Gut-Directed Hypnotherapy for Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis.

Abstract

Background: Gut-directed hypnotherapy has been shown to be an effective treatment for irritable bowel syndrome, but prior studies have been small with variable delivery modalities. This systematic review and meta-analysis investigates the efficacy of gut-directed hypnotherapy for irritable bowel syndrome (IBS) symptoms and the impact of delivery characteristics.

Methods: PubMed, Embase, and Web of Science were searched. Titles and abstracts, then full text articles, were screened for inclusion criteria. Studies were extracted and assessed for bias using the Cochrane Collaboration risk-of-bias tool. A meta-analysis was performed to assess the impact of gut-directed hypnotherapy on global IBS symptoms and pain. A sub-group analysis was conducted to assess the impact of gut-directed hypnotherapy delivery characteristics on IBS-related outcomes.

Results: Twelve studies in 11 papers met inclusion criteria, involving 1158 patients with IBS. Eight studies provided continuous measures sufficient for meta-analysis. On systematic review, all 12 studies found gut-directed hypnotherapy to be superior to the comparator; nine were statistically significant. On meta-analysis, gut-directed hypnotherapy improved global IBS symptoms (SMD 0.73 [-0.09-1.55], I² 93%). Gut-directed hypnotherapy with high-volume delivery and gut-directed hypnotherapy delivered in groups showed statistically significant improvement in global IBS symptoms (SMD 0.56 [0.29-0.83], I² 0%; SMD 0.41 [0.05-0.77], I² 61%). Gut-directed hypnotherapy also significantly improved pain more than its comparator groups (SMD 0.25 [0.01-0.49], I² 17%).

Conclusion: Gut-directed hypnotherapy may improve global symptoms of IBS. In particular, GDH improved pain symptoms compared to other standard IBS interventions. GDH delivered in groups was effective at reducing global IBS symptoms compared to standard interventions.