Esophageal-directed hypnotherapy was well tolerated and improved symptoms and quality of life in patients with functional heartburn in a pilot study.
“Visceral hypersensitivity and symptom hypervigilance are believed to drive functional heartburn and therefore conventional medical interventions, such as anti-reflux therapy, are not typically effective. This leaves people with limited treatment options for a burdensome medical problem,” Megan E. Riehl, PsyD, a licensed health psychologist and clinical instructor in the division of gastroenterology at University of Michigan, told Healio Gastroenterology. “Esophageal directed hypnotherapy is used to promote a deep state of relaxation with focused attention, which allows the patient to learn to modulate physiological sensations, such as heartburn.”
Megan E. Riehl
John E. Pandolfino
To assess the feasibility, acceptability and clinical utility of esophageal-directed hypnotherapy in patients with functional heartburn, Riehl and colleagues, including John E. Pandolfino, MD, from the Esophageal Center at Northwestern University Feinberg School of Medicine in Chicago, performed an open-label controlled trial of nine adults with functional heartburn (8 women; mean age, 44.9 years) who were recruited from a proton pump inhibitor nonresponder phenotyping study.
Participants underwent 7 weekly hypnotherapy sessions plus CD-guided exercises for daily use at home, and completed questionnaires before and after treatment to assess symptoms, psychological functioning, perceived stress, health-related quality of life and hypnotizability. They were allowed to continue their treatment regimen during the study, including PPIs.
After treatment, visceral anxiety decreased (P = .01), emotional quality of life increased (P = .05), symptom severity decreased (P = .01) and there was a trend for reduced heartburn catastrophizing (P = .06). All participants reported their symptoms improved, with half reporting their esophageal symptoms improved “substantially.”
“Our study was the first to show that hypnotherapy produced improvements in heartburn symptoms, decreased visceral anxiety and improved quality of life,” Riehl said. “This offers patients a non-pharmaceutical option for the treatment of their refractory heartburn symptoms.” – by Adam Leitenberger
The researchers report no relevant financial disclosures.