4th Annual BMRP Investigator Meeting - Abstract

The Effect of Hypnotherapy on Systemic and Rectal Mucosal Measures of Inflammation in Ulcerative Colitis

Joel Mawdsley, Marion Macey, David Jenkins, Louise Langmead and David Rampton^a

Centre for Adult and Paediatric Gastroenterology, Institute of Cell and Molecular Science, Barts and the London, Queen Mary School of Medicine and Dentistry (London, United Kingdom)

Introduction: Hypnotherapy is effective for functional gastrointestinal disorders and claimed by some patients to improve ulcerative colitis (UC).  The possible mechanisms by which hypnotherapy might act are unknown.

Aims: To study the effects of hypnotherapy on systemic and rectal mucosal inflammatory responses in patients with active UC.

Methods: 17 patients with active UC and 11 healthy controls underwent a 50 minute session of gut focused hypnotherapy.  Seven patients with active UC and 11 healthy controls underwent a control procedure.  Before and after each session, systemic inflammatory response was assessed by serum IL-6 and IL-13 concentrations, TNF-alpha and IL-6 production by lipopolysaccharide (LPS)-stimulated whole blood, Natural Killer (NK) cell numbers, platelet activation and platelet-leucocyte aggregate (PLA) formation.  In patients with UC, rectal mucosal inflammation was assessed by TNF-alpha, IL-13, histamine and substance P concentrations in peri-mucosal fluid, reactive oxygen metabolite (ROM) production and rectal mucosal blood flow (RMBF).

Results: Hypnotherapy decreased pulse by median 7 bpm (p=0.0008) and BP by median 2mmHg (p=0.04).  In patients with UC, hypnotherapy reduced serum IL-6 concentration by 51% (p=0.009), but had no effect on serum IL-13 concentration or IL-6 or TNF-alpha production by LPS-stimulated whole blood.  Hypnotherapy caused a transient reduction of 17% in NK cell numbers (p=0.01), but had no effect on platelet activation or PLA formation.  At the mucosal level, hypnotherapy caused a reduction in the concentration in peri-mucosal fluid of SP by median 81% (p=0.0006), histamine by median 35% (p=0.003) and IL-13 by median 54% (p=0.004).  Hypnotherapy also reduced rectal mucosal blood flow by 18% (p=0.0002).  The control protocol did not change any of the variables measured.

Conclusion: Hypnotherapy reduces certain systemic and mucosal measures of inflammation that could contribute to its reported therapeutic efficacy of UC.

^aPrincipal Investigator