title: Effects of gut-directed hypnotherapy on IBS in different clinical settings-results from two randomized, controlled trials.
abstract: OBJECTIVE
  Gut-directed hypnotherapy has been found to be effective in irritable bowel syndrome (IBS). However, randomized, controlled studies are rare and few have been performed outside highly specialized research centers. The objective of this study was to study the effect of gut-directed hypnotherapy in IBS in different clinical settings outside the traditional research units.
  
  
  METHODS
  The study population included IBS patients refractory to standard management. In study 1, patients were randomized to receive gut-directed hypnotherapy (12 sessions, 1 h/week) in psychology private practices or supportive therapy, whereas patients were randomized to receive gut-directed hypnotherapy in a small county hospital or to serve as waiting list controls in study 2. Gastrointestinal symptom severity and quality of life were evaluated at baseline, at 3 months follow-up and after 1 year.
  
  
  RESULTS
  We randomized 138 IBS patients refractory to standard management, 90 in study 1 and 48 in study 2. In both the studies, IBS-related symptoms were improved at 3 months in the gut-directed hypnotherapy groups (P<0.05), but not in the control groups (ns). In study 1, a significantly greater improvement of IBS-related symptom severity could be detected in the gut-directed hypnotherapy group than in the control group (P<0.05), and a trend in the same direction was seen in study 2 (P=0.17). The results seen at 3 months were sustained up to 1 year.
  
  
  CONCLUSIONS
  Gut-directed hypnotherapy is an effective treatment alternative for patients with refractory IBS, but the effectiveness is lower when the therapy is given outside the highly specialized research centers.
authors.affiliation: Department of Internal Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Perjohan
authors.initials: P
authors.lastname: Lindfors
authors.forename: Peter
authors.initials: P
authors.lastname: Unge
authors.forename: Patrik
authors.initials: P
authors.lastname: Arvidsson
authors.forename: Henry
authors.initials: H
authors.lastname: Nyhlin
authors.forename: Einar
authors.initials: E
authors.lastname: Björnsson
authors.forename: Hasse
authors.initials: H
authors.lastname: Abrahamsson
authors.forename: Magnus
authors.initials: M
authors.lastname: Simrén
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D006990:Hypnosis / Q000379:methods*; D043183:Irritable Bowel Syndrome / Q000523:psychology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D011795:Surveys and Questionnaires; D016896:Treatment Outcome