3rd Annual BMRP Investigator Meeting - Abstract

Stress, Hypnosis and Ulcerative Colitis

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

Centre for Gastroenterology, Barts & The London School of Medicine and Dentistry, Queen Mary, University of London (London, England)

Introduction:  Psychological stress reportedly exacerbates IBD.  Hypnotherapy improves irritable bowel and duodenal ulcer and has been proposed as treatment for ulcerative colitis (UC).  How these effects are mediated is unknown.

Aims:  To compare the effects of acute psychological stress and relaxation-inducing hypnosis on systemic and rectal measures of inflammation in UC.

Methods:  15 patients with inactive UC and 16 with active UC underwent 50 minutes of acute stress (IQ test while different music is played into each ear), gut-focused hypnosis, or control (relaxing music).  Autonomic response was assessed by pulse and BP; systemic response by circulating NK cells, platelet activation, platelet-leucocyte aggregate (PLA) formation (flow cytometry) and LPS-stimulated production of IL6 by whole blood (ELISA); and rectal mucosal response by reactive oxygen metabolite (ROM) production (chemiluminescence) and Doppler blood flowmetry.

Results:  In inactive UC, stress significantly (P<0.05) increased pulse rate (mean +7%), systolic BP (+6%), NK cells (+29%), platelet activation (+37%), PLA formation (+41%), and blood IL-6 production (+23%); it increased rectal ROM release by 66%, and reduced blood flow by 15%.  In active UC, hypnosis significantly reduced pulse rate (-6%), NK cells (-15%) and rectal blood flow (-26%), but caused no other changes.  The control protocol had no detectable effects.

Conclusions:  In UC, acute psychological stress increases several potentially pathogenic systemic and mucosal variables.  These findings are relevant not only to IBD, but also to other diseases such as ischemic heart disease and stroke.  To further explore the effects of hypnosis, study of the results of repeated sessions is ongoing.

^aPrincipal Investigator