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Long-Term Success of GUT-Directed Group Hypnosis for Patients With Refractory Irritable Bowel Syndrome: A Randomized Controlled Trial

Moser, Gabriele MD1; Trägner, Silja MD1; Gajowniczek, Ewelina Elwira MD1; Mikulits, Andrea MD1; Michalski, Maria MD1; Kazemi-Shirazi, Lili MD1; Kulnigg-Dabsch, Stefanie MD1; Führer, Martina MD2; Ponocny-Seliger, Elisabeth PhD3; Dejaco, Clemens MD1; Miehsler, Wolfgang MD1

American Journal of Gastroenterology: April 2013 - Volume 108 - Issue 4 - p 602–609
doi: 10.1038/ajg.2013.19
Functional GI Disorders
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OBJECTIVES: Gut-directed hypnotherapy (GHT) in individual sessions is highly effective in the treatment of irritable bowel syndrome (IBS). This study aimed to assess the long-term effect of GHT in group sessions for refractory IBS.

METHODS: A total of 164 patients with IBS (Rome-III-criteria) were screened, and 100 refractory to usual treatment were randomized 1:1 either to supportive talks with medical treatment (SMT) or to SMT with GHT (10 weekly sessions within 12 weeks). The primary end point was a clinically important improvement on several dimensions of daily life (assessed by IBS impact scale) after treatment and 12-month follow-up. The secondary end point was improvement in general quality of life (QOL; Medical Outcome Study Short-Form-36), psychological status (Hospital Anxiety Depression Scale) and reduction of single IBS symptoms. Analysis was by intention to treat.

RESULTS: A total of 90 patients received allocated intervention. After treatment, 28 (60.8%) out of 46 GHT patients and 18 (40.9%) out of 44 SMTs improved (absolute difference 20.0%; 95% confidence interval (CI): 0–40.2%;P=0.046); over 15 months, 54.3% of GHT patients and 25.0% of controls improved (absolute difference 29.4%; 95% CI 10.1–48.6%;P=0.004). GHT with SMT improved physical and psychological well being significantly more than SMT alone (P<0.001). Gender, age, disease duration and IBS type did not have an influence on the long-term success of GHT.

CONCLUSIONS: GHT improves IBS-related QOL, is superior to SMT alone, and shows a long-term effect even in refractory IBS.

1 Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria

2 Anton Proksch Institute (Psychiatry), Vienna, Austria

3 Sigmund Freud Private University, Vienna, Austria

Correspondence: Gabriele Moser, MD, Universität Klinik für Innere Medizin III, Abteilung für Gastroenterologie und Hepatologie, Währinger Gürtel 18-20, WienA-1090, Austria. E-mail: gabriele.moser@meduniwien.ac.at

SUPPLEMENTARY MATERIAL accompanies this paper at http://links.lww.com/AJG/A720, http://links.lww.com/AJG/A721

Received 30 July 2012; accepted 13 January 2013

published online 19 February 2013

© The American College of Gastroenterology 2013. All Rights Reserved.
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