The effect of hypnosis on systemic and rectal mucosal measures of inflammation in ulcerative colitis.
OBJECTIVE
Hypnotherapy is effective in several diseases with a psychosomatic component. Our aim was to study the effects of one session of hypnosis on the systemic and rectal mucosal inflammatory responses in patients with active ulcerative colitis (UC).


METHODS
In total, 17 patients with active UC underwent a 50-min session of gut-focused hypnotherapy. Before and after each procedure, the systemic inflammatory response was assessed by serum interleukin (IL)-6 and IL-13 concentrations, tumor necrosis factor-alpha (TNF-alpha) and IL-6 production by lipopolysaccharide (LPS)-stimulated whole blood, leukocyte count, natural killer (NK) cell number, platelet activation, and platelet-leukocyte aggregate formation. Rectal inflammation was assessed by mucosal release of substance P (SP), histamine, IL-13 and TNF-alpha, reactive oxygen metabolite production, and mucosal blood flow. Eight patients with active UC underwent a control procedure.


RESULTS
Hypnosis decreased pulse by a median 7 beats per minute (bpm) (P= 0.0008); it also reduced the median serum IL-6 concentration by 53% (P= 0.001), but had no effect on the other systemic variables assessed. Hypnosis reduced rectal mucosal release of SP by a median 81% (P= 0.001), histamine by 35% (P= 0.002) and IL-13 by 53% (P= 0.003), and also, blood flow by 18% (P= 0.0004). The control protocol had no effect on any of the variables assessed.


CONCLUSIONS
Hypnosis reduced several components of the systemic and mucosal inflammatory response in active ulcerative colitis toward levels found previously in the inactive disease. Some of these effects may contribute to the anecdotally reported benefits of hypnotherapy and provide a rationale for controlled trials of hypnotherapy in UC.
Centre for Gastroenterology, Institute of Cell and Molecular Science, Barts and the London, Queen Mary School of Medicine and Dentistry, London, UK.
Joel E
JE
Mawdsley
David G
DG
Jenkins
Marion G
MG
Macey
Louise
L
Langmead
David S
DS
Rampton
D000328:Adult; D003093:Colitis, Ulcerative / Q000378:metabolism / Q000473:pathology / Q000628:therapy*; D016207:Cytokines / Q000378:metabolism*; D005260:Female; D006801:Humans; D006990:Hypnosis; D018836:Inflammation Mediators / Q000378:metabolism*; D007413:Intestinal Mucosa / Q000098:blood supply / Q000378:metabolism / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012007:Rectum / Q000098:blood supply / Q000378:metabolism / Q000473:pathology; D012039:Regional Blood Flow / Q000502:physiology; D012812:Sigmoidoscopy; D016896:Treatment Outcome
D016207:Cytokines; D018836:Inflammation Mediators