Hypnotherapy for Functional dyspepsia
Functional dyspepsia (FD) is a disorder of the digestion, specifically movement and sensation in the gut are not acting appropriately. In FD the reason for this failure to act properly cannot be observed in any physical sense, there is no blockage or malformation but rather the digestion is misfiring for some reason. FD is believed to effect between 11-29% of people, although many of these may not be diagnosed cases. (Mahadeva and Goh 2006) Functional dyspepsia is not considered life threatening but does have significant impacts upon the person’s quality of life.(Talley et al 2006)
Typically suffers experience such symptoms as;
· Heartburn and acid reflux.
· Nausea.
· Gas and bloating.
It is generally treated with medication including;
· Acid neutralisers (i.e. Gaviscon).
· Proton pump inhibitors.
· H2 receptor antagonists.
And Life style changes are strongly advised, specifically;
· Smoking cessation.
· Weight reduction.
· Reduction in alcohol consumption.
· Avoidance of trigger food (often spicy and acidic foods).
· Smaller meals.
· Avoiding food 3-4 hours before bed.
However, most treatment has limited effect and the opinion amongst clinicians is starting to favour the use of hypnotherapy.(Sharma 2008)
Hypnotherapy for Functional dyspepsia – The evidence
The key study which underscores the use of hypnotherapy for Functional dyspepsia is a 2002 study carried out by the team at Witherington Hospital in Manchester (UK). (Calvert et al) Patients with functional dyspepsia were randomise to one of three groups;
1. Supportive therapy with a placebo – an experienced researcher giving advice on management and listening to the concerns of patients for 12 x 30minute sessions over 16 weeks.
2. Medical treatment – four visits to receive advised medication. Over 16 weeks.
3. Hypnotherapy – 12×30 minute sessions over 16 weeks.
At the end of the 16 weeks of treatment patients were then tested against baseline scores of symptoms and quality of life, this was repeated at 56 weeks. At both 16 and 56 weeks hypnotherapy showed greater improvements than the other two interventions for both symptoms and quality of life. It is noteworthy that hypnotherapy patients appeared to carry on getting better, they showed even greater improvement at 56 weeks than they did at 16. Although this study by no means answers all the questions around hypnotherapy for FD (Chitkara & Talley 2003), it does highlight its effectiveness.
Hypnotherapy for Functional dyspepsia – The treatment
The model of treatment used in the Manchester study (Calvert et al 2002) employed the following elements.
1) Education and explanation – What FG is & how hypnotherapy can help.
2) Hypnotic induction using eye fixation followed by progressive relaxation and deepening.
3) Suggestions for feeling better and imagery to encourage symptom reduction. Specifically, the patient places their hand on their abdomen and imagine a reduction of symptoms.
4) Direct suggestions to encourage healthy peristalsis, reduced digestive sensitivity and healthy secretion of acids and mucus
5) Visualisation of a comfortable gastric transition, preferably using a metaphor.
A hypnotherapist may wish to help the person with FD in making behavioural changes in line with the recommended lifestyle changes (see above). In addition to the smoking cessation and weight loss work the therapist may consider desensitisation to trigger foods where anticipatory anxiety may have become a factor.
The author – Matt Krouwel is a clinical hypnotherapist specialising in digestive issues. He is currently conduction research with the University of Birmingham (UK).
Hypnotherapy for Functional dyspepsia – References
Calvert, E. L., Houghton, L. A., Cooper, P., Morris, J., & Whorwell, P. J. (2002). Long-term improvement in functional dyspepsia using hypnotherapy. Gastroenterology, 123(6), 1778-1785.
Chitkara, D., & Talley, N. J. (2003). Hypnotherapy for functional dyspepsia: do the results add up?. Gastroenterology, 125(2), 636.
Mahadeva, S., & Goh, K.-L. (2006). Epidemiology of functional dyspepsia: A global perspective. World Journal of Gastroenterology : WJG, 12(17), 2661–2666. http://doi.org/10.3748/wjg.v12.i17.2661
Sharma, R. L. (2008). Functional Dyspepsia: At least recommend hypnotherapy. Bmj, 337(7674), 832.
Talley, N. J., Locke, G. R., Lahr, B. D., Zinsmeister, A. R., Tougas, G., Ligozio, G., … Tack, J. (2006). Functional dyspepsia, delayed gastric emptying, and impaired quality of life. Gut, 55(7), 933–939. http://doi.org/10.1136/gut.2005.078634