Date of Award

2018

Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant

Department

Physician Assistant Studies

Department Chair

John Cavenagh, MBA, PhD, PA-C

Abstract

OBJECTIVE: The objective of this selective EBM review is to determine whether or not “Is gutdirected hypnotherapy an effective treatment for refractory IBS?”

STUDY DESIGN: Review of three English language primary studies, one of which was published in 2012 and two in 2013.

DATA SOURCES: Two randomized controlled trials (RCTs) and one case study published in peer-reviewed journals analyzing the effects of gut-directed hypnotherapy (GHT) on irritable bowel syndrome (IBS) symptoms were found via PubMed and Cochrane databases.

OUTCOMES MEASURED: IBS symptoms including abdominal pain, abdominal distention, more or less frequent stools, looser or harder stools, diarrhea, and constipation were measured through the GI Symptom Questionnaire. Five domains including fatigue, impact on daily activities, sleep disturbance, emotional distress, and eating habits were measured through the IBS Impact Scale. Both the GI symptom questionnaire and the IBS-IS are measured on a sevengraded Likert Scale.

RESULTS: The two RCTs by Moser, et al. and Lindfors, Unge, et al. showed a statistically significant improvement in IBS symptoms at the primary endpoint of intervention (3 months) (p=0.046 and p<0.01 respectively) and again at the 1-year follow-up (p=0.04 and p<0.01 respectively). The case study by Lindfors, Ljotsson, et al. also had a statistically significant improvement from baseline to 3 months (p=0.005).

CONCLUSION: The RCTs by Moser, et al. and Lindfors, Unge, et al. gave adequate evidence that gut-directed hypnotherapy is an effective treatment for refractory IBS. The unclear and inconclusive results in Lindfors, Ljotsson, et al. reduces this confidence due to the poorly explained methods and statistical analysis. Further investigation is warranted to confidently determine the effectiveness of gut-directed hypnotherapy on IBS symptoms.

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