# Sticky  Research Overview - Clinical Hypnotherapy for IBS



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*Research Overview for the use of Clinical Hypnotherapy for Irritable Bowel Syndrome*Examples of research studies and articles regarding the efficacy of the use of clinical hypnotherapy for the treatment of Irritable Bowel Syndrome.=====================================================================Palsson OS, Turner MJ, Whitehead WE. Hypnosis home treatment for irritable bowel syndrome: a pilot study. Int J Clin Exp Hypn. 2006 Jan;54(1):85-99. University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.Hypnosis treatment often improves irritable bowel syndrome (IBS), but the costs and reliance on specialized therapists limit its availability. A 3-month home-treatment version of a scripted hypnosis protocol previously shown to improve all central IBS symptoms was completed by 19 IBS patients. Outcomes were compared to those of 57 matched IBS patients from a separate study receiving only standard medical care. Ten of the hypnosis subjects (53%) responded to treatment by 3-month follow-up (response defined as more than 50% reduction in IBS severity) vs. 15 (26%) of controls. Hypnosis subjects improved more in quality of life scores compared to controls. Anxiety predicted poor treatment response. Hypnosis responders remained improved at 6-month follow-up. Although response rate was lower than previously observed in therapist-delivered treatment, hypnosis home treatment may double the proportion of IBS patients improving significantly across 6 months.ww.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=16316885&query_hl=1&itool=pubmed_docsumSimren M. Hypnosis for irritable bowel syndrome: the quest for the mechanism of action. Int J Clin Exp Hypn. 2006 Jan;54(1):65-84. Sahlgrenska, University Hospital, Goteborg, Sweden. Irritable bowel syndrome (IBS) is a very common condition in the Western part of the world, and it accounts for a large proportion of the workload of a gastroenterologist. Unfortunately, the pathogenesis and pathophysiology of the syndrome are incompletely understood, and the treatment options are limited. However, hypnotherapy is one treatment option that has proven to be very useful in IBS. The mechanisms of action explaining why hypnosis is effective for IBS are not altogether known, but recent studies have shed some light on this issue. These studies, and what can be learned from them about how hypnosis impacts IBS, are reviewed in this article. Hypnosis may affect IBS partly through changes in colorectal sensitivity and improvement in psychological factors. The effects on GI motility and the autonomic nervous system are less clear and need further evaluation.ww.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=16316884&query_hl=1&itool=pubmed_docsumPalsson OS. Standardized hypnosis treatment for irritable bowel syndrome: the north Carolina protocol. Int J Clin Exp Hypn. 2006 Jan;54(1):51-64. University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.The North Carolina protocol is a seven-session hypnosis-treatment approach for irritable bowel syndrome that is unique in that the entire course of treatment is designed for verbatim delivery. The protocol has been tested in two published research studies and found to benefit more than 80% of patients. This article describes the development, content, and testing of the protocol, and how it is used in clinical practice.ww.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=16316883&query_hl=1&itool=pubmed_docsumGonsalkorale WM. Gut-directed hypnotherapy: the manchester approach for treatment of irritable bowel syndrome. Int J Clin Exp Hypn. 2006 Jan;54(1):27-50. University Hospital of South Manchester, Manchester, UK.This article describes the particular approach of using hypnosis as an adjunct to treating irritable bowel syndrome, developed within the Department of Medicine at the University Hospital of South Manchester, UK, since the 1980s. Patients receive up to 12 sessions over a 3-month period, and the majority of patients achieve marked improvement in symptoms and quality of life, an effect that is usually sustained. The therapy has a "gut-directed" framework that aims to teach patients the necessary hypnotic skills to control gut function and reduce symptoms, such as hand warmth on the abdomen and imagery. Other interventions based on particular lifestyle and psychological factors commonly found to influence symptoms are also included as appropriate for the individual patient.ww.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=16316882&query_hl=1&itool=pubmed_docsumWhitehead WE. Hypnosis for irritable bowel syndrome: the empirical evidence of therapeutic effects. Int J Clin Exp Hypn. 2006 Jan;54(1):7-20. University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.Irritable bowel syndrome (IBS) is a complex and prevalent functional gastrointestinal disorder that is treated with limited effectiveness by standard medical care. Hypnosis treatment is, along with cognitive-behavioral therapy, the psychological therapy best researched as an intervention for IBS. Eleven studies, including 5 controlled studies, have assessed the therapeutic effects of hypnosis for IBS. Although this literature has significant limitations, such as small sample sizes and lack of parallel comparisons with other treatments, this body of research consistently shows hypnosis to have a substantial therapeutic impact on IBS, even for patients unresponsive to standard medical interventions. The median response rate to hypnosis treatment is 87%, bowel symptoms can generally be expected to improve by about half, psychological symptoms and life functioning improve after treatment, and therapeutic gains are well maintained for most patients for years after the end of treatment.ww.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=16316880&query_hl=1&itool=pubmed_docsumWhorwell PJ. Review article: The history of hypnotherapy and its role in the irritable bowel syndrome. Aliment Pharmacol Ther. 2005 Dec;22(11-12):1061-7.Hypnosis is a technique by which an individual can gain a degree of control over physiological as well as psychological function. This paper reviews the history of the phenomenon as well as the accumulating evidence that it is effective in relieving the symptoms of irritable bowel syndrome and improving the quality of life of sufferers. The physiological effects of hypnosis are also discussed coupled with an outline of how a hypnotherapy service might be provided.ww.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=16305719&query_hl=1&itool=pubmed_docsumTan G, Hammond DC, Joseph G. Hypnosis and irritable bowel syndrome: a review of efficacy and mechanism of action. DeBakey, M. E. Review. Am J Clin Hypn. 2005 Jan;47(3):161-78.Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder characterized by abdominal pain, distension, and an altered bowel habit for which no cause can be found. Despite its prevalence, there remains a significant lack of efficacious medical treatments for IBS to date. In this paper a total of 14 published studies (N=644) were reviewed on the efficacy of hypnosis in treating IBS (8 with no control group and 6 with a control group). It was concluded that hypnosis consistently produces significant results and improves the cardinal symptoms of IBS in the majority of patients, as well as positively affecting non-colonic symptoms. When evaluated according to the efficacy guidelines of the Clinical Psychology Division of American Psychological Association, the use of hypnosis with IBS qualifies for the highest level of acceptance as being both efficacious and specific. In reviewing the research on the mechanism of action as to how hypnosis works to reduce symptoms of IBS, some evidence was found to support both physiological and psychological mechanisms of action. Simren M, Ringstrom G, Bjornsson ES, Abrahamsson H. Treatment with hypnotherapy reduces the sensory and motor component of the gastrocolonic response in irritable bowel syndrome. Psychosom Med. 2004 Mar-Apr;66(2):233-8.Postprandial symptoms in irritable bowel syndrome are common and relate to an exaggerated motor and sensory component of the gastrocolonic response. We investigated whether this response can be affected by hypnotherapy. METHODS: We included 28 patients with irritable bowel syndrome refractory to other treatments. They were randomized to receive gut-directed hypnotherapy 1 hour per week for 12 weeks (N = 14) or were provided with supportive therapy (control group; N = 14). Before randomization and after 3 months, all patients underwent a colonic distension trial before and after a 1-hour duodenal lipid infusion. Colonic sensory thresholds and tonic and phasic motor activity were assessed. CONCLUSION: Hypnotherapy reduces the sensory and motor component of the gastrocolonic response in patients with irritable bowel syndrome. These effects may be involved in the clinical efficacy of hypnotherapy in IBS.ww.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15039508Gonsalkorale WM, Toner BB, Whorwell PJ. J Psychosom Res. 2004 Mar;56(3):271-8. Cognitive change in patients undergoing hypnotherapy for irritable bowel syndrome. Cognitive changes were evaluated in 78 IBS patients who completed a 12-session hypnosis treatment course, using the recently developed Cognitive Scale for Functional Bowel Disorders. Hypnotherapy resulted in improvement of symptoms, quality of life, anxiety and depression.ww.ibshypnosis.com/IBSresearch.html Â© Copyright 2000-2003, Olafur S. Palsson, Psy.D. All Rights Reserved.Lea R, Houghton LA, Calvert EL, Larder S, Gonsalkorale WM, Whelan V, Randles J,Cooper P, Cruickshanks P, Miller V, Whorwell PJ. Gut-focused hypnotherapy normalizes disordered rectal sensitivity in patients with irritable bowel syndrome. Aliment Pharmacol Ther. 2003 Mar 1;17(5):635-42.This study evaluated the rectal sensitivity changes in IBS patients who received hypnotherapy. Twenty-three IBS patients were tested before and after 12 weeks of hypnotherapy. Following the course of hypnotherapy, the mean pain sensory threshold increased in the hypersensitive subgroup and tended to decrease in the hyposensitive group. Reduction in gut pain sensitivity was associated with a reduction in abdominal pain. These results suggest that hypnotherapy may work at least partly by normalizing bowel perception in those patients who have abnormal gut sensitivity, while leaving normal sensation unchanged.ww.ibshypnosis.com/IBSresearch.html Â© Copyright 2000-2003, Olafur S. Palsson, Psy.D. All Rights Reserved.Gonsalkorale WM, Miller V, Afzal A, Whorwell PJ. Long term benefits of hypnotherapy for irritable bowel syndrome. Gut. 2003 Nov;52(11):1623-9.204 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".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.ww.ibshypnosis.com/IBSresearch.html Â© Copyright 2000-2003, Olafur S. Palsson, Psy.D. All Rights Reserved.Gonsalkorale WM, Houghton LA, Whorwell PJ. Hypnotherapy in irritable bowel syndrome: a large-scale audit of a clinical service with examination of factors influencing responsiveness. Am J Gastroenterol 2002 Apr;97(4):954-61.250 unselected IBS patients were treated in a clinic in Manchester, England, using 12 sessions of hypnotherapy over a 3-month period plus home practice between sessions. Marked improvement was seen in all IBS symptoms, quality of life, and anxiety and depression, with reduced overall IBS severity.ww.ibshypnosis.com/IBSresearch.html Â© Copyright 2000-2003, Olafur S. Palsson, Psy.D. All Rights Reserved.Palsson OS, Turner MJ, Johnson DA, Burnett CK, Whitehead WE. Hypnosis treatment for severe irritable bowel syndrome: investigation of mechanism and effects on symptoms. Dig Dis Sci 2002 Nov;47(11):2605-14. Possible physiological and psychological mechanisms of hypnosis treatment for IBS were investigated in two studies. Patients with severe IBS received seven biweekly hypnosis sessions and used hypnosis audiotapes at home. Rectal pain thresholds and smooth muscle tone were measured before and after treatment in 18 patients (study I), and treatment changes in heart rate, blood pressure, skin conductance, finger temperature, and forehead electromyographic 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, somatization and psychological distress showed large decreases. In conclusion, hypnosis improves IBS symptoms through reductions in psychological distress and somatization. Improvements were unrelated to changes in the physiological parameters measured. 17 of 18 patients in study 1 and 21 of 24 patients in study 2 were judged substantially improved Improvement was well-maintained at 10-12 month follow up in study 2.ww.ibshypnosis.com/IBSresearch.html Â© Copyright 2000-2003, Olafur S. Palsson, Psy.D. All Rights Reserved.Palsson, OS, Turner, MJ, Johnson, DA. Hypnotherapy for irritable bowel syndrome: Symptom improvement and autonomic nervous system effects. Gastroenterology 2000;118(4): A174. Gonsalkorale WM, Cooper P, Cruikshanks P, Miller V, Randles J, Whelan V, Houghton LA, Whorwell PJ. Hypnotherapy for severe irritable bowel syndrome: Gender differences in response? Gastroenterology 1999;116:A999. Vidakovic Vukic M. Hypnotherapy in the treatment of irritable bowel syndrome: methods and results in Amsterdam. Scand J Gastroenterol Suppl, 1999, 230:49-51.Reports results of treatment of 27patients of gut-directed hypnotherapy tailored to each individual patient. All of the 24 who completed treatment were found to be improved.ww.ibshypnosis.com/IBSresearch.html Â© Copyright 2000-2003, Olafur S. Palsson, Psy.D. All Rights Reserved.Houghton LA, Larder S, Lee R, Gonsalcorale WM, Whelan V, Randles J, Cooper P, Cruikshanks P, Miller V, Whorwell PJ. Gut focused hypnotherapy normalises rectal hypersensitivity in patients with irritable bowel syndrome (IBS). Gastroenterology 1999; 116: A1009. Twenty-three patients each received 12 sessions of hypnotherapy. Significant improvement was seen in the severity and frequency of abdominal pain, bloating and satisfaction with bowel habit. A subset of the treated patients who were found to be unusually pain-sensitive in their intestines prior to treatment (as evidenced by balloon inflation tests) showed normalization of pain sensitivity, and this change correlated with their pain improvement following treatment. Such pain threshold change was not seen for the treated group as a whole.ww.ibshypnosis.com/IBSresearch.html Â© Copyright 2000-2003, Olafur S. Palsson, Psy.D. All Rights Reserved.Galovski TE; Blanchard EB. Appl Psychophysiol Biofeedback, 1998 Dec, 23:4, 219-32.Eleven patients completed hypnotherapy, with improvement reported for all central IBS symptoms, as well as improvement in anxiety. Six of the patients were a waiting-control group for comparison, and did not show such improvement while waiting for treatment.ww.ibshypnosis.com/IBSresearch.html Â© Copyright 2000-2003, Olafur S. Palsson, Psy.D. All Rights Reserved.Palsson, OS, Burnett CK, Meyer K, and Whitehead WE. Hypnosis treatment for irritable bowel syndrome. Effects on symptoms, pain threshold and muscle tone. Gastroenterology 1997;112:A803. Seventeen out of 18 patients with severe and treatment-refractory IBS who completed a 7-session standardized course of hypnosis treatment improved substantially. All central symptoms of IBS responded to treatment, including abdominal pain, diarrhea/constipation, and bloating. Psychological well-being also increased after treatment, with overall psychological symptoms, anxiety and somatization markedly decreased.ww.ibshypnosis.com/IBSresearch.html Â© Copyright 2000-2003, Olafur S. Palsson, Psy.D. All Rights Reserved.Koutsomanis D. Hypnoanalgesia in the irritable bowel syndrome. Gastroenterology 1997, 112, A764. This French study showed less analgesic medication use required and less abdominal pain experienced by a group of 12 IBS patients after a course of 6-8 analgesia-oriented hypnosis sessions followed by 4 sessions of autogenic training. Patients were evaluated at 6-month and 12-month follow-up.ww.ibshypnosis.com/IBSresearch.html Â© Copyright 2000-2003, Olafur S. Palsson, Psy.D. All Rights Reserved.Houghton LA; Heyman DJ; Whorwell PJ. Symptomatology, quality of life and economic features of irritable bowel syndrome--the effect of hypnotherapy. Aliment Pharmacol Ther, 1996 Feb, 10:1, 91-5. This study compared 25 severe IBS patients treated with hypnosis to 25 patients with similar symptom severity treated with other methods, and demonstrated that in addition to significant improvement in all central IBS symptoms, hypnotherapy recipients had fewer visits to doctors, lost less time from work than the control group and rated their quality of life more improved. Those patients who had been unable to work prior to treatment resumed employment in the hypnotherapy group but not in the control group. The study quantifies the substantial economic benefits and improvement in health-related quality of life which result from hypnotherapy for IBS on top of clinical symptom improvement.http://www.findarticles.com/p/articles/mi_...252/ai_n6112826ww.ibshypnosis.com/IBSresearch.html Â© Copyright 2000-2003, Olafur S. Palsson, Psy.D. All Rights Reserved.Prior A, Colgan SM, Whorwell PJ. Changes in rectal sensitivity after hypnotherapy in patients with irritable bowel syndrome. Gut 1990; Aug 31:896-8. This study found IBS patients to be less sensitive to pain and other sensations induced via balloon inflation in their gut while they were under hypnosis. Sensitivity to some balloon-induced gut sensations (although not pain sensitivity) was reduced following a course of hypnosis treatment.ww.ibshypnosis.com/IBSresearch.html Â© Copyright 2000-2003, Olafur S. Palsson, Psy.D. All Rights Reserved.Harvey RF; Hinton RA; Gunary RM; Barry RE. Individual and group hypnotherapy in treatment of refractory irritable bowel syndrome. Lancet, 1989 Feb, 1:8635, 424-5. This study employed a shorter hypnosis treatment course than other studies for IBS, and the success rate was lower, most likely demonstrating that a larger number of sessions is necessary for optimal benefit. Twenty out of 33 patients with refractory irritable bowel syndrome treated with four sessions of hypnotherapy in this study improved. Improvement was maintained at a 3-month treatment. These researchers further found that hypnosis treatment for IBS in groups of up to 8 patients seems as effective as individual therapy.ww.ibshypnosis.com/IBSresearch.html Â© Copyright 2000-2003, Olafur S. Palsson, Psy.D. All Rights Reserved.Whorwell PJ; Prior A; Colgan SM. Hypnotherapy in severe irritable bowel syndrome: further experience. Gut, 1987 Apr, 28:4, 423-5.This report summed up further experience with 35 patients added to the 15 treated with hypnotherapy in the1984 Lancet study. For the whole 50 patient group, success rate was 95% for classic IBS cases.Fifteen patients with severe irritable bowel syndrome unresponsive to conventional treatment improved with "gut-directed" hypnotherapy and maintained improvement for a mean duration of 18 months during which they were followed with one hypnotherapy session every 3 months. Two relapsed on one occasion, requiring an extra session. In a larger cohort of 50 patients, overall success rate was 84 percent. Those >50 years of age tended to be non-responders.Whorwell PJ et al. Hypnotherapy in severe irritable bowel syndrome: further experience. Gut 1987 Apr; 28(4):423-25Comment: Hypnotherapy is also a successful approach to managing functional gastrointestinal problems, as demonstrated in this and the following studies. Many of these studies have been conducted on standard treatment failures, making success with the subjects even more impressive. Like biofeedback, the worst outcome is that it might not succeed. Significant negative effects are very rare. Practitioners who have studied and now use hypnosis in their medical practices find it an extremely successful addition to their therapeutic armamentarium."http://www.findarticles.com/p/articles/mi_...252/ai_n6112824ww.ibshypnosis.com/IBSresearch.html Â© Copyright 2000-2003, Olafur S. Palsson, Psy.D. All Rights Reserved.Whorwell PJ; Prior A; Faragher EB. Controlled trial of hypnotherapy in the treatment of severe refractory irritable-bowel syndrome. The Lancet 1984, 2: 1232-4. This study is the earliest and perhaps the best study in this research area to date, as it was thoroughly placebo-controlled and showed dramatic contrast in response to hypnosis treatment above the placebo group. Thirty patients with severe symptoms unresponsive to other treatment were randomly chosen to receive 7 sessions of hypnotherapy (15 patients) or 7 sessions of psychotherapy plus placebo pills (15 patients). The psychotherapy group showed a small but significant improvement in abdominal pain and distension, and in general well-being but not bowel activity pattern. The hypnotherapy patients showed a dramatic improvement in all central symptom. The hypnotherapy group showed no relapses during the 3-month follow-up period.ww.ibshypnosis.com/IBSresearch.html Â© Copyright 2000-2003, Olafur S. Palsson, Psy.D. All Rights Reserved.Additional Studies â€" History of Research on Hypnotherapy in GastroenterologyCalvert EL, Houghton LA, Cooper P, Whorwell PJ. Hypnotherapy is effective in the long-term treatment of functional dyspepsia. Gastroenterology 2001;120(5):A115.Beaugerie L, Burger AJ, Cadranel JF, Lamy P, Gendre JP, Le Quintrec F. Modulation of orocaecal transit time by hypnosis. Gut 1991;32:393-394. ww.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2026339&dopt=AbstractKlein KB, Spiegel D. Modulation of gastric acid secretion by hypnosis. Gastroenterology 1989;96:1383-1387. ww.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2714570&dopt=Abstract Colgan SM. , Faragher EB. , Whorwell PJ. Controlled trial of hypnotherapy in relapse prevention of duodenal ulceration. The Lancet 1988;1(8598):1299-300..


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The IBS Audio Program 100Â® uses the gut-specific clinical hypnotherapy treatment known as the Ongoing Progressive Session Induction Method (OPSIM). The program was developed by Michael Mahoney, who is one of the leading clinical hypnotherapists for IBS in the United Kingdom. Michael Mahoney has been in hypnotherapy practice since 1987 and is affiliated with the Guardian Medical Centre in Warrington, Cheshire, England. Since 1991, IBS patients have been regularly referred to him by gastroenterologists and family care physicians. He is an associate member of the Primary Care Society for Gastroenterology. In 1996, Mahoney was asked to participate in a medical research study of IBS hypnotherapy funded by the UK National Health Service through a gastroenterology practice which was monitored by the local Health Authority Audit Commission. Gastroenterologists screened 20 long-term refractory IBS patients presenting with various IBS symptoms who had undergone medical diagnostic tests, and had taken prescription medications without attaining significant symptom relief. Each patient underwent Mahoneyâ€™s introductory and five subsequent hypnotherapy sessions. Sessions for all patient groups were staggered over 12 months. Patients indicated an overall reduction of 80% in symptom severity and frequency of presentation. In 1997, a new research study was begun which utilized improved processes and delivery methods developed by Mahoney. The independent study monitored patients using these new IBS hypnotherapy sessions recorded on home audio tapes. Patients were asked to mark as a percentage the improvement they felt during the program period, immediately after program completion, in February 1998 and the three follow up periods of assessment at 12 months, February 1999; 24 months, February 2000; and 36 months, February 2001. The treatment group included 11 females and 4 males; average age 34. For females: Average frequency of symptom presentation: 3.4 times daily. Average length of time IBS symptoms present: 8.63 years. Average length of time on medications: 5.5 years. Average reduction in medications: 96%.For males: Average frequency of symptom presentation: 2.5 times daily. Average length of time IBS symptoms present: 4.75 years. Average length of time on medications: 3.8 years. Average reduction in medications: 94 %.An average success rate based on reduction of symptom severity, and frequency of symptom presentation was close to or exceeding 90% for reduction of all symptoms for all patients. Over 20 IBS and related symptoms, including pain, diarrhea, constipation, and bloating, were quantified by the patients and individually measured, as was the perceived improvement in overall quality of life.The results of this study are currently being readied for independent publication in order that this study may be subject to peer review and analysis. The recorded sessions used in the study were made available to the public in 1998 as the IBS Audio Program 100â„¢. The program has been successfully used by thousands of IBS sufferers in over 30 countries, and is available through the Internet as well as the site for the Royal College of General Practitioners. The program is available in a slim, discreet folder consisting of 3 CDs with therapeutic sessions, an instructional booklet, and a 4th CD entitled, the IBS CompanionÂ© which explains IBS to others in the IBS patientâ€™s life.Dr. Nick Read, MB,BChir,MD,FRCP,MA,Sheffield, England, provides this affirmation for patients with irritable bowel syndrome: â€œI have listened to Michael Mahoney's excellent IBS Audio Programme 100â„¢ and I can thoroughly recommend it. Based on Mr. Mahoney's extensive experience in helping people with Irritable Bowel Syndrome, it provides a comprehensive educational package on IBS and a series of hypnotherapy sessions, each building on the previous one to produce a 100-day course on managing your IBS. Many of my patients have found it to be the answer for their IBS. So do try it. This could be the best money you could spend.â€ Clinical trial graphs for over 20 IBS and related symptoms may be viewed here:http://www.ibsaudioprogram100.com/audio-program.html.


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This updated listing of studies (some are included above) show that hypnotherapy is effective for helping reduce the symptoms of IBS - These protocols are different from the IBS Audio Program, but are not readily available unless you live near the hospitals where they are used, or can find a therapist that is trained in this protocol.Research Overview for other independent research studies regarding The efficacy of use of clinical hypnotherapy for the treatment of Irritable Bowel Syndrome.* The hypnotherapy protocols used in these studies are not readily accessible. *The effect of nurse-led gut-directed hypnotherapy upon health quality of life in patients with irritable bowel syndrome: Hypnotherapy Substantially Improves Quality of Life in IBS. Smith, Graeme D. University of Edinburgh, Scotland. J Clin Nursing 2006;15:678-684Gut-directed hypnotherapy for irritable bowel syndrome: piloting a primary care-based randomised controlled trial. Roberts, L. et. al. Br J Gen Pract. 2006 Feb;56(523):115-21 Gut-directed hypnotherapy benefits patients via symptom reduction and reduced medication usage.Effects of tailored and manualized hypnotic inductions for complicated irritable bowel syndrome patients. Barabasz A, Barabasz M. Int J Clin Exp Hypn. 2006 Jan;54(1):100-12.Hypnosis home treatment for irritable bowel syndrome: a pilot study. Palsson OS, Turner MJ, Whitehead WE. Int J Clin Exp Hypn. 2006 Jan;54(1):85-99. University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA. - Hypnosis treatment often improves irritable bowel syndrome (IBS), but the costs and reliance on specialized therapists limit its availability. A 3-month home-treatment version of a scripted hypnosis protocol previously shown to improve all central IBS symptoms was completed. Hypnosis subjects improved more in quality of life scores compared to controls. Hypnosis responders remained improved at 6-month follow-up. Hypnosis home treatment may double the proportion of IBS patients improving significantly across 6 months.Hypnosis for irritable bowel syndrome: the quest for the mechanism of action. Simren M. Int J Clin Exp Hypn. 2006 Jan;54(1):65-84. Sahlgrenska, University Hospital, Goteborg, Sweden.Standardized hypnosis treatment for irritable bowel syndrome: the North Carolina protocol. Palsson OS. Int J Clin Exp Hypn. 2006 Jan;54(1):51-64. University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA. - The North Carolina protocol was found to benefit more than 80% of IBS patients.Gut-directed hypnotherapy: the Manchester approach for treatment of irritable bowel syndrome. Gonsalkorale WM. Int J Clin Exp Hypn. 2006 Jan;54(1):27-50. University Hospital of South Manchester, UK. Hypnosis for irritable bowel syndrome: the empirical evidence of therapeutic effects. Whitehead WE. Int J Clin Exp Hypn. 2006 Jan;54(1):7-20. University of North Carolina at Chapel Hill, Chapel Hill, North CarolinaSystematic review: the effectiveness of hypnotherapy in the management of irritable bowel syndrome. Wilson S, Maddison T, Roberts L, Greenfield S, Singh S; Birmingham IBS Research Group. Aliment Pharmacol Ther. 2006 Sep 1;24(5):769-80. Review. - The published evidence suggests that hypnotherapy is effective in the management of IBS. Over half of the trials indicated a significant benefit. Review article: The history of hypnotherapy and its role in the irritable bowel syndrome. Whorwell PJ. Aliment Pharmacol Ther. 2005 Dec;22(11-12):1061-7.Hypnosis and irritable bowel syndrome: a review of efficacy and mechanism of action. Tan G, Hammond DC, Joseph G. DeBakey, M. E. Review. Am J Clin Hypn. 2005 Jan;47(3):161-78. - A total of 14 published studies (N=644) were reviewed on the efficacy of hypnosis in treating IBS. It was concluded that hypnosis consistently produces significant results and improves the cardinal symptoms of IBS in the majority of patients, as well as positively affecting non-colonic symptoms. When evaluated according to the efficacy guidelines of the Clinical Psychology Division of American Psychological Association, the use of hypnosis with IBS qualifies for the highest level of acceptance as being both efficacious and specific. Hypnosis in Contemporary Medicine. Mayo Clinic Proc. 2005;80:511-524 © 2005 Mayo Foundation for Medical Education and Research - Overview of several trials &#8230; confirmed that "in addition to relieving the symptoms of irritable bowel syndrome, hypnotherapy profoundly improves the patients' quality of life and reduces absenteeism from work." - www.mayoclinicproceedings.com/inside.asp?AID=888&UIDTreatment with hypnotherapy reduces the sensory and motor component of the gastrocolonic response in irritable bowel syndrome. Simren M, Ringstrom G, Bjornsson ES, Abrahamsson H. Psychosom Med. 2004 Mar-Apr;66(2):233-8.Cognitive change in patients undergoing hypnotherapy for irritable bowel syndrome. Gonsalkorale WM, Toner BB, Whorwell PJ. J Psychosom Res. 2004 Mar;56(3):271-8. Gut-focused hypnotherapy normalizes disordered rectal sensitivity in patients with irritable bowel syndrome. Lea R, Houghton LA, Calvert EL, Larder S, Gonsalkorale WM, Whelan V, Randles J,Cooper P, Cruickshanks P, Miller V, Whorwell PJ. Aliment Pharmacol Ther. 2003 Mar 1;17(5):635-42.Hypnosis home treatment for irritable bowel syndrome (IBS): exploratory study. Palsson OS, Whitehead WE, Turner MJ. Am J Gastroenterol. 2003;98:S274. [Abstract #822] Long term benefits of hypnotherapy for irritable bowel syndrome. Gonsalkorale WM, Miller V, Afzal A, Whorwell PJ. Gut. 2003 Nov;52(11):1623-9. - 204 patients completed questionnaires scoring symptoms, quality of life, anxiety, and depression before, immediately after, and up to six years following hypnotherapy. This study demonstrates that beneficial effects of hypnotherapy appear to last at least five years. Viable therapeutic option for the treatment of IBS.Hypnotherapy in irritable bowel syndrome: a large-scale audit of a clinical service with examination of factors influencing responsiveness. Gonsalkorale WM, Houghton LA, Whorwell PJ. Am J Gastroenterol 2002 Apr;97(4):954-61. - 250 unselected IBS patients were treated in a clinic in Manchester, England, using 12 sessions of hypnotherapy over a 3-month period plus home practice between sessions. Marked improvement was seen in all IBS symptoms, quality of life, and anxiety and depression, with reduced overall IBS severity.Hypnosis treatment for severe irritable bowel syndrome: investigation of mechanism and effects on symptoms. Palsson OS, Turner MJ, Johnson DA, Burnett CK, Whitehead WE. Dig Dis Sci 2002 Nov;47(11):2605-14. Hypnotherapy for irritable bowel syndrome: Symptom improvement and autonomic nervous system effects. Palsson, OS, Turner, MJ, Johnson, DA. Gastroenterology 2000;118(4): A174. Hypnotherapy for severe irritable bowel syndrome: Gender differences in response? Gonsalkorale WM, Cooper P, Cruikshanks P, Miller V, Randles J, Whelan V, Houghton LA, Whorwell PJ. Gastroenterology 1999;116:A999. Hypnotherapy in the treatment of irritable bowel syndrome: methods and results in Amsterdam. Vidakovic Vukic M. Scand J Gastroenterol Suppl, 1999, 230:49-51. - Treatment of 27 patients of gut-directed hypnotherapy tailored to each individual patient. All of the 24 who completed treatment were found to be improved.Gut focused hypnotherapy normalises rectal hypersensitivity in patients with irritable bowel syndrome (IBS). Houghton LA, Larder S, Lee R, Gonsalcorale WM, Whelan V, Randles J, Cooper P, Cruikshanks P, Miller V, Whorwell PJ. Gastroenterology 1999; 116: A1009.Treatment of irritable bowel syndrome with hypnotherapy. Galovski, T.E., Blanchard, E.B. Appl Psychophysiol Biofeedback,1998 Dec, 23:4, 219-32. - Eleven patients completed hypnotherapy, with improvement reported for all central IBS symptoms, as well as improvement in anxiety. Hypnosis treatment for irritable bowel syndrome. Effects on symptoms, pain threshold and muscle tone. Palsson, OS, Burnett CK, Meyer K, and Whitehead WE. Gastroenterology 1997;112:A803. Hypnoanalgesia in the irritable bowel syndrome. Koutsomanis D. Gastroenterology 1997, 112, A764. - French study showed less analgesic medication required and less abdominal pain experienced by IBS patients after a course of 6-8 analgesia-oriented hypnosis sessions.Symptomatology, quality of life and economic features of irritable bowel syndrome--the effect of hypnotherapy. Houghton LA; Heyman DJ; Whorwell PJ. Aliment Pharmacol Ther, 1996 Feb, 10:1, 91-5. - This study compared 25 severe IBS patients treated with hypnosis to 25 patients with similar symptom severity treated with other methods, and demonstrated that in addition to significant improvement in all central IBS symptoms, hypnotherapy recipients had fewer visits to doctors, lost less time from work than the control group and rated their quality of life more improved. Those patients who had been unable to work prior to treatment resumed employment in the hypnotherapy group but not in the control group. The study quantifies the substantial economic benefits and improvement in health-related quality of life which result from hypnotherapy for IBS on top of clinical symptom improvement.Cognitive change in patients undergoing hypnotherapy for irritable bowel syndrome. Gonsalkorale, WM; Toner, BB; and Whorwell, PJ. J Psychosom Res, March 1, 2004; 56(3): 271-8.Changes in rectal sensitivity after hypnotherapy in patients with irritable bowel syndrome. Prior A, Colgan SM, Whorwell PJ.Gut 1990; Aug 31:896-8. Individual and group hypnotherapy in treatment of refractory irritable bowel syndrome. Harvey RF; Hinton RA; Gunary RM; Barry RE. Lancet, 1989 Feb, 1:8635, 424-5. - Patients with refractory irritable bowel syndrome treated with four sessions of hypnotherapy improved and maintained at a 3-month treatment. Hypnotherapy in severe irritable bowel syndrome: further experience. Whorwell PJ; Prior A; Colgan SM. Gut, 1987 Apr, 28:4, 423-5. - This report summed up further experience with 35 patients added to the 15 treated with hypnotherapy in the 1984 Lancet study. For the whole 50 patient group, success rate was 95% for classic IBS cases.Controlled trial of hypnotherapy in the treatment of severe refractory irritable-bowel syndrome. Whorwell PJ; Prior A; Faragher EB. The Lancet 1984, 2: 1232-4. - This study is the earliest and perhaps the best study in this research area to date, as it was thoroughly placebo-controlled and showed dramatic contrast in response to hypnosis treatment above the placebo group. Thirty patients with severe symptoms unresponsive to other treatment were randomly chosen to receive 7 sessions of hypnotherapy (15 patients) or 7 sessions of psychotherapy plus placebo pills (15 patients). The psychotherapy group showed a small but significant improvement in abdominal pain and distension, and in general well-being but not bowel activity pattern. The hypnotherapy patients showed a dramatic improvement in all central symptoms. The hypnotherapy group showed no relapses during the 3-month follow-up period.---------------------------------------------------------------------------


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· Hypnotherapy for irritable bowel syndrome--a systematic review. Hefner J, Rilk A, Herbert BM, Zipfel S, Enck P, Martens U.. Z Gastroenterol. 2009 Nov;47(11):1153-9. Epub 2009 Nov 6. Review. German. PubMed PMID: 19899024. https://www.thieme-connect.com/DOI/DOI?10.1055/s-0028-1109697AbstractThe Irritable bowel syndrome (IBS) is a highly prevalent functional disorder with a remarkable clinical and economic impact. Several pathogenetic factors of IBS are discussed and summarised within a bio-psycho-social model. Data from published hypnotherapeutic interventions with approximately 800 patients show long-lasting symptom relief. The underlying mechanisms of action are not well understood. Nine mechanism studies show influences of hypnosis on colorectal sensitivity, colorectal motility and mental strain (anxiety, depression, maladaptive cognitions). Results are often contradictory and effects of hypnosis on several of the proposed pathogenetic factors are not examined at all. This paper reviews previous studies on hypnotherapy in IBS patients with a focus on symptom relief and mechanisms of action.· Clinical trial: short- and long-term benefit of relaxation training for irritable bowel syndrome. van der Veek PP, van Rood YR, Masclee AA.. Aliment Pharmacol Ther. 2007 Sep 15;26(6):943-52. PubMed PMID: 17767479.AbstractBACKGROUND: Psychotherapy is effective in treating irritable bowel syndrome, but the effect of relaxation training, a brief psychological group intervention, is not known. AIM: To determine the efficacy of relaxation training in a large cohort of irritable bowel syndrome patients. METHODS: Ninety-eight irritable bowel syndrome patients were included in this randomized controlled trial. Forty-six patients received standard medical care (CON) and 52 received four 90-min sessions of relaxation training in small groups in addition to standard medical care. Irritable bowel syndrome symptom severity, medical consumption and quality of life were assessed at baseline in patients and in 38 healthy controls and evaluated in patients at 3, 6 and 12 months after intervention. RESULTS: Irritable bowel syndrome symptom severity was significantly reduced in the relaxation training group compared to CON at 3, 6 and 12 months after treatment (time-by-treatment interaction, P = 0.002). The number needed to treat for long-term improvement was 5. Quality of life had improved (general health, P = 0.017; health change, P = 0.05). Frequency of doctor visits was reduced (P = 0.039). CONCLUSIONS: Relaxation training is a brief group intervention that significantly improves symptom severity, general health perception and medical consumption in irritable bowel syndrome patients immediately after, as well as 6 and 12 months after intervention.· Mind/Body Psychological Treatments for Irritable Bowel Syndrome, Bruce D. Naliboff1,2,3, Michael P. Fresé1,2,3 and Lobsang Rapgay2 1UCLA Center for Neurovisceral Sciences and Women's Health, 2Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA and 3Veterans Administration Greater Los Angeles Healthcare System, Los Angeles, CA, USA, Evidence-Based Complementary and Alternative Medicine, Oxford Journal, eCAM May 17, 2007, eCAM, doi:10.1093/ecam/nem046 Currently, the goal of treatment for those with IBS is to improve the quality of life through a reduction in symptoms. While the majority of treatment approaches involve the use of traditional medicine, more and more patients seek out a non-drug approach to managing their symptoms. Current forms of non-drug psychologic or mind/body treatment for IBS [which] include hypnotherapy&#8230;have been proven efficacious in clinical trials&#8230;· Hypnotherapy for irritable bowel syndrome in Saudi Arabian patients. Al Sughayir MA. East Mediterr Health J. 2007 Mar-Apr;13(2):301-8. PubMed PMID: 17684852.AbstractThis study investigated whether hypnotherapy provides a significant therapeutic effect in Saudi Arabian patients with irritable bowel syndrome. Patients (n=26) were consecutively recruited at a psychiatry outpatient clinic after diagnosis by a gastroenterologist and a medical evaluation for irritable bowel syndrome. Each patient had 12 sessions of hypnotherapy over a period of 12 weeks (1 session per week). Patients completed a scale measuring symptom severity before and 3 months after the trial. Hypnotherapy significantly enhanced a feeling of better quality of life more in male than in female patients, and bowel habit dissatisfaction was reduced more in female than in male patients.


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Here are some independent sources regarding the use of clinical hypnotherapy protocols for severe refractory IBS as well as for long-term results for children with IBS.While these protocols may not be readily available to the public - there is hope via the IBS Audio Program 100 for Adults and Teens and the IBS Audio Program 60 For Children which is available now and has been helping sufferers for many years. Very cost effective, no travel and free support if needed.Here are the studies... http://www.nature.co...jg2011487a.htmlPediatricsThe American Journal of Gastroenterology , (7 February 2012) | doi:10.1038/ajg.2011.487Long-Term Follow-Up of Gut-Directed Hypnotherapy vs. Standard Care in Children With Functional Abdominal Pain or Irritable Bowel SyndromeArine M Vlieger, Juliette M T M Rutten, Anita M A P Govers, Carla Frankenhuis and Marc A BenningaAbstractOBJECTIVES:We previously showed that gut-directed hypnotherapy (HT) is highly effective in the treatment of children with functional abdominal pain (FAP) and irritable bowel syndrome (IBS). Aim of this follow-up study was to investigate the long-term effects of HT vs. standard medical treatment plus supportive therapy (SMT).METHODS:All 52 participants of our previous randomized controlled trial (RCT) were invited to complete a standardized abdominal pain diary, on which pain frequency and pain intensity were scored. Furthermore, the Children's Somatization Inventory (CSI) and a general quality of life (QOL) questionnaire were filled out. Clinical remission was defined as >80% improvement in pain scores compared with baseline.RESULTS:All 27 HT patients and 22 out of 25 SMT patients participated in this study. Two patients of the SMT group were lost to follow-up and one refused to participate. After a mean duration of 4.8 years follow-up (3.4-6.7), HT was still highly superior to conventional therapy with 68 vs. 20% of the patients in remission after treatment (P=0.005). Pain intensity and pain frequency scores at follow-up were 2.8 and 2.3, respectively, in the HT group compared with 7.3 and 7.1 in the SMT group (P<0.01). Also, somatization scores were lower in the HT group (15.2 vs. 22.8; P=0.04). No differences were found in QOL, doctors' visits, and missed days of school or work between the two groups.CONCLUSIONS:The beneficial effects of gut-directed HT are long lasting in children with FAP or IBS with two thirds still in remission almost 5 years after treatment, making it a highly valuable therapeutic option.------NEW YORK (Reuters Health) - Hypnosis may bring lasting relief to some kids with irritable bowel syndrome or chronic stomach pain, a small study suggests.Researchers found that of 52 children with the tummy troubles, those who had six hypnosis sessions -- plus at-home "self-hypnosis" -- were still doing well five years later.More than two-thirds were free or mostly free of abdominal pain. That compared with just 20 percent of kids who were given standard therapy alone.Researchers led by Dr. Arine M. Vlieger, of St. Antonius Hospital in the Netherlands, reported the results in the American Journal of Gastroenterology.Many people may think of hypnosis as someone waving a pocket watch in front of your face, then making you do strange things, noted Miranda van Tilburg, an assistant professor of medicine at the University of North Carolina at Chapel Hill.But in medicine, hypnosis is used to help people create relaxing images in their minds to ease symptoms like pain and anxiety, explained van Tilburg, who was not involved in the current study but researches and uses "guided imagery" -- basically, self-hypnosis -- for kids' abdominal pain."Gut-directed" hypnotherapy may, for instance, suggest images for normalizing bowel function -- like picturing a smoothly flowing river.A number of studies since the 1980s have found that hypnosis helps some people with irritable bowel syndrome (IBS) when standard treatment fails. There's also evidence it can help kids with so-called functional abdominal pain.Functional abdominal pain -- which is thought to affect up to 20 percent of children -- refers to persistent stomach pain that cannot be traced to a particular disorder. IBS involves abdominal pain too, but people also have bouts of constipation, diarrhea or both.Often, tactics like diet changes, pain medication or extra fiber are enough to ease the symptoms of either disorder.When that fails, there's behavioral therapy. Cognitive behavioral therapy -- which targets the unhealthy thinking patterns and behaviors that can contribute to health problems -- has been shown to help some cases of IBS or functional abdominal pain.But no one knows yet if cognitive behavioral therapy helps beyond one year, van Tilburg pointed out.The current findings are important, she told Reuters Health, because they suggest that hypnosis can offer lasting relief."We've known that it has short-term effects, six months to a year," said van Tilburg. "But the hope is that people will master the skill, and then practice it as a lifelong skill."It's not clear whether kids in this study did keep using self-hypnosis over the long term, van Tilburg noted. But the advantage in pain relief was still there.The findings are based on 52 children and teenagers who were randomly assigned to either have gut-directed hypnotherapy or stick with standard care alone, like diet changes and fiber.Kids in the hypnosis group had six sessions with a therapist and were given CDs to help them practice self-hypnosis at home.Five years later, 68 percent of kids in the hypnosis group were still largely free of abdominal pain, compared with 20 percent of kids who'd received only standard care.The hypnosis group was also faring better in other symptoms, like bloating and bowel problems.It's not clear why hypnosis might help with abdominal pain or other gut symptoms, according to van Tilburg. One theory had been that it alters pain sensitivity in the intestines, she noted -- but recent research suggests that's not what is happening.Instead, hypnosis might affect how the brain processes pain signals from the gut. But for now, that's speculation, van Tilburg said.One obstacle to trying hypnosis for your child's belly problems is availability. More psychologists and pediatricians are doing training in hypnosis these days, Vlieger told Reuters Health by email.But there's still a dearth of properly trained professionals, van Tilburg said.And, she cautioned, "there are a lot of people out there who call themselves hypnotherapists, but they don't have the right training to treat medical conditions."If parents want to find a health professional who uses hypnosis, van Tilburg suggested trying the American Society of Clinical Hypnosis website, http://www.asch.net.Of course, there's a cost, which only some insurance plans would cover. Six or seven hypnotherapy sessions could run around $1,000, on average.Van Tilburg and her colleagues are looking at making the therapy more widely available via CD. In a small 2009 study, they found that kids who learned self-hypnosis by CD were able to soothe their functional abdominal pain over eight weeks; nearly three-quarters said their pain had lessened by at least half.Vlieger said her team is now doing a clinical trial to compare CD-based self-hypnosis against face-to-face hypnosis with a therapist. They should know how the two tactics size up -- in effectiveness and costs -- in about two years.http://wtaq.com/news...woes-long-term/-----Long-term effects of hypnotherapy in patients with refractory irritable bowel syndrome.Scand J Gastroenterol. 2012 Feb 20;Authors: Lindfors P, Unge P, Nyhlin H, Ljótsson B, Björnsson ES, Abrahamsson H, Simrén MAbstractAbstract Objective. Gut-directed hypnotherapy is considered to be an effective treatment in irritable bowel syndrome (IBS) but few studies report the long-term effects. This retrospective study aims to evaluate the long-term perceived efficacy of gut-directed hypnotherapy given outside highly specialized hypnotherapy centers. Methods. 208 patients, who all had received gut-directed hypnotherapy, were retrospectively evaluated. The Subjective Assessment Questionnaire (SAQ) was used to measure changes in IBS symptoms, and patients were classified as responders and non-responders. Patients were also asked to report changes in health-care seeking, use of drugs for IBS symptoms, use of alternative non-pharmacological treatments, and if they still actively used hypnotherapy. Results. Immediately after hypnotherapy, 103 of 208 patients (49%) were responders and 75 of these (73%) had improved further at the follow-up 2-7 years after hypnotherapy (mean 4 years). A majority of the responders still used hypnotherapy on a regular basis at follow-up (73%), and the responders reported a greater reduction in health-care seeking than non-responders. A total of 87% of all patients reported that they considered gut-directed hypnotherapy to be worthwhile, and this differed between responders and non-responders (100% vs. 74%; p < 0.0001). Conclusion. This long-term follow-up study indicates that gut-directed hypnotherapy in refractory IBS is an effective treatment option with long-lasting effects, also when given outside highly specialized hypnotherapy centers. Apart from the clinical benefits, the reduction in health-care utilization has the potential to reduce the health-care costs.PMID: 22339617 [PubMed - as supplied by publisher]


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