# Sticky  Welcome to the CBT and HT Forum - Treatment Methods Defined



## cookies4marilyn

* Welcome to the IBS Cognitive Behavioral Therapy and Clinical Hypnotherapy Forum *Included here for your general information, are some article summaries and also links for those of you in need of understanding these two treatment methods. The links provided are a small random sampling of research and information to get the reader started, but are just a representation and are by no means a complete listing. It is up to the reader to investigate fully the treatment options that are right for you. Many articles and research abstracts can be found by searching this site and the internet in general, especially medical research sites such as Medline and PubMed. Research and IBS patient feedback has found that both prescriptions and OTC (over the counter) medications for IBS may not always provide full relief for symptoms, or possibly be short-lived at best, or can work better in combination with other treatments. As an adjunct to conventional medical care, mind-body treatment methods have consistently shown to be helpful for the majority of patients who use them. Both of these treatment methods have been successfully used for the reduction and mitigation of IBS and related symptoms. They are very similar methods in that they both use the mind to help the function and health of the body. The general difference between the two methods, put simply, is that cognitive behavioral therapy involves active direct thought on the part of the individual, and can include some elements of hypnotherapy, such as relaxation techniques, etc., whereas the use of clinical hypnotherapy works on the subconscious mind, and the patient does not have to actively do anything but listen and ï¿½take partï¿½ in the sessions. Skills for coping with IBS symptoms, IBS thought patterns, worry of travel, and retraining the mind and thought processes are part of both methods.Clinical hypnotherapy is not stage hypnosis, but rather it is a state of focused concentration that everyone experiences to one degree or another on a daily basis. But with hypnotherapy, it is also a relaxed state, and one in which the patient is always in control at all times. The American Gastroenterological Association has approved the use of this treatment method for IBS since 1996.Please have a definitive diagnosis of IBS from your medical doctor or gastroenterologist, as many other more serious conditions may have symptoms similar to IBS, and also be aware that individuals can have co-existing (co-morbid) medical conditions alongside IBS as well, and that these treatment methods will not necessarily address those co-existing conditions. (An example of this is perhaps lactose intolerance, or a true food allergy (as opposed to a food trigger). Many true IBS patients using these treatment methods have been able to reintroduce once ï¿½forbiddenï¿½ foods into their diet, whereas someone who is lactose intolerant, will always have to avoid it, for example.A realistic viewpoint of these two methods, is finding a CB Therapist or Clinical Hypnotherapist trained to specifically treat the IBS condition. This is something to take into consideration and to investigate before commencing sessions. However, for Clinical Hypnotherapy there is information below that helps to address this.This is just a very general overview of the two treatment methods ï¿½ be sure to thoroughly research beyond these offerings for more complete understanding and consult your professional medical doctor/gastroenterologist/practitioner before embarking on any treatment method.^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^ *INFORMATION ABOUT BOTH METHODS:* http://rdu.news14.com/content/headlines/?ArID=52106&SecID=2 Headlines - August 12, 2004 Copyright ï¿½ 2004 TWEAN d.b.a. News 14 CarolinaCognitive-Behavioral Therapy - Hypnosis Can Help Soothe Irritable Bowel Syndrome7/28/2004 4:22 PMBy: Dr. Olafur S. Palsson, UNC Health Care Excerpt: The limited success of standard medical treatment has led researchers to seek different treatment alternatives for IBS. So far, the most promising of these have been psychological treatments.Many types of psychological treatment have been tested for IBS. The two that have been most consistently successful are cognitive-behavioral therapy and hypnosis. The majority of studies on both of these therapies have shown that they substantially improve all the central symptoms of IBS in up to 70-80 percent of treated patients and that the benefit often lasts for years after treatment.Both hypnosis and cognitive-behavioral therapy typically require about 8-12 visits to a therapist. In cognitive-behavioral therapy, the therapists work to help patients to overcome distorted and negative thinking patterns that adversely affect life functioning and amplify symptoms, and help them to adopt more effective ways to handle life situations that aggravate the bowel problems.Hypnosis uses a special altered mental state of heightened focus to produce its beneficial effects. Mental imagery and hypnotic suggestions are used to bring about overall relaxation of the bowels and the whole body, lessened sensitivity to gut discomfort, and increased mental control over bowel symptoms. These psychological treatments have proven to have several important advantages that make it likely that they will be increasingly important in the care of IBS in the coming years. They often work well for patients who have not improved from regular medical treatment, they have no uncomfortable side effects and they produce long-term improvement in symptoms. Finally, they often enhance psychological well-being and quality of life in addition to improving gastrointestinal symptoms. At the present time, the main limitations to widespread use of psychological treatments for IBS are the costs of treatment and the lack of therapists who are experienced in these specialized applications of hypnosis and cognitive-behavioral therapy. IBS sufferers who do not gain satisfactory symptom relief from standard medical treatment may therefore want to discuss these psychological treatment options with their doctor.Olafur S. Palsson, Psy.D., is an associate professor of medicine in the Division of Gastroenterology and Hepatology at the University of North Carolina at Chapel Hill.^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^CLINICAL HYPNOTHERAPY FOR IRRITABLE BOWEL SYNDROMEMany of us have experienced a great reduction of our IBS symptoms by using clinical hypnotherapy. Yes, it seemed odd to some of us too, at first. But after reading and asking questions, many of us, after trying so many other methods of symptom management, have used hypnosis with great success. It took us all some reading to understand the how & why. The links provided below have helped many of us garner this understanding. Hopefully they will help you too. It has been said that a potential problem with these treatment methods in addition to cost, and traveling to appointments, is finding a therapist specifically trained in IBS treatment. Many of us here have found relief with the IBS Audio Program 100 by Michael Mahoney of Cheshire England, whose sponsor banner is displayed on this forum. Michael first began development of these sessions in 1991. This program uses gut-specific clinical hypnotherapy processes to alleviate IBS and related symptoms with therapy sessions replicated from the clinical setting and recorded on 3 CDs. This is the most widely known home course available for clinical hypnotherapy for IBS and has been clinically trialed showing at least three years of continued ongoing improvement after program completion. This program has been used successfully with thousands of IBS patients in 33 countries. In addition, the program provides a 4th CD which is useful in explaining the IBS conditions to others. Further information and support for users of the program can be found on this forum, the links below, as well as the site: www.ibsaudioprogram100.com or ibscds.com.FAQ About the IBS Audio Program 100 - Mike's Informational Postings ï¿½ COMPILATION: http://www.ibsgroup.org/ubb/ultimatebb.php...c;f=11;t=001865 Success Stories Using CBT and HT: http://www.ibsgroup.org/ubb/ultimatebb.php...c;f=11;t=000017 ------------------------------------Excerpt from CME http://www.medscape.com/viewprogram/2745_pnt American College of Gastroenterology 68th Annual Scientific Meeting and Postgraduate CourseIBS/Other Functional GI Disorders CMERelease Date: October 31, 2003; Valid for credit through October 31, 2004Other independent research about treating IBS using clinical hypnotherapy sessions on recordings, but not available to the public: HypnosisOther novel approaches to management are also undergoing investigation. Palsson and colleagues[18] looked at the value of hypnosis for treating IBS in a pilot study.Hypnosis was performed by a novel home-treatment course via an audio compact disc recording. The investigators studied 19 patients with IBS and found that 53% responded to treatment by the 3-month follow-up timepoint. The control group comprised 57 patients with IBS from a separate study. Only 26% of these controls responded by 3 months to standard medical care, although the groups may not be directly comparable. Nonresponders to hypnosis tended to be patients with higher anxiety scores. Previously, hypnosis has been shown to be beneficial both in IBS and functional dyspepsia in randomized, controlled (but not blinded) studies.[19] Hypnosis is therefore promising and additional work is needed in this area, particularly if simple strategies can be used to save on therapist time and costs.18. Palsson OS, Whitehead WE, Turner MJ. Hypnosis home treatment for irritable bowel syndrome (IBS): exploratory study. Am J Gastroenterol 2003;98:S274. [Abstract #822] 19. Calvert EL, Houghton LA, Cooper P, Morris J, Whorwell PJ. Long-term improvement in functional dyspepsia using hypnotherapy. Gastroenterology. 2002;123:1778-1785. General IBS Hypnotherapy Info: http://www.ibshypnosis.com -------------------------"Hypnosis For Irritable Bowel": http://my.webmd.com/content/article/1728.87469 "The Effects Of Hypnosis on Gastrointestinal Problems": http://www.med.unc.edu/medicine/fgidc/hypnosis.htm Treating IBS by Hypnosis? http://www.healthandage.com/Home/gm=2!gid2...79238!7537!7038 ----------------American College of Gastroenterology 68th Annual Scientific Meeting "Hypnosis for IBS http://www.medscape.com/viewarticle/463080 --------------------------------------Gut. 2003 Nov;52 11:1623-9. Links Long term benefits of hypnotherapy for irritable bowel syndrome.Gonsalkorale WM, Miller V, Afzal A, Whorwell PJ.Department of Medicine, University Hospital of South Manchester, Manchester, UK. 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.PMID: 14570733^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^COGNITIVE BEHAVIORAL THERAPY FOR IRRITABLE BOWEL SYNDROME Barbara Bradley Bolen, Ph.D., is a clinical psychologist from Farmingdale, NY., and is a member of the American Psychological Association, Association for Advancement of Behavior Therapy and the International Foundation for Functional Gastrointestinal Disorders. Dr. Bolen is the co-author of Breaking the Bonds of Irritable Bowel Syndrome: A Psychological Approach to Regaining Control of Your Life. This book provides a comprehensive overview of IBS, and describes its treatments.With permission, here is an excerpt from a previous post:There is an old saying that if you give a child a fish, you feed that child for a day, but if you teach a child to fish, they are fed for a lifetime. In accordance with this old proverb, Cognitive behavioral therapy CBT is a form of psychotherapy that strives to actively teach people skills and strategies that they can use to help themselves feel better. A considerable amount of research indicates that CBT is effective in helping to reduce the symptoms of Irritable Bowel Syndrome. Many people wonder how psychotherapy can help IBS if IBS is a physical disorder. One of the major triggers that can set off or exacerbate IBS is stress. In addition, IBS is a very stressful disorder to live with. CBT provides an individual with tools for combating stress, reducing the anxiety response and thus calming the GI system. The cognitive therapy part of CBT helps individuals to identify, challenge and replace unhealthy thought patterns. When we are thinking clearly, we are able to deal with the world in a calm, rational manner. However, our thinking often gets distorted, due to our personalities, our past history, our emotional state or lack of information. When thinking gets distorted it can lead to excessive emotional reactions. For an individual with IBS, these thought distortions may lead to an anxiety response that can trigger symptoms. For example, if a person with IBS thinks ï¿½My stomach is rumbling. Uh, oh! I know I am going to be sick. What is I canï¿½t make it to the bathroom? This is terrible!ï¿½, that person is going to experience anxiety and perhaps set off the very symptoms they are afraid of. If instead, the person thinks, ï¿½Just because my stomach is making some noise does not necessarily mean I am going to have symptoms. I will just focus on what I am doing and see what happensï¿½, that person will remain calm and be less likely to stimulate their digestive system. The behavioral aspect of CBT involves skill training. Relaxation techniques, including deep breathing skills and progressive muscle relaxation, help the individual to reduce the physiological symptoms of anxiety. An anxiety reaction can be likened to a home security alarm. Relaxation techniques send the message to the body that there is no emergency and that the alarm can be shut off. CBT for IBS may also include skill training in assertion and anger management, as research has shown that IBS patients often have difficulty in these areas. IBS can wreak havoc on a personï¿½s quality of life. CBT helps IBS sufferers to regain a sense of control over their life. With the skills gained in CBT, one no longer needs to be a passive victim of this disruptive disorder, but can now actively use strategies which are effective in reducing the frequency, intensity and duration of IBS symptoms. Barbara Bradley Bolen, Ph.D. Author of: Breaking the Bonds of Irritable Bowel Syndrome New Harbinger Publications 2000For more information please visit http://www.irritablebowel.net/ More Information re CBT:New York Daily News - Health - Gut reactions ï¿½ CBT Info http://www.nydailynews.com/12-10-2002/city...64p-39684c.html http://www.ibsgroup.org/cgi-local/ubbcgi/u...c;f=11;t=000004 http://www.buffalo.edu/reporter/vol34/vol3...ticles/IBS.html


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## cookies4marilyn

Here is an Overview of Published Research To Date on Hypnosis for IBS Over ten peer-reviewed, double blind clinical studies on hypnotherapy for IBS are condensed in this overview. The clinical trials are drawn from Gut, Lancet, Gastroenterology, and other internationally respected medical journals. The study results are consistent and their conclusions are overwhelmingly positive. The overview was conducted by Olafur S. Palsson, Psy.D., who specializes in clinical hypnotherapy research for IBS at the University of North Carolina's Center for Functional GI & Motility Disorders. (There are no links to the full abstracts of these studies, as the overview presents them in condensed form, and the complete overview is given here). 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 the 1984 Lancet study. For the whole 50 patient group, success rate was 95% for classic IBS cases, but substantially less for IBS patients with atypical symptom picture or significant psychological problems. The report also observed that patients over age 50 seemed to have lower success rate from this treatment. 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. Prior A, Colgan SM, Whorwell PJ. Changes in rectal sensitivity after hypnotherapy in patients with irritable bowel syndrome. Gut 1990;31:896. 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. 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. 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. 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. 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. Gut pain thresholds and smooth muscle tone, measured with a barostat and balloon inflation tests, were unchanged following treatment. 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 27 patients of gut-directed hypnotherapy tailored to each individual patient. All of the 24 who completed treatment were found to be improve. 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. 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. This study is notable as the largest case series of IBS patients treated with hypnosis and reported on to date. 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 (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. 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 with a barostat 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.


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## cookies4marilyn

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## Dr Dani MD

Thank you for the great summary--all of these studies are great examples of CBT and HT working for IBS. Whorwell was the first one to develop a specific IBS script and test it out with patients in the 1980's. The mind-body connection is for real and it is almost completely ignored in Western/Conventional Medicine. This is unfortunate because these therapies DO work, especially for chronic conditions like IBS. If u want to start using the mind-body connection to control IBS symptoms, start by listening to a simple relaxation recording and then place ur hands over ur belly and focus on warming the area to make ur connection b/t ur brain and gut strongerDr. Dani


cookies4marilyn said:


> Here is an Overview of Published Research To Date on Hypnosis for IBS Over ten peer-reviewed, double blind clinical studies on hypnotherapy for IBS are condensed in this overview. The clinical trials are drawn from Gut, Lancet, Gastroenterology, and other internationally respected medical journals. The study results are consistent and their conclusions are overwhelmingly positive. The overview was conducted by Olafur S. Palsson, Psy.D., who specializes in clinical hypnotherapy research for IBS at the University of North Carolina's Center for Functional GI & Motility Disorders. (There are no links to the full abstracts of these studies, as the overview presents them in condensed form, and the complete overview is given here). 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 the 1984 Lancet study. For the whole 50 patient group, success rate was 95% for classic IBS cases, but substantially less for IBS patients with atypical symptom picture or significant psychological problems. The report also observed that patients over age 50 seemed to have lower success rate from this treatment. 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. Prior A, Colgan SM, Whorwell PJ. Changes in rectal sensitivity after hypnotherapy in patients with irritable bowel syndrome. Gut 1990;31:896. 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. 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. 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. 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. 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. Gut pain thresholds and smooth muscle tone, measured with a barostat and balloon inflation tests, were unchanged following treatment. 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 27 patients of gut-directed hypnotherapy tailored to each individual patient. All of the 24 who completed treatment were found to be improve. 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. 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. This study is notable as the largest case series of IBS patients treated with hypnosis and reported on to date. 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 (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. 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 with a barostat 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.


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## cookies4marilyn

Updated ListingResearch Overview for 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 to patients in general. www.ncbi.nlm.nih.gov/sites/entrez?db=pubmed&cmd=link&linkname=pubmed_pubmed&uid=12003432· 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.· 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;15:678-684· Gut-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.· Where does hypnotherapy stand in the management of irritable bowel syndrome? A systematic review. J Altern Complement Med. 2006 Jul-Aug;12(6):517-27. Gholamrezaei A, Ardestani SK, Emami MH.Clinical Hypnotherapy Research Group, Medical Student Research Committee, Isfahan University of Medical Sciences (IUMS), Isfahan, Iran. [email protected]: Irritable bowel syndrome (IBS) is a gastrointestinal disorder characterized by chronic abdominal pain and altered bowel habits in the absence of any organic cause. Despite its prevalence, there remains a significant lack of efficient medical treatment for IBS to date. However, according to some previous research studies, hypnosis has been shown to be effective in the treatment of IBS. AIM: To determine the definite efficacy of hypnosis in the treatment of irritable bowel syndrome. METHODS: A systematic review of the literature on hypnosis in the treatment of IBS from 1970 to 2005 was performed using MEDLINE. Full studies published in English were identified and selected for inclusion. We excluded case studies and those studies in which IBS symptoms were not in the list of outcome measures. All studies were reviewed on the basis of the Rome Working Team recommendations for design of IBS trials. RESULTS: From a total of 22 studies, seven were excluded. The results of the reviewed studies showed improved status of all major symptoms of IBS, extracolonic symptoms, quality of life, anxiety, and depression. Furthermore these improvements lasted 2-5 years. CONCLUSIONS: Although there are some methodologic inadequacies, all studies show that hypnotherapy is highly effective for patients with refractory IBS, but definite efficacy of hypnosis in the treatment of IBS remains unclear due to lack of controlled trials supporting this finding.· Hypnotherapy for treatment of irritable bowel syndrome. Webb AN, Kukuruzovic RH, Catto-Smith AG, Sawyer SM. Cochrane Database Syst Rev. 2007 Oct 17;(4):CD005110. Review. PubMed PMID: 17943840.Royal Children's Hospital Melbourne, Gastroenterology, Flemington Road, Parkville Victoria 3052, Melbourne, Australia. [email protected]: Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder of unknown aetiology. Current pharmacological treatments have limited value. Hypnotherapy has been reported to have beneficial effects for IBS symptoms. OBJECTIVES: To evaluate the efficacy of hypnotherapy for the treatment of irritable bowel syndrome. SEARCH STRATEGY: Published and unpublished randomised clinical trials and quasi-randomised clinical trials were identified through structured searches of MEDLINE (1966 to March 2006), EMBASE (1980 to March 2006), PsycINFO (1806 to March 2006), CINAHL (Cumulative Index to Nursing and Allied Health Literature, 1982 to March 2006), AMED (Allied and Complementary Medicine Database, 1985 to March 2006) and The Cochrane Central Register of Controlled trials. Conference proceedings from Digestive Disease Week (1980 to 2005) were also searched. SELECTION CRITERIA: Eligible studies included all randomised and quasi-randomised clinical studies comparing hypnotherapy for the treatment of irritable bowel syndrome with no treatment or another therapeutic intervention. DATA COLLECTION AND ANALYSIS: All studies were evaluated for eligibility for inclusion. Included studies were assessed for quality and data were extracted independently by four authors. The primary outcome measure of interest was the overall bowel symptom severity score which combines abdominal pain, diarrhoea or constipation and bloating. Secondary outcomes included abdominal pain, diarrhoea, constipation, bloating, quality of life, patient's overall assessment of well-being, psychological measures as per validated questionnaires, and adverse events. MAIN RESULTS: Four studies including a total of 147 patients met the inclusion criteria. Only one study compared hypnotherapy to an alternative therapy (psychotherapy and placebo pill), two studies compared hypnotherapy with waiting-list controls and the final study compared hypnotherapy to usual medical management. Data were not pooled for meta-analysis due to differences in outcome measures and study design. The therapeutic effect of hypnotherapy was found to be superior to that of a waiting list control or usual medical management, for abdominal pain and composite primary IBS symptoms, in the short term in patients who fail standard medical therapy. Harmful side-effects were not reported in any of the trials. However, the results of these studies should be interpreted with caution due to poor methodological quality and small size. AUTHORS' CONCLUSIONS: The quality of the included trials was inadequate to allow any conclusion about the efficacy of hypnotherapy for irritable bowel syndrome. More research with high quality trials is needed.· 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 Carolina· Systematic 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. www.medscape.com/viewarticle/543563· 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&UID· Treatment 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.*Research Overview for the use of Clinical Hypnotherapy for CHILDREN with Functional Abdominal Pain, Irritable Bowel Syndrome and Related Symptoms*The hypnotherapy protocols used in these studies are not readily accessible. · Treatment of chronic recurrent abdominal pain: laparoscopy or hypnosis? J Laparoendosc Adv Surg Tech A. 2009 Feb;19(1):93-6. Galili O, Shaoul R, Mogilner J. Department of General Surgery, Bnei-Zion Medical Center, Haifa, Israel. - http://www.ncbi.nlm.nih.gov/pubmed/19196096?ordinalpos=5&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum Functional chronic recurrent abdominal pain (FCRAP) is long lasting, intermittent, or constant pain affecting 15-30% of children ages 4-18 and presents a diagnostic and treatment challenge to the physician&#8230;Seventeen patients underwent just one single session of hypnosis. RESULTS: A possible nonorganic etiology for the abdominal pain was revealed in all cases. In 14 adolescents, all clinical symptoms resolved. Hypnosis was not effective in 3 cases, in whom secondary gain was probably responsible for their symptoms. No side effects have been noted during and after the study. Follow-up was available for a period of 4-24 months&#8230; the use of hypnotherapy in children with FCRAP is not a common practice. The current study highly supports the use of hypnosis as a part of the biobehavioral approach for this dilemma.· Home Based Guided Imagery to Treat Pediatric Functional Abdominal Pain. Van Tilburg, M., UNC Center for Functional GI and Motility Disorders, Chapel Hill, NC 2007 - Randomized trial using home based guided imagery CDs for treatment of FAP showed 85% in the treatment group as having somewhat to remarkably better symptom improvement.· Hypnotherapy for children with functional abdominal pain or irritable bowel syndrome: a randomised controlled trial. Abstract 914. Vlieger AM, Menko-Frankenhuis C, Wolfkamp SC, Tromp E, Benninga MA., Department of Pediatrics, St. Antonius Hospital, Nieuwegein, The Netherlands.Gastroenterology. 2007 Nov;133(5):1430-6. Epub 2007 Sep 2. PubMed PMID: 17919634. Mean pain intensity scores in the hypnotherapy group decreased from 13.5 at the start of the study to 3.0 at the end of treatment and 1.4 after a year of follow-up. After a year of follow-up, the hypnotherapy had resulted in a successful pain elimination in 85% of the children, compared to 25% of those getting standard care. BACKGROUND & AIMS: Functional abdominal pain (FAP) and irritable bowel syndrome (IBS) are highly prevalent in childhood. A substantial proportion of patients continues to experience long-lasting symptoms. Gut-directed hypnotherapy (HT) has been shown to be highly effective in the treatment of adult IBS patients. We undertook a randomized controlled trial and compared clinical effectiveness of HT with standard medical therapy (SMT) in children with FAP or IBS. METHODS: Fifty-three pediatric patients, age 8-18 years, with FAP (n = 31) or IBS (n = 22), were randomized to either HT or SMT. Hypnotherapy consisted of 6 sessions over a 3-month period. Patients in the SMT group received standard medical care and 6 sessions of supportive therapy. Pain intensity, pain frequency, and associated symptoms were scored in weekly standardized abdominal pain diaries at baseline, during therapy, and 6 and 12 months after therapy. RESULTS: Pain scores decreased significantly in both groups: from baseline to 1 year follow-up, pain intensity scores decreased in the HT group from 13.5 to 1.3 and in the SMT group from 14.1 to 8.0. Pain frequency scores decreased from 13.5 to 1.1 in the HT group and from 14.4 to 9.3 in the SMT group. Hypnotherapy was highly superior, with a significantly greater reduction in pain scores compared with SMT (P < .001). At 1 year follow-up, successful treatment was accomplished in 85% of the HT group and 25% of the SMT group (P < .001). CONCLUSIONS: Gut-directed HT is highly effective in the treatment of children with longstanding FAP or IBS.· Treatment options for chronic abdominal pain in children and adolescents. Miranda A, Sood M. Division of Pediatric Gastroenterology, Hepatology and Nutrition, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI. - Curr Treat Options Gastroenterol. 2006 Sep;9(5):409-15. Treatment should be &#8230; based on the severity of symptoms&#8230; and the impact the disorder has on the child's school attendance and normal functioning. Various psychological interventions, such as cognitive-behavioral therapy, hypnosis, and guided imagery, have been successfully used in children with chronic abdominal pain.· Evaluation of guided imagery as treatment for recurrent abdominal pain in children: a randomized controlled trial. Weydert JA, Shapiro DE, Acra SA, Monheim CJ, Chambers AS, Ball TM. BMC Pediatr. 2006 Nov 8;6:29 Integrative Pain Management, Children's Mercy Hospital, 2401 Gillham Road, Kansas City, Missouri 64108 - The therapeutic efficacy of guided imagery with progressive muscle relaxation found in this study is consistent with our present understanding of the pathophysiology of recurrent abdominal pain (RAP) in children. Although unfamiliar to many pediatricians, guided imagery is a simple, noninvasive therapy with potential benefit for treating children with RAP.· Hypnosis: An important multifaceted therapy. Ran D. Anbar, MD Journal of Pediatrics, Volume 149, Issue 4, Pages 438-439 (October 2006) - Why should a clinician be interested in learning about hypnosis? Patients often have complaints that sometimes do not respond to traditional allopathic treatment. Clinical hypnosis has been shown to improve or reduce many such ailments, including anxiety &#8230; irritable bowel syndrome, insomnia, recurrent abdominal pain&#8230;· Treatment of functional abdominal pain in childhood with cognitive behavioral strategies. Youssef NN, Rosh JR, Loughran M, Schuckalo SG, Cotter AN, Verga BG, Mones RL. J Pediatr Gastroenterol Nutr. 2004 Aug;39(2):192-6. Division of Pediatric Gastroenterology, University of Medicine & Dentistry, New Jersey Goryeb Children's Hospital, Morristown 07962 - Guided imagery and progressive relaxation can safely and effectively reduce chronic abdominal pain in children with FGIDs. This treatment also improve social functioning and school attendance.· A pilot study of the use of guided imagery for the treatment of recurrent abdominal pain (RAP) in children. Ball TM, Shapiro DE, Monheim CJ, Weydert JA. Clin Pediatr (Phila). 2003 Jul - Aug;42(6):527-32. Department of Pediatrics, Steele Memorial Children's Research Center, University of Arizona, College of Medicine, Tucson 85724-5073 - The use of relaxation along with guided imagery is an effective and safe treatment for childhood RAP.· Self-hypnosis for treatment of functional abdominal pain in childhood. Anbar RD. Clin Pediatr. 2001;40:447-451. - Functional abdominal pain&#8230; can respond to psychological intervention &#8230; functional abdominal pain of 4 of 5 pediatric patients resolved within 3 weeks after a single session of instruction in self-hypnosis. Potential impact of widespread application of such hypnotherapy may be large, because abdominal pain is thought to be the most common recurrent physical symptom &#8230;among children and adolescents.


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## jonagelle

Cognitive behavior therapy (CBT) is a type of psychotherapeutic treatment that helps patients understand the feelings and thoughts that influence behaviors. CBT is commonly used to cure a wide range of disorders including addiction, phobias, depression and anxiety.Cognitive behavior therapy is generally short-term and focused on assisting clients cope with a very particular problem. During the course of treatment, people learn how to identify and change disturbing or destructive thought patterns that have a negative influence on behavior. The underlying concept behind CBT is that the feelings and thoughts play a fundamental role in our behavior. For example, a person who spends a lot of time thinking about runway accidents, plane crashes, and other air disasters may find themselves avoiding air travel. The goal of cognitive behavior therapy is to teach patients that while they cannot manage every aspect of the world around them.


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## cookies4marilyn

Most of the research for hypnosis or hypnotherapy for IBS is based on gut-directed or gut-specific protocols which target all aspects of the IBS condition. CBT addresses it on a cognitive or thinking level, while hypnotherapy uses the subconsious mind to aid the body in balancing motility levels as well as the fear, anxiety and emotional distress that the IBS condition can cause. Two well researched and established IBS protocols go beyond just coping, in that they have been known to greatly reduce or even eliminate symptoms, alongside the fear and worry that the patient suffers as a result of the symptoms. The imagery works hand in hand over several sessions to accomplish this.


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