In the largest long-term study of hypnotherapy for irritable bowel syndrome (IBS) to date, seven out of 10 patients reported an improvement in symptoms after treatment and four out of five respondents maintained the improvement for years after stopping hypnosis. Those who did not maintain a response to hypnosis only deteriorated slightly.
“We have known that this treatment is effective, but this study confirms that patients can maintain the improvements for many years,” researcher Wendy M. Gonsalkorale, PhD, tells WebMD. “There is growing interest in hypnosis for the treatment of IBS, but too few patients know about it.”
Most Sufferers Are Women
As many as 58 million Americans suffer from the symptoms of irritable bowel syndrome and four out of five sufferers are women, based on figures from the American College of Gastrointerology.
Typically people with IBS have recurrent symptoms of abdominal pain, distention, and altered bowel movements — diarrhea, constipation, or a combination of both. Because there is no obvious cause for the array of gastrointestinal disturbances experienced by patients and conventional GI treatments often do not work.
It has been almost two decades since British researcher Peter Whorwell and colleagues first reported on the use of hypnotherapy in the treatment of IBS. Since that time other small studies have also shown hypnosis to be effective, but this new research, appearing in the latest issue of Gut, is the first to follow a large group of patients for years after treatment.
For the study, Gonsalkorale and Whorwell followed 204 patients for up to six years. Researchers asked patients to score their IBS symptoms, as well as their overall quality of life, and levels of depression and anxiety immediately before hypnotherapy and after the treatment. They also responded to a mailed questionnaire sent at least a year and no more than six years after treatment ended. The hypnotherapy course consisted of 12-weekly, one-hour sessions.
Almost three-quarters of the patients (71%) gave positive reports following hypnotherapy, and 81% said they maintained their improvement over time. The sustained improvements reported by most of the patients could not be attributed to other treatments because fewer than one in 10 used other treatments following hypnotherapy.
“This study demonstrates that the beneficial effects of hypnotherapy appear to last at least five years,” the researchers write. “Thus, it is a viable therapeutic option for the treatment of irritable bowel syndrome.”
Researcher Olafur S. Palsson, PsyD, who has studied IBS says the number of patients in the new study and the length of follow-up put hypnosis in a favorable light and possibly show it may be the most effective long-term treatment for irritable bowel syndrome. But he says that it is still rarely offered to IBS patients and is not often covered by insurance.
“Hypnotherapy still carries the aura of mystery and magic, and is not really used much for medical conditions in this country,” Palsson says. “It requires special training that clinicians in most medical settings simply do not have. And it is considered more costly than drug therapy because it requires repeated sessions.”
The University of North Carolina researcher says hypnosis may actually be much cheaper than other treatments because the long-term results appear to be so promising.
“There are only a couple of medications approved for the treatment of irritable bowel syndrome, and it can be expensive to keep patients on these medications long-term,” says Palsson. “For many patients, hypnotherapy is a very cost-effective way of improving outcome.”
Sixty million Americans deal with this uncomfortable sensation at least once a month: heartburn. It’s not only painful, but can be life-altering, or even deadly if ignored. No wonder that heartburn and other gastrointestinal medications are among the most popular drugs on the market. But these “miracle drugs” are far from perfect; some patients report mixed results and long-term side effects.
For patients who don’t get relief from medication, their gastroenterologists are turning to psychologists for help. Hypnotherapy can be an effective treatment for heartburn and other stomach conditions. It’s a powerful alternative treatment, backed with plenty of scientific evidence, which is increasingly being offered at the nation’s leading medical centers.“
There’s a robust amount of literature behind hypnotherapy beginning in the 1980s,” said Laurie Keefer, Ph.D, director of psychosocial research at the Icahn School of Medicine at Mount Sinai. “We’ve really taken to calling it brain-gut therapy.”
Hypnosis, which exploits the relationship between the mind and digestive system, can also help with conditions like GERD and the inflammatory bowel diseases, Crohn’s disease and ulcerative colitis. Untreated GERD has been linked to esophageal cancer.
Amber Ponticelli, 35, started having digestive problems in 2007. Initially, she only felt dizzy and weak in the morning, but soon developed severe abdominal pain. Unable to eat or drink for months, she lost 20 pounds and was ultimately left bedridden.
After seeing multiple gastroenterologists at leading medical institutions, she was eventually diagnosed with a genetic condition that is associated with many GI symptoms.
“I thought I was dying. I had to quit my job and ended up moving to the city with my boyfriend just to be closer to the doctors I was seeing in the city,” Ponticelli told NBC News.
After traditional treatment like medications and lifestyle changes, a wary Ponticelli was referred to Keefer for a hypnotherapy session.
Hypnosis uses progressive relaxation techniques through suggestions of calming imagery and sensations. Patients are able to concentrate on improving their symptoms which often range from abdominal pain and constipation to diarrhea and bloating.
For the therapy to be effective it takes a series of eight or more visits and some homework is required of the patient, like listening to tapes at home. The treatment is covered by most insurance plans and cost for each visit ranges between $100 and $150.
Contrary to many popular portrayals on television and in fiction, a clinical hypnotherapist does not have mind-control over the hypnotized patient. The patient is usually aware of what is happening and their surroundings, both during and after a hypnosis session. A session can be offered in-person and remotely, via a service called telemedicine.
“Telemedicine is critical because not every place in the country has somebody qualified or trained to provide this treatment, so it allows us to have a much broader reach for these very common disorders,” Keefer told NBC News.
Studies show more than three quarters of patients experience at least a 50 percent reduction in symptoms. Many are able to stop medication, including popular acid reducing drugs.
Hypnosis optimizes the brain depth function, but it’s not a fix for everyone.
Approximately 15-20 percent of people can’t be hypnotized, said Dr. Olaf Palsson, psychologist and professor of medicine at the University of North Carolina School of Medicine. Fortunately, patients do not have to be highly hypnotizable to benefit from gut-directed hypnotherapy, so many could find relief.
According to gastroenterologist Dr. Rajeev Jain of the American Gastroenterological Association, gut-directed hypnosis therapy can treat functional disorders of the GI tract, such as irritable bowel syndrome, where there is often a large overlay of depression and anxiety disorders. He views hypnotherapy as one form of complementary and alternative medicine (CAM). Lifestyle factors such as diet are also important and should be taken into account.
Today, Ponticelli, who lives outside of Chicago, is back to work as a Pilates instructor, and eating her favorite foods, an activity she had not enjoyed in years. She’s also eating for two. “I’m 17-and-a-half weeks along now and feel good,” said Ponticelli.
She still takes some medications, but adding hypnotherapy to her regimen has been life-changing. “I’m extremely grateful that I’m actually doing this and I don’t think I would have been able to do anything without this treatment. That’s the real truth of it.”
Sarah Blau settles into a wicker chair, stretching her feet onto an ottoman. In a soothing voice, Laurie Keefer, says, “I’m going to count from one to three, and as I count, your eyelids will get heavy and they’ll close whenever it feels right.”
Dr. Keefer, a health psychologist at Mount Sinai Health System, has Ms. Blau progressively relax each part of her body and guides her to “a place of rest and comfort and healing.”
“Enjoy the beauty of this natural, healing place,” she tells her, “and as you do, something very powerful and healthy and positive is taking place deep inside your body. Your body knows what it needs to maintain healing your gut. It knows how to keep pleasant sensations in and avoid pain and discomfort.”
Hypnotherapy—when patients enter a trance-like state using relaxation and visual images—is often associated with alternative medicine. But increasingly medical centers are using it to treat digestive conditions like acid reflux, irritable bowel syndrome and ulcerative colitis, a disease Ms. Blau learned she had in 2016.
Dr. Keefer works at the Susan and Leonard Feinstein Inflammatory Bowel Disease Clinical Center at Mount Sinai. There she does hypnotherapy for patients with Crohn’s disease and ulcerative colitis, diseases caused by inflammation of the intestines.
The treatment usually consists of about seven sessions over three months, with home practice in between. Studies have found the effects can last more than a year and work in more than half of patients.
In addition to Mount Sinai, hypnosis for patients with digestive conditions is available at University of Michigan, Beth Israel Deaconess Medical Center in Boston, University of Washington in Seattle, Baylor College of Medicine in Houston and Loyola University Medical Center and Northwestern Memorial Hospital in the Chicago area. Mayo Clinic in Rochester, Minn., also is exploring adding hypnotherapy for IBS patients.
There is a three-to-six-month wait list for the treatment at the University of Michigan, says Megan Riehl, an assistant professor of medicine and gastrointestinal psychologist.
“Some patients get a little uneasy about the word ‘hypnosis,’ ” says Andrea Bradford, an assistant professor of medicine at Baylor, which started offering the treatment in 2016. “It conjures up images of some guy in Vegas making you bark like a dog. It takes some education to explain to them what it constitutes and what it does not.”
She says about one-third of patients are open to it. Experts theorize that hypnotherapy works because many gastrointestinal disorders are affected by a faulty connection between the brain and the gut, or digestive tract.
The gut and brain are in constant communication. When something disrupts that communication, the brain misinterprets normal signals, which can cause the body to become hypersensitive to stimuli detected by nerves in the gut, causing pain. Experts believe hypnosis shifts the brain’s attention away from those stimuli by providing healthy suggestions about what’s going on in the gut.
“It doesn’t get rid of the stimulus. Your GI tract is still moving. It’s just changing the threshold of perception so you’re not paying attention or feeling it with the same intensity,” says John Pandolfino, chief of gastroenterology and hepatology at Northwestern, which started offering hypnotherapy in 2006 and has plans to expand to two regional hospitals.
Northwestern has trained health psychologists in GI disorders who have moved on to start programs at other academic centers. Sarah Quinton, a gastrointestinal psychologist at Northwestern, conducts the treatments there, along with two other psychologists and students in training. Because there aren’t many treatments for IBS, hypnotherapy has become “the front-line therapy,” Dr. Pandolfino says.
Dr. Pandolfino says he will take patients with reflux problems whose symptoms aren’t improving off their medication. After that, if their acid levels are normal but they still experience symptoms, like chest pain, he recommends hypnotherapy. This happens with “a large number of patients,” Dr. Pandolofino says.
David Dewey, a 58-year-old real-estate developer in the Chicago suburbs, says hypnotherapy helped rid him of abdominal pain that sometimes kept him up at night. His doctor at Northwestern told him that his diagnosis of IBS was incorrect and that the real problem was related to his brain.
His doctor said, he recalls, “It sounds crazy, but we’ve been having great success with hypnotherapy.” He figured he had nothing to lose, since nothing else had helped for two years. The pain disappeared in under 10 sessions. “Sometimes it creeps back a little, and I just do one or two [home] sessions and it goes away,” Mr. Dewey says.
Olafur Palsson, a professor of medicine and clinical psychologist at the University of North Carolina at Chapel Hill, developed the first script, or protocol, for hypnosis treatment for IBS in 1995. The script has been adapted for use in other GI disorders.
He has trained hundreds of therapists in the protocol, which he says 600 therapists across the country use today. Most professionals who conduct hypnotherapy treatments are psychologists. Shoba Krishnamurthy, a gastroenterologist at the University of Washington, got training and decided to incorporate it into her practice about three years ago.
“It’s mostly for patients who have had a work-up but we haven’t found anything abnormal in tests, so there is not a specific abnormality to treat,” she says. Ms. Blau, a 32-year-old who has been undergoing hypnotherapy at Mount Sinai, began the treatments in the fall, when her colitis was under control, as a preventive measure. It has remained that way. “I’ve been feeling really good,” she says.
• Gastrointestinal disorders: ulcers, irritable bowel syndrome, colitis, crohn’s disease
• Dermatologic disorders: eczema, herpes, neurodermatitis, pruritus, psoriasis and warts
• Surgery/anesthesiology: when hypnosis is the sole anesthetic and when patient needs to be able to respond to questions from surgeon
• Acute and chronic pain: back, dental and cancer pain, headaches or arthritis
• Burns: when hypnotic anesthesia and feelings of coolness can reduce inflammation and promote healing.
• Nausea/vomiting: chemotherapy and pregnancy
• Childbirth: eliminates risks that medications can pose to both the mother and child
• Hemophilia: control vascular flow and keep from requiring a blood transfusion
• Allergies/asthma
• High blood pressure (hypertension)
• Raynaud’s disease
(Courtesy of www.asch.net)
A Boston area Hypnotherapist, with 10 years of medical experience as an RN, Paul has been helping clients since 2001 to overcome everyday challenges. Read more
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In the largest long-term study of hypnotherapy for irritable bowel syndrome (IBS) to date, seven out of 10 patients reported an improvement in symptoms after treatment and four out of five respondents maintained the improvement for years after stopping hypnosis. Those who did not maintain a response to hypnosis only deteriorated slightly.
time other small studies have also shown hypnosis to be effective, but this new research, appearing in the latest issue of Gut, is the first to follow a large group of patients for years after treatment.
“Hypnotherapy still carries the aura of mystery and magic, and is not really used much for medical conditions in this country,” Palsson says. “It requires special training that clinicians in most medical settings simply do not have. And it is considered more costly than drug therapy because it requires repeated sessions.”
