The patients stricken by inflammatory bowel disease (IBD) commonly report that stress intensifies their symptoms. Those who are in remission report that stress precedes repeated bouts with the disease, which is a combination of Crohn’s disease and ulcerative colitis. Primary symptoms of this condition are diarrhea accompanied by bleeding, abdominal pain and lesser symptoms such as weight loss, anemia and fever. In addition to inflammation of the gastrointestinal tract, it can include mouth ulcers, erythema nodosum, sclerosing cholangitis, arthralgia and iritis. The disease can range from moderately severe to incapacitating. The combination of Crohn’s disease and ulcerative colitis known as inflammatory bowel disease can be fatal. The cause or causes are only hypothesized at this time. Studies (Bamias, Nyce, De La Rue, & Cominelli, 2005; Wen & Fiocchi, 2004; Young & Abreu, 2006) conclude that an immune function disorder is most likely the cause. Treatment is with medication (anti-inflammatory or immunomodulatory). Patients who do not respond to treatment may require surgical intervention.
Hypnotherapy has been successful at treating other stress-related diseases, both physical and mental. Theoretically, it may have a beneficial effect on severe cases of IBS. When other treatments fail, it might be a last resort effort to avoid surgery. Gruzelier (2002) studied the effects of hypnosis on stress and psychological aspects of disease. Indications are that it does allow the patient to influence their own physiology favorably and therefore, may be a viable adjunctive treatment option for IBS patients.
Hypnotherapy in conjunction with gastroenterology has been researched for two decades. The method of “gut-focused hypnosis” was (for purposes of this study) given weekly for 12 weeks. An audio recording was given to each of the 15 participants and they were urged to practice at home between the one-week intervals.
The fifteen patients who were not experiencing a good outcome with the use of medications alone were studied to assess how hypnotherapy affected them. The subjects numbered 15 total, of which 12 had ulcerative colitis and 3 had Crohn’s disease. None were improving with usual treatment. Those in the ulcerative colitis group each had one-third of their colon affected by the disease. The Crohn’s disease group was classified as the ileocolic variety. The severity scale used included a rating of mild, moderate, severe or very severe. Before the study, all subjects were classified as severe or very severe.
At the end of 12 weeks, 14 of the subjects reported their symptoms as being mild or moderate. Four subjects with ulcerative colitis experienced remission, 6 ulcerative colitis subjects were classified as mild and one ulcerative colitis subject was moderate. One patient with ulcerative colitis did not respond to hypnotherapy for IBS and required surgery. One patient with Crohn’s disease had a relapse during the follow-up and required surgery at a later time.
The results of the studied compared favorably to classification prior to hypnotherapy when 5 subjects reported very poor quality of life (33.3%), 6 reported poor (40%), 3 reported moderate (20%) and one reported good (6.7%). Following hypnotherapy, 12 subjects (79.9%) considered quality of life excellent (4 subjects) or good (8 subjects). One reported moderate and, as mentioned, 2 required surgical intervention.
Although it is not proposed that hypnotherapy can replace medication in treating IBS, it is considered a viable complementary treatment. Hypnotherapy improved response to medication and quality of life in the majority of subjects studied. New research into adding hypnotherapy to conventional treatment for IBS patients is strongly indicated. A single-blind study with a control group is likely to yield valuable data.
Bamias, G., Nyce, M. R., De La Rue, S. A., & Cominelli, F. (2005). New concepts in the pathophysiology of inflammatory bowel disease. Annals of Internal Medicine, 143, 895–904.
Gruzelier, J. H. (2002). A review of the impact of hypnosis, relaxation, guided imagery and individual differences on aspects of immunity and health. Stress, 5, 147–163. Wen, Z., & Fiocchi, C. (2004). Inflammatory bowel disease: Autoimmune or immunemediated pathogenesis? Clinical Developments in Immunology, 11(3–4), 195–204.
Filed under: IBS