Effects on gastrointestinal transit and antroduodenojejunal manometry after gut-directed hypnotherapy in irritable bowel syndrome (IBS)

Abstract

Background. Gut-directed hypnotherapy is an effective treatment in irritable bowel syndrome (IBS) but little is known about the mechanisms of action. In this study we aimed to investigate the effects on gastrointestinal motility when treating IBS with gut-directed hypnotherapy. Methods. We randomized 90 patients with IBS, refractory to standard management to receive gut-directed hypnotherapy 1 h/week for 12 weeks or supportive treatment for the same time period. Eighty-one subjects (40 hypnotherapy, 41 controls) could be evaluated by one or more of the following investigations, both before and after the intervention: gastric emptying time, small bowel transit time, colonic transit time, and antroduodenojejunal manometry. Results. No significant differences in gastric emptying time, small bowel transit time, or colonic transit time was found when comparing the baseline and post-intervention measurements in the hypnotherapy group or in the control group. The same was true concerning the results of the antroduodenojejunal manometry. However, there was a numerical trend toward a higher number of migrating motor complexes at manometry and an accelerated gastric emptying time after hypnotherapy that did not reach statistical significance. Conclusions. In this study, we were not able to find evidence for long-standing effects on gastrointestinal motility as a mediator of the effects on IBS when treating the condition with gut-directed hypnotherapy. Further research to understand the mechanism of action is needed.

Key Words::

• gut-directed hypnotherapy
• irritable bowel syndrome
• manometry
• transit investigation

Acknowledgments

We express our gratitude to the three private practice psychologists, who provided the hypnotherapy – Susanna Carolusson, Berndt Westman, and Anne Holmgren.

Declaration of interest: Guarantor of the article: Magnus Simrén, MD, PhD. Specific author contributions: Paper writing, study design, and data analysis: Perjohan Lindfors; Paper writing and data analysis. Hans Törnblom; Study design and performance of study: Riadh Sadik, Einar Björnsson, and Hasse Abrahamsson; PI, study design, data analysis, and paper writing: Magnus Simrén. All authors have approved and critically reviewed the manuscript. Financial support: This study was supported by Västra Götaland Region (Dagmar funds), the Swedish Research Council (Grants 13409, 21691, and 21692), the Marianne and Marcus Wallenberg Foundation, University of Gothenburg, Centre for Person-Centred Care (GPCC), Sahlgrenska Academy, and the Faculty of Medicine, University of Gothenburg. Potential competing interests: Magnus Simrén has received unrestricted research grants from Danone and AstraZeneca, and served as a Consultant/Advisory Board member for Danone, Novartis, and Shire/Movetis.