factors influencing responsiveness. American Journal of Gastroenterology, 97(4),954-61.
This paper reported outcomes for 250 consecutive IBS patients treated in a hypnos clinic in Manchester, England, using a structured course of 12 sessions of hypnotherapy over a 3-month period plus home practice with audio recordings between sessions. Marked improvement was seen in all IBS symptoms (overall IBS severity was reduced by more than half on the average after treatment), quality of life, and anxiety and depression. All subgroups of patients appeared to do equally well except males with diarrhea, who improved far less than other patients for unknown reason.
4. Miller, V., Carruthers, H. R., Morris, J., Hasan, S. S., Archbold, S., & Whorwell, P. J. (2015). Hypnotherapy for irritable bowel syndrome: an audit of one thousand adult patients. Alimentary Pharmacology & Therapeutics, 41(9), 844-55
This article summarized outcome of hypnotherapy for one thousand IBS patients treated in a gastroenterology hypnotherapy unit in Manchester, England. All the patients were treated with 12 sessions of hypnotherapy following the structured treatment approach of the Manchester group. Overall, 76% of the patients improved from the treatment. Success rates were higher for females than males (80% vs. 62%) and slightly higher in patients with anxiety (79% vs 71%). In addition to bowel symptom improvement, non-gastrointestinal symptoms also improved significantly on average after treatment, and hypnotherapy also improved quality of life scores.
5. Palsson, O. S., Turner, M. J., Johnson, D. A., Burnett, C. K. &, Whitehead, W. E. (2002). Hypnosis treatment for severe irritable bowel syndrome: investigation of mechanism and effects on symptoms. Digestive Diseases and Sciences, Nov;47(11), 2605-14.
This paper describes two studies assessing the impact of hypnosis treatment using the standardized North Carolina protocol on IBS symptoms and possible physiological and psychological mechanisms underlying the the treatment effects. Patients with severe IBS received seven biweekly hypnosis sessions and used hypnosis audio recordings at home in between therapy visits. Bowel pain thresholds and smooth muscle tone were measured with computer-controlled balloon inflation tests before and after treatment in 18 patients (study I), and treatment changes in heart rate, blood pressure, sweat gland activity, finger temperature, and forehead muscle activity were assessed in 24 patients (study II). Somatization, anxiety, and depression were also measured. All central IBS symptoms improved substantially from treatment in both studies. Rectal pain thresholds, rectal smooth muscle tone and autonomic functioning (except sweat gland reactivity) were unaffected by hypnosis treatment. However, the number and severity of non-gastrointestinal symptoms and psychological distress showed large decreases. Improvements in bowel symptoms were unrelated to changes in the physiological parameters measured. 17 of 18 patients in study 1 (94%) and 21 of 24 patients in study 2 (87.5%) were judged to be treatment responders. Improvement was well-maintained at 10-12 month follow up in study 2.