Group Hypnosis for Irritable Bowel Syndrome
Condition: Irritable Bowel Syndrome
MeSH terms: Irritable Bowel Syndrome; Syndrome
Study type: Interventional

Summary: 
      This randomised controlled trial (RCT) aimed at assessing the efficacy of hypnotherapy in
      group sessions (GHT) with a 12-months follow-up.
    

Detailed description: 
      Method:Patients with IBS, fulfilling Rome III criteria, and aged between 18 and 70, were
      recruited from the University Hospital of Vienna, from primary care physicians and the
      Austrian IBS patients' organisation by an information letter with an invitation to
      participate in this RCT. Patients were invited for an interview at the University hospital to
      confirm the IBS diagnosis according to the guidelines. Exclusion criteria were: pregnancy,
      bowel surgery, mental retardation, insufficient knowledge of German, a concomitant severe
      organic and/or psychiatric disease, and recently indicated treatment with anti-depressants.
      Anti-depressants at a stable dose for longer than three months were allowed for admission to
      the study. The time for patients to reach the hospital was not to be longer than one hour.
      Patients with lactose and fructose intolerance as diagnosed by breath tests were not excluded
      if they had had an adequate diet over a period of more than three weeks without any change of
      their IBS symptoms.

      Randomisation and therapy If 12 patients fulfilled all inclusion criteria they were randomly
      assigned to one of the two study arms at a 1:1 ratio. Randomisation was done by using
      permutated blocks of four in order to provide a balanced allocation. The investigator who
      generated the randomisation schedule was independent of the rest of the trial (blinded).
      Randomisation was either to supportive talks and symptomatic (standard) medical treatment
      (SMT, IBS-symptom-related) according to the guidelines (15-17) or to GHT with SMT. The GHT
      protocol used was the Manchester protocol of gut-directed hypnotherapy ( ) and consisted of
      10 weekly sessions (45 minutes) with six patients per group over a treatment period of 12
      weeks. GHT was performed at the University Hospital by two experienced physicians, trained in
      Manchester (UK). At the first session patients were informed about effects of hypnosis and at
      the third session subjects were given a compact disc (created by hypnotherapists) for
      practicing at home on a daily basis (practicing was documented). After an induction of
      hypnosis by closing the eyes a combination of standard deepening procedures followed. Then
      suggestions for ego-strengthening, power of self-control and gut-specific relaxation were
      made with hands on abdomen and visualization of slow, rhythmic waves (water, sea, or river)
      in pleasant, relaxing situations. The final phase involved imagery to increase one's sense of
      control and self-efficacy over IBS symptoms. GHT patients received also SMT. For control
      patients the same frequency and duration (45 minutes, SMT) of doctor's visits were offered at
      the University Hospital provided by a physician with additional qualification in
      psychosomatic medicine. No kind of relaxation techniques was allowed for control patients
      during the study. Psychotherapies and (changes of) symptomatic medication were allowed for
      all patients if indicated. If anti-depressants were taken at a stable dose at baseline, no
      dose reduction or increase was allowed until the six-month follow-up.

      All data were collected by study coordinators not involved in the treatment. Data were
      entered into SPSS 17.0 and analysed by an independent person with no information about
      patients' randomisation (blinded).
    

Intervention name(s): Gut-focused hypnotherapy in group sessions
Intervention type(s): Other
Intervention description(s): weekly session (45 min) of gut focused hypnotherapy (10 sessions within 12 weeks)
Other intervention name(s): hypnosis; gut directed hypnosis; gut directed hypnotherapy; gut focused hypnosis
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: IBS; RCT; psychology; hypnosis; psychotherapy; group therapy