Hypnotherapy effective for noncardiac, non-GERD chest pain
Clinical Question
Is hypnotherapy an effective treatment for patients with recurrent chest pain but no evidence of reflux or heart disease?Clinical Question
Bottom Line
Hypnotherapy improves short-term symptoms and well-being in patients with noncardiac, nonreflux chest pain. Whether this persists over the long term is unknown. (LOE = 1b-)Bottom Line
Reference
Jones H, Cooper P, Miller V, Brooks N, Whorwell PJ. Treatment of non-cardiac chest pain: a controlled trial of hypnotherapy. Gut 2006;55:1403-1408. [PMID:16627548]Reference
Study Design
Randomized controlled trial (single-blinded)Study Design
Funding
GovernmentFunding
Allocation
ConcealedAllocation
Setting
Outpatient (specialty)Setting
Synopsis
Patients commonly return for evaluation of recurrent chest pain despite a previous evaluation that showed no evidence of heart disease or acid reflux. In this small but very well designed study, the researchers identified 28 patients with chest pain at least once a week who had a normal coronary catheterization, normal 24-hour esophageal pH monitoring, normal gastroscopy (if performed), and no response to a proton pump inhibitor (if taken). The patients were randomized to receive either hypnotherapy or supportive therapy as a control intervention. Patients initially met with their counselor or hypnotherapist weekly for 9 weeks, then every other week for 4 weeks, and then had a final visit 4 weeks later; sessions were 30 minutes long. Patients receiving supportive therapy also were given a placebo tablet to make the control intervention more convincing. The mean age of patients was 57 years, and analysis was by intention to treat. The primary outcomes were a global assessment of well-being (asking patients whether they felt completely better, moderately better, slightly better, no change, slightly worse, moderately worse, or much worse) and the score on a 100-point visual analog scale for chest pain. The hypnotherapy group improved significantly more than the control group for both outcomes. Regarding chest pain, 12 of 15 treated patients reported at least a 10-point improvement compared with 3 of 13 in the control group (80% vs 23%; P = .008). Similarly, 11 of 15 hypnotherapy patients reported improvement in global well-being compared with only 3 of 13 in the control group (73% vs 23%; P = .023).Synopsis
Citation
Barry, Henry, et al., editors. "Hypnotherapy Effective for Noncardiac, non-GERD Chest Pain." EE+ POEM Archive, John Wiley & Sons, 2019. Evidence Central, evidence.unboundmedicine.com/evidence/view/infoPOEMs/426737/all/Hypnotherapy_effective_for_noncardiac__non_GERD_chest_pain.
Hypnotherapy effective for noncardiac, non-GERD chest pain. In: Barry HH, Ebell MHM, Shaughnessy AFA, et al, eds. EE+ POEM Archive. John Wiley & Sons; 2019. https://evidence.unboundmedicine.com/evidence/view/infoPOEMs/426737/all/Hypnotherapy_effective_for_noncardiac__non_GERD_chest_pain. Accessed May 30, 2023.
Hypnotherapy effective for noncardiac, non-GERD chest pain. (2019). In Barry, H., Ebell, M. H., Shaughnessy, A. F., & Slawson, D. C. (Eds.), EE+ POEM Archive. John Wiley & Sons. https://evidence.unboundmedicine.com/evidence/view/infoPOEMs/426737/all/Hypnotherapy_effective_for_noncardiac__non_GERD_chest_pain
Hypnotherapy Effective for Noncardiac, non-GERD Chest Pain [Internet]. In: Barry HH, Ebell MHM, Shaughnessy AFA, Slawson DCD, editors. EE+ POEM Archive. John Wiley & Sons; 2019. [cited 2023 May 30]. Available from: https://evidence.unboundmedicine.com/evidence/view/infoPOEMs/426737/all/Hypnotherapy_effective_for_noncardiac__non_GERD_chest_pain.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC
T1 - Hypnotherapy effective for noncardiac, non-GERD chest pain
ID - 426737
ED - Barry,Henry,
ED - Ebell,Mark H,
ED - Shaughnessy,Allen F,
ED - Slawson,David C,
BT - EE+ POEM Archive
UR - https://evidence.unboundmedicine.com/evidence/view/infoPOEMs/426737/all/Hypnotherapy_effective_for_noncardiac__non_GERD_chest_pain
PB - John Wiley & Sons
DB - Evidence Central
DP - Unbound Medicine
ER -