The role of hypnotherapy for the treatment of inflammatory bowel diseases

Abstract

Inflammatory bowel diseases (IBD) are chronic disorders of unknown aetiology which are characterized by episodes of exacerbations and remissions. There is evidence that perceived distress contributes to IBD symptom flares; anxiety and depression are frequently found in patients with the active disease. Because there is no cure, treatment has to focus on prevention of complications, induction/maintenance of remission and improvement of quality of life. Gut-directed hypnotherapy (GHT) has been used successfully in functional gastrointestinal disorders. Few experimental studies and case reports have been published for IBD; GHT increases the health-related quality of life and reduces symptoms. Additionally, GHT seems to have an immune-modulating effect and is able to augment clinical remission in patients with quiescent ulcerative colitis.

Keywords::

• brain–gut axis
• hypnosis
• inflammatory bowel diseases
• integrated care
• psychological distress
• psychotherapy
• treatment

Financial & competing interests disclosure

The author has no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.

Key issues

• Perceived distress contributes to inflammatory bowel diseases (IBD) symptom flares; anxiety and depression are frequently found in patients with active disease.

• Patients with IBD are more likely to suffer from functional gastrointestinal disorders than the general population. With gut-directed hypnotherapy (GHT), the patients can learn to control symptoms and physiological functions.

• GHT has been used to reduce stress and improve the quality of life in IBD patients.

• The feasibility and acceptability of GHT (single and group sessions) for IBD patients is proven and no negative effects of treatment were found.

• An experimental study has shown that GHT is able to reduce several components of the systemic and mucosal inflammatory response in active ulcerative colitis.

• The first randomized controlled trial has demonstrated a significant effect of GHT on prolonging clinical remission in patients with quiescent ulcerative colitis.

• GHT for IBD patients is one option to integrate the knowledge about the brain–gut axis into clinical practice.

• Integrated models of care should become the standard of management of IBD patients.