Lay Summary

Proposal No. IBD-0213R
Principal Investigator:  David S. Rampton, DPhil
Applicant Organization:  Queen Mary and Westfield College, University of London (United Kingdom)
Project Title:  Hypnotherapy for prevention of relapse in ulcerative colitis: a randomized, single-blinded, controlled clinical trial
Period of Award:  October 1, 2007 – February 28, 2011

Worsening of ulcerative colitis (UC) can be provoked by psychological stresses.  As yet, there have been no proper scientific studies to find out whether stress reduction can improve the course of UC.  Hypnotherapy is a technique by which a practitioner induces a temporary trance-like state in patients.  The practitioner uses suggestion to induce relaxation as well as beneficial modification of the way in which the patient experiences the gut working.  In previous studies in our lab, we have shown that a single 50-minute session of hypnosis can reduce special indicators of inflammation both in the blood stream and in the lining of the lower bowel (rectum).

Many patients with UC need to take the immunosuppressive drug, azathioprine, in addition to a 5ASA drug, to keep their disease under control.  While azathioprine is usually effective in maintaining remission of UC, it does carry the risk of possible side effects.  We now plan to study hypnotherapy to see whether it can prevent relapse (worsening) of UC in patients who normally need to take azathioprine to keep their UC inactive.  To do this, we shall ask 66 patients who agree to participate in the trial to stop their azathioprine. They will be allocated to receive either gut-focussed hypnotherapy (44 patients) or, as a control, non-emotive educational sessions (22 patients) once a month for three months, with intervening self-hypnosis daily in the active arm.  We shall then record the numbers of patients in each group who develop relapse of their UC after six months and after a year.  We shall diagnose relapse from patients’ own diaries recording diarrhoea and bleeding, and by sigmoidoscopy.  As part of these studies, we shall also do particular blood tests and take specimens from the lining of the rectum during the sigmoidoscopy to assess by special laboratory testing how hypnotherapy might be working to reduce inflammation in the bowel.

It is hoped that this clinical trial will identify a new drug-free way of reducing the chances of relapse in patients with UC.  It should also shed further light on the ways in which the brain can affect the function of the inflamed bowel.