Short courses of cognitive therapy or hypnosis can alleviate the symptoms of irritable bowel syndrome(IBS) for the estimated 15% of adult Americans who have this disorder according to several recent studies.
The First Study
In one study, Jeffrey M. Lackner, director of the behavioral medicine clinic and assistant professor of medicine at the University at Buffalo School of Medicine, assigned 59 patients to either a 1O-week course of cognitive therapy, a four-week course, or a wait list.
Both the short and long cognitive therapy sessions included the same information, but the short course had a self-study workbook developed specifically for the study.
The therapy instructed IBS patients on how to undo some of their stressful habits, such as negative thinking patterns and poor coping skills, both of which can create anxiety and exacerbate IBS symptoms. "These people spend a lot of time in their head, engaging in worrisome thinking," Lackner says.
The study participants were encouraged to be more flexible in problem-solving and to learn skills, such as relaxation, that would help them take control of their symptoms. Muscle-relaxation training was also included in the therapy.
In total, 74% of the people who had the long course of therapy said their symptoms improved moderately to substantially, and 73% of the short course patients reported the same improvements.
"Whether the patients went to 10 sessions or four, they achieved clinically significant improvements in symptom relief and quality of life and were satisfied [with the program]," Lackner says.
In two other studies, hypnotherapy helped reduce the symptoms and improve the quality of life for people who have IBS, reports Dr. Magnus Simren, an associate professor and consultant at Goteborg University in Sweden.
One hypnotherapy trial involved 87 IBS patients; another looked at 48.
In each study, approximately one-half of the participants received 12 weekly "gut-directed" hypnotherapy sessions, in which the therapist helped the patients visualize a fully functioning gastrointestinal (GI) tract.
The other half of the participants were assigned to a control group that did not receive hypnotherapy.
Simren evaluated the patients at the start of the study, immediately after treatment, six months after treatment and 12 months after treatment, asking them to complete questionnaires that asked about their quality of life, anxiety, depression and GI symptoms.
"The hypnotherapy groups improved significantly regarding GI symptoms," he says. "The control groups did not." Of the patients receiving hypnotherapy, 52% improved significantly, compared with just 32% of the control group.
Improvements lasted or even increased at 12 months, and were most marked for abdominal pain, bloating and distension. Anxiety and depression improved at one year in the smaller study of 48 patients, but not in the study of 87 patients. The reason for that disparity is unclear, Simren says.
How It Works
Although experts are not sure just how cognitive therapy and hypnosis ease IBS symptoms, Lackner's and Simren's results are in line with other studies that have come to similar conclusions.
Dr. Emeran Mayer, a professor of medicine and physiology at the University of California at Los Angeles, believes that hypnotherapy works because it alters the way the brain reacts to stress, reducing levels of body arousal. "There's a very important role for these kinds of [mind-body] approaches," he says.
Simren says that patients who are eager for relief from IBS symptoms-which can include abdominal pain, cramps, bloating, food intolerances, constipation or diarrhea-don't really care how hypnotherapy works, just that it does. "I tell them, 'This is how you can get control of your symptoms,' and most are satisfied with that explanation," he says.
In addition, this type of therapy doesn't necessarily need to be ongoing, especially once patients learn the new skills.
Simren and Lackner suggest that IBS patients choose a therapist who has experience with this type of treatment. "It's very important that the therapist does have an interest in bodily symptoms, not just the mind," Simren says.