The efficacy of gut-directed hypnotherapy for treating symptoms of irritable bowel syndrome is comparable to the low FODMAP diet, according to randomized controlled trial data.
“The low FODMAP diet is increasingly applied by health professionals in patients with IBS as a first-line dietary therapy,” researchers from the department of gastroenterology at Monash University in Australia wrote. “Another promising approach … is gut-directed hypnotherapy wherein suggestions for the control and normalization of gastrointestinal function are made to the subconscious mind.”
Although several trials have shown efficacy for reducing symptoms, designing a blinded placebo in trials of gut-directed hypnotherapy is difficult, as patients typically know what intervention they are receiving. “An alternative is to compare the therapy with an active control group with proven efficacy,” the researchers wrote.
Therefore, they randomly assigned 25 IBS patients to six weekly 1-hour hypnotherapy sessions, 24 to the low FODMAP diet and 25 to both interventions for 6 weeks. All patients were naive to dietary and psychological therapies.
Change in overall gastrointestinal symptoms measured using a 100-mm visual analogue scale after 6 weeks served as the primary endpoint. Durability of efficacy, quality of life and changes in psychological indices measuring anxiety and depression after 6 months served as secondary endpoints.
Overall symptom improvements at 6 weeks were comparable across groups, with 72% of the hypnotherapy group, 71% of the diet group and 72% of the combination group achieving at least 20-mm improvement. Improvements were durable 6 months after treatment in 74% of the hypnotherapy group, 82% of the diet group and 54% of the combination group. Individual symptoms similarly improved in each group, as well.
Quality of life also improved similarly across groups (P .001), but patients in the hypnotherapy group achieved significant psychological improvements at 6 months compared with baseline as measured by the State Trait Personality Inventory for anxiety (P < .0001) and depression (P = .011).
“Given the importance of psychological health in patients with IBS, these data in total might be considered to show that gut-directed hypnotherapy is a superior alternative to the low FODMAP diet,” the researchers concluded.
“Gut-directed hypnotherapy should be regarded as a viable modality as primary therapy for patients with IBS.” –Adam Leitenberger
Disclosures: This study was funded by the department of gastroenterology at Monash University. Please see the full study for a list of all researchers’ relevant financial disclosures.
Hypnotherapy as effective as low FODMAP diet in IBS | Peters SL, et al. Aliment Pharmacol Ther. 2016;doi:10.1111/apt.13706 | July 13, 2016