Irritable Bowel Syndrome (IBS) - University Of Sydney Trial

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Irritable Bowel Syndrome (IBS)
University Of Sydney Trial

University of Sydney Trial 2004/2006.

Julie Phillips-Moore Ph.D.


FIRST AUSTRALIAN TRIAL ON HYPNOSIS AS A TREATMENT FOR IRRITABLE BOWEL SYNDROME.

For decades, health professionals have focused solely on the causes of disease rather than on the psychological effects on health and disease, and the effects of disease on the psyche. In other words, emphasis has been more on pathology than on factors which promote health.

There is now a great body of evidence suggesting that direct connections exist between parts of the body that had previously been thought of as being independent. Increasing evidence suggests that the pathophysiology of IBS is not limited to the gut, brain, or autonomic nervous system but that all three systems are involved. The influence of the mind on the body and vice versa is becoming more widely acknowledged, therefore, any potential new therapy should be optimally targeted at addressing the brain-gut axis. One potentially successful intervention aimed at breaking abnormal cycles within the brain-gut axis in IBS is hypnotherapy.

Psychological distress, which can trigger or exacerbate symptoms has been shown to be an important component of IBS symptoms and should be considered when treatment strategies are designed. To date, researchers who have carried out studies on hypnotherapy as a treatment for IBS have not specifically addressed the mental, psychological and emotional aspects of IBS.

The primary aim of this trial was to achieve a more holistic approach when attending to IBS patients and to evaluate the effectiveness of hypnosis and imagery in the treatment of IBS in an Australian population. More specifically, the study aimed at comparing the use of standard gut-directed imagery (i.e. imagery addressing only physiological symptoms) used in previous hypnosis trials, with imagery that reflected the patients complete symptom picture (holistic).

Volunteers for the trial were randomly assigned to one of three groups: two experimental groups (either holistic or standard gut-directed hypnosis) and one control group (relaxation therapy). Throughout the trial, participants completed the Bowel Symptom Severity questionnaire which assessed the degree to which IBS symptoms interfered with their daily lives, and the SF-36 which broadly related to the participants quality of life, mental health, and social activities.

At the commencement of the trial period, the majority of participants (81.6%) suffered abdominal pain most of the time (of these, 59.2% had mild to moderate pain and 40.8% had severe to very severe pain) with 61.2% of participants experiencing pain several times a week or daily. In the three months prior to treatment, 98.0% of participants experienced bloating and 78.4% of participants had visible abdominal swelling. All participants presented with either anxiety or depression. The majority of participants in this study were women (86.3%), and the majority of sufferers were aged between 20-40 (82.3%).

All participants demonstrated improvement in the overall severity of their individual IBS symptoms and quality of life at the end of the treatment period, with the holistic group (blue) having a numerically better outcome than the other two groups.


Irritable Bowel Syndrome Symptom Scales (BSS1-5) - Overall Symptom
Severity by Treatment Groups and Control Group.



 
Psychological treatments, such as hypnotherapy, are rarely suggested to IBS patients as, up until now, medication (such as antispasmodics, antidepressants, anti-diarrhoeals and laxatives) has been the treatment of choice. Considering the high cost of medication, repeated visits to medical practitioners, and the high prevalence of stress, IBS sufferers would obtain a great deal of benefit from programmes such as hypnotherapy. 

As result of this trial, a 7-week treatment protocol has been set up to address both the physiological and emotional/psychological aspects of IBS. This will be conducted at the Sydney Essential Health, 130 Edgecliff Road, Woollahra. 2025


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