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Gastrointestinal Disorders
Hypnotherapy Offers Superior Treatment For Irritable Bowel Syndrome And Functional Abdominal Pain
A pioneering study authored by a few of my colleagues in The Netherlands was published in Gastroenterology (2007, Issue 133, pages 1430-1435), a well-respected mainstream medical journal. This was a prospective, randomized controlled study of 53 patients with functional abdominal pain and irritable bowel syndrome. The patients were assigned to receive either hypnotherapy or standard medical treatment. Each group had six sessions over three months. Pain intensity, pain frequency, and associated symptoms were scored at baseline, weekly during treatment, and at 6 and 12 months. Hypnotherapy was highly superior, with a significantly greater reduction in pain scores compared with standard medical therapy. The results were noticeable after only one week of treatment. In addition, at one-year follow-up, the success rate was 85% in the hypnotherapy group compared with 25% in the standard medical therapy group.
Certain Gastrointestinal (GI) Disorders Respond To Medical Hypnosis
Functional Abdominal Pain (FAP), previously called Recurrent Abdominal Pain (RAP), can be a difficult problem to treat. The diagnosis is made when there are at least three episodes of pain severe enough to affect a child’s activities over a three-month period. The pain is unrelated to meals, activity, or stool patterns. It may be accompanied by nausea, dizziness, headache, and fatigue. The patient may become pale during an episode. The episodes last less than an hour. The patient has normal growth and development. Often there is a family history of GI problems.
There is no organic etiology. That means that all diagnostic tests are negative, including blood tests, ultrasound, and endoscopy (when a doctor uses a special scope to look at the patient’s upper gastrointestinal tract, including the stomach and esophagus, as well as the lower gastrointestinal tract, including the rectum and colon). In addition, all radiographic studies are negative, including CT scans and x-ray studies such as upper GI series (barium swallow) and lower GI series (in which a barium enema is given). Additional tests may be ordered and these, too, will turn out to have normal results.
Irritable Bowel Syndrome (IBS) is characterized by chronic abdominal pain and altered bowel habits. There may be constipation or diarrhea. The pain is sometimes made worse by eating or stress. It is often better after a bowel movement.* Here, again, test results are negative. And, it is important to realize that even though the test results are negative, the pain is still quite real. Many of these patients may have “visceral hypersensitivity,” which means that they have a lower threshold for pain.
Abdominal Migraine (AM) may cause recurrent abdominal pain. These patients typically also have migraine headaches, but not always.**
Cyclic Vomiting Syndrome (CVS) is a condition in which patients have three or more episodes of vomiting in one year. They are completely normal between episodes, and each episode is virtually the same. The vomiting may last anywhere from hours to days. In addition, there is no organic cause for the vomiting.
CVS has been associated with abdominal migraine and migraine headaches. One difference between abdominal migraine and CVS is that abdominal migraines are characterized by pain and not vomiting. Both conditions may include headaches and are often treated with medications used for migraine.***
Often Treated With Same Medication as That For Migraine Headaches
It is interesting that patients with IBS, AM, and CVS are often treated with the same medication that is used to treat migraine headaches. And, the time frame may be similar. For example, patients with migraine headaches often experience an “aura.” This is a sensation, a warning sign of some sort, that in 10 to 30 minutes, the migraine headache will occur.
IBS and AM patients may also experience an aura. Often, their pain begins slowly and then escalates. If the pain starts slowly, that can be the equivalent of an aura. So, in the past, the aura was the signal that the IBS episode or AM or migraine headache was going to occur. Patients who learn self-hypnosis can use the aura or beginning of the episode to use this technique to prevent the episode from occurring.
Much Higher Success Rate with Hypnotherapy
In fact, a prospective study of patients with IBS and FAP was done comparing hypnotherapy (HT) and standard medical therapy (SMT). The HT group did far better both short-term and long-term. Specifically, at one-year follow-up, successrate was 85% in the HT group compared with 25% in the SMT group.**** One of the most commonly used medications for IBS and FAP is amitriptyline, an antidepressant. Studies have shown repeatedly that this medication is no more effective than placebo for these problems.
Learn more about hypnosis in the treatment of Migraine Headaches.
*Chun, Andrew B, and Wald, Arnold, in Uptodate, online, November 4, 2009.
**Fishman, Mary B, MD, and Aronson, Mark D, MD, in Uptodate, online, May 26, 2009.
***Dulued, Emily, MD, Desilets, David J, MD, Boles, Richard G. in Uptodate, online, September 23, 2009.
****Vlieger et al. Gastroenterology, November, 2007.
To contact Dr. Lazarus, you may phone him at: 650-322-5333. Or, email him a brief form.
