Gastroenterology

Gastroenterology

Volume 123, Issue 6, December 2002, Pages 1778-1785
Gastroenterology

Clinical–Alimentary Tract
Long-term improvement in functional dyspepsia using hypnotherapy,☆☆

https://doi.org/10.1053/gast.2002.37071Get rights and content

Abstract

Background & Aims: We have shown hypnotherapy (HT) to be effective in irritable bowel syndrome, with long-term improvements in symptomatology and quality of life (QOL). This study aimed to assess the efficacy of HT in functional dyspepsia (FD). Methods: A total of 126 FD patients were randomized to HT, supportive therapy plus placebo medication, or medical treatment for 16 weeks. Percentage change in symptomatology from baseline was assessed after the 16-week treatment phase (short-term) and after 56 weeks (long-term) with 26 HT, 24 supportive therapy, and 29 medical treatment patients completing all phases of the study. QOL was measured as a secondary outcome. Results: Short-term symptom scores improved more in the HT group (median, 59%) than in the supportive (41%; P = 0.01) or medical treatment (33%; P = 0.057) groups. HT also benefited QOL (42%) compared with either supportive therapy (10% [P < 0.001]) or medical treatment (11% [P < 0.001]). Long-term, HT significantly improved symptoms (73%) compared with supportive therapy (34% [P < 0.02]) or medical treatment (43% [P < 0.01]). QOL improved significantly more with HT (44%) than with medical treatment (20% [P < 0.001]). QOL did improve in the supportive therapy (43%) group, but 5 of these patients commenced taking antidepressants during follow-up. A total of 90% of the patients in the medical treatment group and 82% of the patients in the supportive therapy group commenced medication during follow-up, whereas none in the HT group did so (P < 0.001). Those in the HT group visited their general practitioner or gastroenterologist significantly less (median, 1) than did those in the supportive therapy (median, 4) and medical treatment (median, 4) groups during follow-up (P < 0.001). Conclusions: HT is highly effective in the long-term management of FD. Furthermore, the dramatic reduction in medication use and consultation rate provide major economic advantages.

GASTROENTEROLOGY 2002;123:1778-1785

Section snippets

Patients

All patients attending the endoscopy unit at the University Hospital of South Manchester with dyspeptic symptoms and a negative endoscopy were considered for the study, and those fulfilling the Rome I19 criteria for FD were recruited. Patients were excluded if they had predominant gastroesophageal reflux-like symptoms, had a history of peptic ulcer disease, or were regularly using nonsteroidal anti-inflammatory drugs. All patients with a history of abdominal surgery, with the exception of

Results

Recruitment of patients and their flow through each stage of the study, as recommended by the CONSORT statement,28 are illustrated in Figure 2.

. Study flow diagram. Reprinted with permission from Department of Medical Illustration, Withington Hospital, Manchester, England.

A total of 149 patients were eligible for the study, of which 23 (15%) declined to participate, leaving 126 patients. Of these 126 patients, 32 were randomized to receive HT; 48, to supportive therapy; and 46, to medical

Discussion

This study clearly demonstrates that HT is more effective than medical treatment or supportive therapy plus placebo medication in both the short- and long-term management of FD. HT not only improves all aspects of symptomatology and QOL, but also has considerable economic advantages. Of particular interest is the striking difference in the medication needs of the 3 groups. None of the patients receiving HT resumed any form of drug therapy, whereas 90% of patients in the medical group and 82% of

Acknowledgements

The authors thank Professor M. J. S. Langman for helpful criticism during the preparation of this manuscript.

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  • Cited by (0)

    Address requests for reprints to: Peter J. Whorwell, M.D., Department of Medicine, Education and Research Centre, Wythenshawe Hospital, Southmoor Road, Manchester M23 9LT, United Kingdom. e-mail: [email protected]; fax: (44) 161-434-5194.

    ☆☆

    Supported by a grant from the Wellcome Trust.

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