6th Annual BMRP Investigator Meeting - Abstract
Hypnotherapy for Prevention of Relapse in Ulcerative Colitis: A Randomised, Single-Blind, Controlled Clinical Trial
Mahmood Wahed1, Anton Emmanuel2, Louise Langmead2, Joel Mawdsley3, David Rampton1,a, Jeremy Sanderson4, Marianne Smith2
1Digestive Diseases Clinical Academic Unit, Queen Mary School of Medicine and Dentistry; 2Department of Gastroenterology, University College Hospital; 3 Department of Gastroenterology, West Middlesex University Hospital; 4Department Gastroenterology, St. Thomas’ Hospital (London, United Kingdom)
Gut-focussed hypnosis (GFH) is a trance-like state during which suggestion is used to induce relaxation and improve patients’ experience of gut function: it is effective in irritable bowel, duodenal ulcer and non-ulcer dyspepsia. We have previously shown in UC that 50 mins of GFH reduces measures of inflammation in blood and rectal mucosa. Emotional stress may provoke relapse in UC, but the therapeutic potential of stress reduction has not been formally assessed.
Many patients with UC need azathioprine (or mercaptopurine) to maintain remission. Thiopurines require regular blood checks and can cause side-effects. We have started a trial to see whether GFH can reduce the relapse rate after 6 and 12 months in patients stopping azathioprine. 66 such patients will be randomised to GFH (with intervening self-hypnosis daily) (n=44) or, as a control, non-emotive educational sessions (n=22) monthly for 3 months. Relapse is diagnosed using the Simple Clinical Activity Index and at sigmoidoscopy (Baron score > 1). We also measure routine blood tests, serum IL6 and IL13 levels, and rectal mucosal release of substance P, TNFα, IL13 and histamine at 0, 1 and 12 months.
It is hoped that this trial will identify a new drug-free way of reducing the risk of relapse in patients with UC withdrawing from thiopurine treatment. It should also shed further light on the ways in which the brain affects the function of the inflamed bowel.
aPrincipal Investigator