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P J Whorwell - One of the best experts on this subject based on the ideXlab platform.
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gut focused Hypnotherapy for functional gastrointestinal disorders evidence base practical aspects and the manchester protocol
Neurogastroenterology and Motility, 2019Co-Authors: Dipesh H Vasant, P J WhorwellAbstract:Background Despite their high prevalence and advances in the field of neurogastroenterology, there remain few effective treatment options for functional gastrointestinal disorders (FGIDs). It is recognized that approximately 25% of sufferers will have symptoms refractory to existing therapies, causing significant adverse effects on quality of life and increased healthcare utilization and morbidity. Gut-focused Hypnotherapy, when delivered by trained therapists, has been shown to be highly effective in severe refractory FGIDs. However, Hypnotherapy continues to be surrounded by much misunderstanding and skepticism. Purpose The purpose of this review is to provide a contemporary overview of the principles of gut-focused Hypnotherapy, its effects on gut-brain interactions, and the evidence-base for its efficacy in severe FGIDs. As supplementary material, we have included a Hypnotherapy protocol, providing the reader with an insight into the practical aspects of delivery, and as a guide, an example of a script of a gut-focused Hypnotherapy session.
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owe 09 outcomes of gut focused Hypnotherapy in school children and adolescents with severe refractory irritable bowel syndrome
Gut, 2019Co-Authors: Syed S Hasan, P J Whorwell, Pamela Cruickshanks, Dipesh H VasantAbstract:Introduction Irritable Bowel Syndrome (IBS) symptoms in school children and adolescents are relatively common, often causing considerable embarrassment, social withdrawal, disruption to education and psychological distress. Pharmacological options in this group are limited due to safety concerns concerning antidepressants, making behavioural therapies such as gut-focussed Hypnotherapy an attractive treatment option. Here, we evaluated outcomes from gut-focussed Hypnotherapy in patients with IBS ≤ 18 years of age. Methods Consecutive young patients (≤18 years of age) with severe IBS symptoms referred to our tertiary neurogastroenterology unit received 12 sessions of gut-focussed Hypnotherapy at weekly intervals using the Manchester Protocol. All patients completed the Tellgen Absorption Scale before treatment and all completed the following measures before and after Hypnotherapy; IBS symptom severity score (IBS-SSS), Hospital Anxiety and Depression scale (HADS), Non Colonic Symptom score and quality-of-life (QoL) score. Interference with education and the impact of Hypnotherapy was also recorded. The primary outcome measure was response to Hypnotherapy defined by a 50 point reduction in IBS-SSS. Data, expressed as mean ± standard error, were compared statistically before and after treatment using paired t-tests. Results Young patients fulfilling Rome III diagnostic criteria for IBS (n=26, median age 16 (range –8) years, n=17 (65%) female, mean duration of IBS 5.3 ± 0.9 years, n=11 IBS-D, n=6 IBS-C and n=9 IBS-mixed) completed the Hypnotherapy programme. Mean baseline IBS-SSS was 321.5 ± 16.0. After Hypnotherapy, n=23/26 (88%) responded, with an overall mean reduction in IBS-SSS of -160.9 ± 15.4 (P Conclusion These data, which form one of the largest reported series of gut-focussed Hypnotherapy in children and adolescents with severe IBS, suggest that this treatment is even more effective in this group of patients than in adults. Hypnotherapy in severe childhood IBS patients may therefore have a role in preventing further suffering in adult life, reducing healthcare utilisation and related costs with wider socio-economic benefits. Furthermore, it allows many of them to return to full time education.
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skype Hypnotherapy for irritable bowel syndrome effectiveness and comparison with face to face treatment
International Journal of Clinical and Experimental Hypnosis, 2019Co-Authors: Shariq S Hasan, James S Pearson, Julie Morris, P J WhorwellAbstract:Gut-focused Hypnotherapy is an effective treatment for irritable bowel syndrome but is not widely available. This study assessed whether providing Hypnotherapy by Skype might partially overcome thi...
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long term benefits of Hypnotherapy for irritable bowel syndrome
Gut, 2003Co-Authors: W M Gonsalkorale, Vivien Miller, A Afzal, P J WhorwellAbstract:Background and aims: There is now good evidence from several sources that Hypnotherapy can relieve the symptoms of irritable bowel syndrome in the short term. However, there is no long term data on its benefits and this information is essential before the technique can be widely recommended. This study aimed to answer this question. Patients and methods: 204 patients prospectively completed questionnaires scoring symptoms, quality of life, anxiety, and depression before, immediately after, and up to six years following Hypnotherapy. All subjects also subjectively assessed the effects of Hypnotherapy retrospectively in order to define their “responder status”. Results: 71% of patients initially responded to therapy. Of these, 81% maintained their improvement over time while the majority of the remaining 19% claimed that deterioration of symptoms had only been slight. With respect to symptom scores, all items at follow up were significantly improved on pre-Hypnotherapy levels (p<0.001) and showed little change from post-Hypnotherapy values. There were no significant differences in the symptom scores between patients assessed at 1, 2, 3, 4, or 5+ years following treatment. Quality of life and anxiety or depression scores were similarly still significantly improved at follow up (p<0.001) but did show some deterioration. Patients also reported a reduction in consultation rates and medication use following the completion of Hypnotherapy. Conclusion: This study demonstrates that the beneficial effects of Hypnotherapy appear to last at least five years. Thus it is a viable therapeutic option for the treatment of irritable bowel syndrome.
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symptomatology quality of life and economic features of irritable bowel syndrome the effect of Hypnotherapy
Alimentary Pharmacology & Therapeutics, 1996Co-Authors: Lesley A Houghton, D J Heyman, P J WhorwellAbstract:AIMS: The purposes of this study were to quantify the effects of severe irritable bowel syndrome on quality of life and economic functioning, and to assess the impact of Hypnotherapy on these features. METHODS: A validated quality of life questionnaire including questions on symptoms, employment and health seeking behaviour was administered to 25 patients treated with Hypnotherapy (aged 25-55 years; four male) and to 25 control irritable bowel syndrome patients of comparable severity (aged 21-58 years; two male). Visual analogue scales were used and scores derived to assess the patients' symptoms and satisfaction with each aspect of life. RESULTS: Patients treated with Hypnotherapy reported less severe abdominal pain (P < 0.0001), bloating (P < 0.02), bowel habit (P < 0.0001), nausea (P < 0.05), flatulence (P < 0.05), urinary symptoms (P < 0.01), lethargy (P < 0.01), backache (P = 0.05) and dyspareunia (P = 0.05) compared with control patients. Quality of life, such as psychic well being (P < 0.0001), mood (P < 0.001), locus of control (P < 0.05), physical well being (P < 0.001) and work attitude (P < 0.001) were also favourably influenced by Hypnotherapy. For those patients in employment, more of the controls were likely to take time off work (79% vs. 32%; p = 0.02) and visit their general practitioner ( 58% vs. 21%; P = 0.056) than those treated with Hypnotherapy. Three of four Hypnotherapy patients out of work prior to treatment resumed employment compared with none of the six in the control group. CONCLUSION: This study has shown that in addition to relieving the symptoms of irritable bowel syndrome, Hypnotherapy profoundly improves the patients' quality of life and reduces absenteeism from work. It therefore appears that, despite being relatively expensive to provide, it could well be a good long-term investment.
Lesley A Houghton - One of the best experts on this subject based on the ideXlab platform.
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gut focused Hypnotherapy normalizes disordered rectal sensitivity in patients with irritable bowel syndrome
Alimentary Pharmacology & Therapeutics, 2003Co-Authors: Richard Lea, W M Gonsalkorale, Lesley A Houghton, Patricia Cooper, E L Calvert, S Larder, V Whelan, J Randles, P Cruickshanks, Vivien MillerAbstract:SUMMARY Background: We have previously shown that Hypnotherapy alters rectal sensitivity in some patients with irritable bowel syndrome. However, this previous study used incremental volume distension of a latex balloon, which might be susceptible to subject response bias and might compromise the assessment of compliance. In addition, the study group was symptomatically rather than physiologically defined. Aim: To assess the effect of Hypnotherapy on rectal sensitivity in hypersensitive, hyposensitive and normally sensitive irritable bowel syndrome patients using a distension technique (barostat) that addresses these technical issues. Methods: Twenty-three irritable bowel syndrome (Rome I) patients (aged 24‐72 years) were assessed before and after 12 weeks of Hypnotherapy in terms of rectal sensitivity, symptomatology, anxiety and depression. Normal values for sensitivity were established in 17 healthy volunteers (aged 20‐55 years). Results: Compared with controls, 10 patients were hypersensitive, seven hyposensitive and six normally sensitive before treatment. Following Hypnotherapy, the mean pain sensory threshold increased in the hypersensitive group (P ¼ 0.04) and decreased in the hyposensitive group, although the latter failed to reach statistical significance (P ¼ 0.19). Normal sensory perception was unchanged. Sensory improvement in the hypersensitive patients tended to correlate with a reduction in abdominal pain (r ¼ 0.714, P ¼ 0.07). Conclusion: Hypnotherapy improves abnormal sensory perception in irritable bowel syndrome, leaving normal sensation unchanged.
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symptomatology quality of life and economic features of irritable bowel syndrome the effect of Hypnotherapy
Alimentary Pharmacology & Therapeutics, 1996Co-Authors: Lesley A Houghton, D J Heyman, P J WhorwellAbstract:AIMS: The purposes of this study were to quantify the effects of severe irritable bowel syndrome on quality of life and economic functioning, and to assess the impact of Hypnotherapy on these features. METHODS: A validated quality of life questionnaire including questions on symptoms, employment and health seeking behaviour was administered to 25 patients treated with Hypnotherapy (aged 25-55 years; four male) and to 25 control irritable bowel syndrome patients of comparable severity (aged 21-58 years; two male). Visual analogue scales were used and scores derived to assess the patients' symptoms and satisfaction with each aspect of life. RESULTS: Patients treated with Hypnotherapy reported less severe abdominal pain (P < 0.0001), bloating (P < 0.02), bowel habit (P < 0.0001), nausea (P < 0.05), flatulence (P < 0.05), urinary symptoms (P < 0.01), lethargy (P < 0.01), backache (P = 0.05) and dyspareunia (P = 0.05) compared with control patients. Quality of life, such as psychic well being (P < 0.0001), mood (P < 0.001), locus of control (P < 0.05), physical well being (P < 0.001) and work attitude (P < 0.001) were also favourably influenced by Hypnotherapy. For those patients in employment, more of the controls were likely to take time off work (79% vs. 32%; p = 0.02) and visit their general practitioner ( 58% vs. 21%; P = 0.056) than those treated with Hypnotherapy. Three of four Hypnotherapy patients out of work prior to treatment resumed employment compared with none of the six in the control group. CONCLUSION: This study has shown that in addition to relieving the symptoms of irritable bowel syndrome, Hypnotherapy profoundly improves the patients' quality of life and reduces absenteeism from work. It therefore appears that, despite being relatively expensive to provide, it could well be a good long-term investment.
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Use of Hypnotherapy in gastrointestinal disorders
European Journal of Gastroenterology and Hepatology, 1996Co-Authors: C. Y. Francis, Lesley A HoughtonAbstract:Medical history is full of anecdotal reports on the use of hypnosis in the treatment of gastrointestinal and other disorders. Unfortunately, much of the work published to date consists mainly of short case reports or involves small numbers of patients. They have, however, all broadly given the same message: that patients symptoms improve and they cope better with their condition after Hypnotherapy. More recently, controlled trials have shown that patients with severe refractory irritable bowel syndrome or relapsing duodenal ulcer disease respond well to Hypnotherapy. This article aims to give an overview of the areas in gastroenterology where Hypnotherapy has been applied, discussing in particular what progress has been made in the area of irritable bowel syndrome.
Andrew R. Mayer - One of the best experts on this subject based on the ideXlab platform.
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mind body Hypnotherapy treatment of women with urgency urinary incontinence changes in brain attentional networks
American Journal of Obstetrics and Gynecology, 2020Co-Authors: Loren H. Ketai, Yuko M. Komesu, Robert E. Sapien, Rebecca G. Rogers, Ronald Schrader, Andrew B Dodd, Andrew R. MayerAbstract:BACKGROUND Prior study of patients with urgency urinary incontinence by functional magnetic resonance imaging showed altered function in areas of the brain associated with interoception and salience and with attention. Our randomized controlled trial of Hypnotherapy for urgency urinary incontinence demonstrated marked improvement in urgency urinary incontinence symptoms at two months. A sub-sample of these urgency urinary incontinent women underwent functional magnetic resonance imaging before and after treatment. OBJECTIVE To determine if Hypnotherapy treatment of urgency urinary incontinence compared to pharmacotherapy was associated with altered brain activation or resting connectivity on functional Magnetic Resonance Imaging. STUDY DESIGN A sub-sample of women participating in a randomized control trial comparing Hypnotherapy versus pharmacotherapy for treatment of urgency urinary incontinence was evaluated with functional magnetic resonance imaging. Scans were obtained pretreatment and 8-12 weeks after treatment initiation. Brain activation during bladder-filling and resting functional connectivity with an empty and partially filled bladder were assessed. Brain regions of interest were derived from those previously showing differences between healthy controls and untreated urgency urinary incontinence participants in our prior work, and included regions in the interoceptive and salience, ventral attentional and dorsal attentional networks. RESULTS Following treatment, participants in both groups demonstrated marked improvement in incontinence episodes (p < .001). Bladder filling task functional magnetic resonance imaging data from the combined groups (n=64, 30 Hypnotherapy, 34 Pharmacotherapy) demonstrated decreased activation of the left temporoparietal junction, a component of the ventral attentional network (p<.01) compared to baseline. Resting functional connectivity differed only with the bladder partially filled (n = 54). Compared to pharmacotherapy, Hypnotherapy participants manifested increased functional connectivity between the anterior cingulate cortex and the left dorsolateral prefrontal cortex, a component of the dorsal attentional network (p<.001). CONCLUSIONS Successful treatment of urgency urinary incontinence with both pharmacotherapy and Hypnotherapy was associated with decreased activation of the ventral (bottom up) attentional network during bladder filling. This may be attributable to decreased afferent stimuli arising from the bladder in the pharmacotherapy group. In contrast, decreased ventral attentional network activation associated with Hypnotherapy may be mediated by the counterbalancing effects of the dorsal (top down) attentional network.
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Hypnotherapy or medications: a randomized noninferiority trial in urgency urinary incontinent women.
American Journal of Obstetrics and Gynecology, 2020Co-Authors: Yuko M. Komesu, Robert E. Sapien, Rebecca G. Rogers, Ronald M. Schrader, Andrew R. Mayer, Loren H. KetaiAbstract:Abstract Background Urgency urinary incontinence afflicts many adults, and most commonly affects women. Medications, a standard treatment, may be poorly tolerated with poor adherence. This warrants investigation of alternative interventions. Mind-body therapies such as Hypnotherapy may offer additional treatment options for those with urgency urinary incontinence. Objective To evaluate Hypnotherapy’s efficacy compared to medications in treating women with urgency urinary incontinence. Study Design This investigator-masked, non-inferiority trial compared Hypnotherapy to medications at a Southwestern U.S. academic center and randomized women with non-neurogenic urgency urinary incontinence to weekly Hypnotherapy sessions for two months (and continued self-hypnosis thereafter) or to medication and weekly counseling for two months (and medication alone thereafter). The primary outcome was the between group comparison of percent change in urgency incontinence on 3-day bladder diary at two months. Important secondary outcomes were between group comparisons of percent change in urgency incontinence at six and 12 months. Outcomes were analyzed based on non-inferiority margins of 5% for between group differences, P -5%, non-inferiority would be proven). Results One hundred fifty-two women were randomized to treatment between April 2013-October 2016. One-hundred forty-two women (70 Hypnotherapy, 72 medications) had 3-day diary information at two months and were included in the primary outcome analysis. Secondary outcomes were analyzed for women with diary data at six then 12 months’ time-points; 138 women (67 Hypnotherapy, 71 medications) at six months, 140 women (69 Hypnotherapy, 71 medications) at 12 months. There were no differences between group’s urgency incontinence episodes at baseline: median (Q1, Q3) for Hypnotherapy was 8 (4, 14) and medication 7 (4, 11), P=0.165. For the primary outcome, while both interventions showed improvement, Hypnotherapy did not prove non-inferior to medication at 2 months. Hypnotherapy’s median percent improvement was 73.0% (95% CI 60.0%-88˖9%), medication’s improvement was 88.6% (95% CI 78.6%-100.0%). The median difference in percent change between groups was 0% (95% CI -16.7-0.0%); because the lower margin of the CI did not meet the pre-determined non-inferiority margin of > -5%, Hypnotherapy did not prove non-inferior to medication. In contrast, Hypnotherapy was non-inferior to medication for the secondary outcomes at six months (Hypnotherapy 85.7% improvement, 95% CI 75.0-100%; medications 83.3% improvement, 95% CI 64.7%-100%; median difference in percent change between groups of 0%, 95% CI 0.0%-6.7%) and 12 months (Hypnotherapy 85.7% improvement, 95% CI 66.7-94.4%; medications 80% improvement, 95% CI 54.5-100%; median difference in percent change between groups of 0%, 95% CI -4.2%-9.5%). Conclusions Both Hypnotherapy and medications were associated with substantially improved urgency urinary incontinence at all follow-up. The study did not prove the non-inferiority of Hypnotherapy compared to medications at 2 months, the study’s primary outcome. Hypnotherapy proved non-inferior to medications at longer-term follow-up, 6 and 12 months. Hypnotherapy is a promising, alternative treatment for women with UUI.
Rebecca G. Rogers - One of the best experts on this subject based on the ideXlab platform.
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mind body Hypnotherapy treatment of women with urgency urinary incontinence changes in brain attentional networks
American Journal of Obstetrics and Gynecology, 2020Co-Authors: Loren H. Ketai, Yuko M. Komesu, Robert E. Sapien, Rebecca G. Rogers, Ronald Schrader, Andrew B Dodd, Andrew R. MayerAbstract:BACKGROUND Prior study of patients with urgency urinary incontinence by functional magnetic resonance imaging showed altered function in areas of the brain associated with interoception and salience and with attention. Our randomized controlled trial of Hypnotherapy for urgency urinary incontinence demonstrated marked improvement in urgency urinary incontinence symptoms at two months. A sub-sample of these urgency urinary incontinent women underwent functional magnetic resonance imaging before and after treatment. OBJECTIVE To determine if Hypnotherapy treatment of urgency urinary incontinence compared to pharmacotherapy was associated with altered brain activation or resting connectivity on functional Magnetic Resonance Imaging. STUDY DESIGN A sub-sample of women participating in a randomized control trial comparing Hypnotherapy versus pharmacotherapy for treatment of urgency urinary incontinence was evaluated with functional magnetic resonance imaging. Scans were obtained pretreatment and 8-12 weeks after treatment initiation. Brain activation during bladder-filling and resting functional connectivity with an empty and partially filled bladder were assessed. Brain regions of interest were derived from those previously showing differences between healthy controls and untreated urgency urinary incontinence participants in our prior work, and included regions in the interoceptive and salience, ventral attentional and dorsal attentional networks. RESULTS Following treatment, participants in both groups demonstrated marked improvement in incontinence episodes (p < .001). Bladder filling task functional magnetic resonance imaging data from the combined groups (n=64, 30 Hypnotherapy, 34 Pharmacotherapy) demonstrated decreased activation of the left temporoparietal junction, a component of the ventral attentional network (p<.01) compared to baseline. Resting functional connectivity differed only with the bladder partially filled (n = 54). Compared to pharmacotherapy, Hypnotherapy participants manifested increased functional connectivity between the anterior cingulate cortex and the left dorsolateral prefrontal cortex, a component of the dorsal attentional network (p<.001). CONCLUSIONS Successful treatment of urgency urinary incontinence with both pharmacotherapy and Hypnotherapy was associated with decreased activation of the ventral (bottom up) attentional network during bladder filling. This may be attributable to decreased afferent stimuli arising from the bladder in the pharmacotherapy group. In contrast, decreased ventral attentional network activation associated with Hypnotherapy may be mediated by the counterbalancing effects of the dorsal (top down) attentional network.
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Hypnotherapy or medications: a randomized noninferiority trial in urgency urinary incontinent women.
American Journal of Obstetrics and Gynecology, 2020Co-Authors: Yuko M. Komesu, Robert E. Sapien, Rebecca G. Rogers, Ronald M. Schrader, Andrew R. Mayer, Loren H. KetaiAbstract:Abstract Background Urgency urinary incontinence afflicts many adults, and most commonly affects women. Medications, a standard treatment, may be poorly tolerated with poor adherence. This warrants investigation of alternative interventions. Mind-body therapies such as Hypnotherapy may offer additional treatment options for those with urgency urinary incontinence. Objective To evaluate Hypnotherapy’s efficacy compared to medications in treating women with urgency urinary incontinence. Study Design This investigator-masked, non-inferiority trial compared Hypnotherapy to medications at a Southwestern U.S. academic center and randomized women with non-neurogenic urgency urinary incontinence to weekly Hypnotherapy sessions for two months (and continued self-hypnosis thereafter) or to medication and weekly counseling for two months (and medication alone thereafter). The primary outcome was the between group comparison of percent change in urgency incontinence on 3-day bladder diary at two months. Important secondary outcomes were between group comparisons of percent change in urgency incontinence at six and 12 months. Outcomes were analyzed based on non-inferiority margins of 5% for between group differences, P -5%, non-inferiority would be proven). Results One hundred fifty-two women were randomized to treatment between April 2013-October 2016. One-hundred forty-two women (70 Hypnotherapy, 72 medications) had 3-day diary information at two months and were included in the primary outcome analysis. Secondary outcomes were analyzed for women with diary data at six then 12 months’ time-points; 138 women (67 Hypnotherapy, 71 medications) at six months, 140 women (69 Hypnotherapy, 71 medications) at 12 months. There were no differences between group’s urgency incontinence episodes at baseline: median (Q1, Q3) for Hypnotherapy was 8 (4, 14) and medication 7 (4, 11), P=0.165. For the primary outcome, while both interventions showed improvement, Hypnotherapy did not prove non-inferior to medication at 2 months. Hypnotherapy’s median percent improvement was 73.0% (95% CI 60.0%-88˖9%), medication’s improvement was 88.6% (95% CI 78.6%-100.0%). The median difference in percent change between groups was 0% (95% CI -16.7-0.0%); because the lower margin of the CI did not meet the pre-determined non-inferiority margin of > -5%, Hypnotherapy did not prove non-inferior to medication. In contrast, Hypnotherapy was non-inferior to medication for the secondary outcomes at six months (Hypnotherapy 85.7% improvement, 95% CI 75.0-100%; medications 83.3% improvement, 95% CI 64.7%-100%; median difference in percent change between groups of 0%, 95% CI 0.0%-6.7%) and 12 months (Hypnotherapy 85.7% improvement, 95% CI 66.7-94.4%; medications 80% improvement, 95% CI 54.5-100%; median difference in percent change between groups of 0%, 95% CI -4.2%-9.5%). Conclusions Both Hypnotherapy and medications were associated with substantially improved urgency urinary incontinence at all follow-up. The study did not prove the non-inferiority of Hypnotherapy compared to medications at 2 months, the study’s primary outcome. Hypnotherapy proved non-inferior to medications at longer-term follow-up, 6 and 12 months. Hypnotherapy is a promising, alternative treatment for women with UUI.
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Hypnotherapy for treatment of overactive bladder: a randomized controlled trial pilot study.
Female Pelvic Medicine & Reconstructive Surgery, 2011Co-Authors: Yuko M. Komesu, Robert E. Sapien, Rebecca G. Rogers, Loren H. KetaiAbstract:OBJECTIVES : The objective of the study was to obtain pilot data comparing Hypnotherapy and behavioral therapy (Hypnotherapy) to behavioral therapy alone (behavioral therapy) in overactive bladder (OAB) treatment. METHODS : Women with OAB were randomized to Hypnotherapy or behavioral therapy treatments. Patient Global Impression of Improvement (PGI-I), the OAB-q Short Form (OAB-q SF) questionnaire, and voiding diaries were recorded, and within- and between-group differences were compared. RESULTS : Twenty women enrolled in and completed the study. Both Hypnotherapy and behavioral therapy groups improved their mean number of voids (P = 0.005, P = 0.01, respectively) and their OAB-q SF distress scores (P = 0.002, P = 0.03). The Hypnotherapy group had significant improvement in quality-of-life scores (P < 0.001), whereas the behavioral group did not (P = 0.05). Between-group comparisons showed that the Hypnotherapy group had superior PGI-I scores compared with the behavioral group (P < 0.009). The Hypnotherapy group trended toward greater improvement in OAB-q quality-of-life scores compared with the behavioral therapy group (67% vs 42% improvement), although this did not reach statistical significance (P = 0.07). Number of voids and OAB-q SF distress scores improved in both groups with no difference between groups. CONCLUSIONS : Both groups improved with treatment. Hypnotherapy resulted in superior PGI-I scores compared with behavioral therapy. Voiding and OAB-q SF results trended toward greater improvement with Hypnotherapy. As a pilot study, recruitment was underpowered to find statistical differences between groups' voids and OAB scores. These findings support the need for an expanded trial that could likely show Hypnotherapy to be superior in OAB treatment.
Vivien Miller - One of the best experts on this subject based on the ideXlab platform.
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Hypnotherapy for non-cardiac chest pain: long-term follow-up.
Gut, 2007Co-Authors: Vivien Miller, Helen Jones, Peter J. WhorwellAbstract:We have been researching the effects of Hypnotherapy in gastroenterology for many years and recently reported in Gut 1 that a course of 12 sessions of Hypnotherapy seems to be beneficial in the treatment of non-cardiac chest pain. In a study on 28 patients comparing the effects of either Hypnotherapy or a similar duration of supportive listening combined with placebo medication (control group), the active treatment resulted in a much better outcome. Of the 15 patients randomised to Hypnotherapy, 12 (80%) responded to treatment, as judged by either a complete or …
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Treatment of non-cardiac chest pain: a controlled trial of Hypnotherapy
Gut, 2006Co-Authors: Helen Jones, Vivien Miller, Patricia Cooper, N H Brooks, Peter J. WhorwellAbstract:Background: Non-cardiac chest pain (NCCP) is an extremely debilitating condition of uncertain origin which is difficult to treat and consequently has a high psychological morbidity. Hypnotherapy has been shown to be effective in related conditions such as irritable bowel syndrome where its beneficial effects are long lasting. Aims: This study aimed to assess the efficacy of Hypnotherapy in a selected group of patients with angina-like chest pain in whom coronary angiography was normal and oesophageal reflux was not contributory. Patients and methods: Twenty eight patients fulfilling the entry criteria were randomised to receive, after a four week baseline period, either 12 sessions of Hypnotherapy or supportive therapy plus placebo medication over a 17 week period. The primary outcome measure was global assessment of chest pain improvement. Secondary variables were a change in scores for quality of life, pain severity, pain frequency, anxiety, and depression, as well as any alteration in the use of medication. Results: Twelve of 15 (80%) Hypnotherapy patients compared with three of 13 (23%) controls experienced a global improvement in pain (p = 0.008) which was associated with a significantly greater reduction in pain intensity (p = 0.046) although not frequency. Hypnotherapy also resulted in a significantly greater improvement in overall well being in addition to a reduction in medication usage. There were no differences favouring Hypnotherapy with respect to anxiety or depression scores. Conclusion: Hypnotherapy appears to have use in this highly selected group of NCCP patients and warrants further assessment in the broader context of this disorder.
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long term benefits of Hypnotherapy for irritable bowel syndrome
Gut, 2003Co-Authors: W M Gonsalkorale, Vivien Miller, A Afzal, P J WhorwellAbstract:Background and aims: There is now good evidence from several sources that Hypnotherapy can relieve the symptoms of irritable bowel syndrome in the short term. However, there is no long term data on its benefits and this information is essential before the technique can be widely recommended. This study aimed to answer this question. Patients and methods: 204 patients prospectively completed questionnaires scoring symptoms, quality of life, anxiety, and depression before, immediately after, and up to six years following Hypnotherapy. All subjects also subjectively assessed the effects of Hypnotherapy retrospectively in order to define their “responder status”. Results: 71% of patients initially responded to therapy. Of these, 81% maintained their improvement over time while the majority of the remaining 19% claimed that deterioration of symptoms had only been slight. With respect to symptom scores, all items at follow up were significantly improved on pre-Hypnotherapy levels (p<0.001) and showed little change from post-Hypnotherapy values. There were no significant differences in the symptom scores between patients assessed at 1, 2, 3, 4, or 5+ years following treatment. Quality of life and anxiety or depression scores were similarly still significantly improved at follow up (p<0.001) but did show some deterioration. Patients also reported a reduction in consultation rates and medication use following the completion of Hypnotherapy. Conclusion: This study demonstrates that the beneficial effects of Hypnotherapy appear to last at least five years. Thus it is a viable therapeutic option for the treatment of irritable bowel syndrome.
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Long term benefits of Hypnotherapy for irritable bowel syndrome
Gut, 2003Co-Authors: W M Gonsalkorale, Vivien Miller, A Afzal, Peter J. WhorwellAbstract:Background and aims: There is now good evidence from several sources that Hypnotherapy can relieve the symptoms of irritable bowel syndrome in the short term. However, there is no long term data on its benefits and this information is essential before the technique can be widely recommended. This study aimed to answer this question. Patients and methods: 204 patients prospectively completed questionnaires scoring symptoms, quality of life, anxiety, and depression before, immediately after, and up to six years following Hypnotherapy. All subjects also subjectively assessed the effects of Hypnotherapy retrospectively in order to define their “responder status”. Results: 71% of patients initially responded to therapy. Of these, 81% maintained their improvement over time while the majority of the remaining 19% claimed that deterioration of symptoms had only been slight. With respect to symptom scores, all items at follow up were significantly improved on pre-Hypnotherapy levels (p
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gut focused Hypnotherapy normalizes disordered rectal sensitivity in patients with irritable bowel syndrome
Alimentary Pharmacology & Therapeutics, 2003Co-Authors: Richard Lea, W M Gonsalkorale, Lesley A Houghton, Patricia Cooper, E L Calvert, S Larder, V Whelan, J Randles, P Cruickshanks, Vivien MillerAbstract:SUMMARY Background: We have previously shown that Hypnotherapy alters rectal sensitivity in some patients with irritable bowel syndrome. However, this previous study used incremental volume distension of a latex balloon, which might be susceptible to subject response bias and might compromise the assessment of compliance. In addition, the study group was symptomatically rather than physiologically defined. Aim: To assess the effect of Hypnotherapy on rectal sensitivity in hypersensitive, hyposensitive and normally sensitive irritable bowel syndrome patients using a distension technique (barostat) that addresses these technical issues. Methods: Twenty-three irritable bowel syndrome (Rome I) patients (aged 24‐72 years) were assessed before and after 12 weeks of Hypnotherapy in terms of rectal sensitivity, symptomatology, anxiety and depression. Normal values for sensitivity were established in 17 healthy volunteers (aged 20‐55 years). Results: Compared with controls, 10 patients were hypersensitive, seven hyposensitive and six normally sensitive before treatment. Following Hypnotherapy, the mean pain sensory threshold increased in the hypersensitive group (P ¼ 0.04) and decreased in the hyposensitive group, although the latter failed to reach statistical significance (P ¼ 0.19). Normal sensory perception was unchanged. Sensory improvement in the hypersensitive patients tended to correlate with a reduction in abdominal pain (r ¼ 0.714, P ¼ 0.07). Conclusion: Hypnotherapy improves abnormal sensory perception in irritable bowel syndrome, leaving normal sensation unchanged.