Help
Subscribe


GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy

 22 February 2018

Advanced search
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Roy Pounder

Home

News  
Journals
Review Articles
Slide Atlas
Video Clips
Online Books
Advanced Digestive Endoscopy
Classical Cases
Conference Diary
PubMed
International GH Links
USA GH Links
National GH Links
National GI Societies
Other Useful Links




Emails on Gastroenterology and Hepatology
the National AIDS Treatment Advocacy Project
Visit the gastroenterology section of the EUMS

News

Patient-practitioner relationship can improve IBS outcomes

This week's issue of the British Medical Journal investigates components of the placebo effect in a trial in patients with irritable bowel syndrome.

News image

fiogf49gjkf04

Professor Ted Kaptchuk and colleagues from Massachusetts, USA investigated whether placebo effects can experimentally be separated into 3 components.

The 3 components included assessment and observation ('waiting list patients'), a therapeutic ritual (placebo treatment), and a supportive patient-practitioner relationship.

The team progressively combined these 3 components to produce incremental clinical improvement in patients with irritable bowel syndrome.

The global improvement scale score was 5 for the ‘augmented' treatment group
British Medical Journal

The team assessed the relative magnitude of these components in 262 adults, with a mean age of 39 years.

The patients were diagnosed by Rome II criteria, and had a score of 150 on the symptom severity scale.

For 3 weeks, patients were either allocated to a waiting list (observation), or placebo acupuncture alone (the ‘limited‘ group).

A third group was given placebo acupuncture with a patient-practitioner relationship augmented by warmth, attention, and confidence (the ‘augmented‘ group).

At 3 weeks, half of the patients were randomly assigned to continue in their originally assigned group for an additional 3 weeks.

The team measured global improvement scale, adequate relief of symptoms, symptom severity score, and quality of life.

The researchers found that at 3 weeks, scores on the global improvement scale were 3.8, 4.3, and 5 for waiting list, ‘limited', and ‘augmented' treatment groups, respectively.

The proportion of patients reporting adequate relief showed a similar pattern.

The team noted that 28% on the waiting list, 44% in the limited group, and 62% in the augmented group reported adequate relief.

The researchers found the same trend in response existed in symptom severity score, and quality of life.

All pairwise comparisons between augmented and limited patient-practitioner relationship were significant.

Those with augmented patient-practitioner relationship showed improvements in the global improvement scale, adequate relief of symptoms, symptom severity score, and quality of life.

The research team observed that results were similar at 6 week follow-up.

Professor Kaptchuk's team concluded, "Factors contributing to the placebo effect can be progressively combined in a manner resembling a graded dose escalation of component parts."

"Non-specific effects can produce statistically and clinically significant outcomes and the patient-practitioner relationship is the most robust component."

BMJ 2008: 336(5): 999-1003
06 May 2008

Go to top of page Email this page Email this page to a colleague

 22 February 2018 
Outcomes with Crohn’s after infliximab withdrawal
 22 February 2018 
Elderly onset of IBD

 22 February 2018 
Autophagy enhancers
 21 February 2018 
Management of hemorrhoids in the USA
 21 February 2018 
Adalimumab and infliximab in biologic-naïve Crohn's
 21 February 2018 
Cystic fibrosis and colorectal cancer
 20 February 2018 
Complications and surveillance colonoscopies
 20 February 2018 
Treatment algorithm for polyp cancers
 20 February 2018 
Predictors of postoperative infection in Crohn's
 19 February 2018 
Screening colonoscopy in the right and left colon
 19 February 2018 
NAFLD prevalence in the USA
 19 February 2018 
Fructans in children with IBS

 16 February 2018 
Inflammatory bowel diseases are global diseases
 16 February 2018 
Undetected celiac in the elderly
 16 February 2018 
Fructans induce non-celiac gluten sensitivity
 15 February 2018 
NSAIDS and GI damage
 15 February 2018 
Oral direct-acting antiviral treatment for Hep C virus genotype 1
 15 February 2018 
Primary vs secondary surgery for the presence of lymph node metastasis
 14 February 2018 
Predicting adenoma detection rate
 14 February 2018 
Normal bowel frequency characterization in the USA 
 13 February 2018 
Personalising treatment options for IBS
 13 February 2018 
Prebiotics improve endothelial dysfunction
 13 February 2018 
Diagnostic criteria for a Rome IV functional gastrointestinal disorders
 12 February 2018 
Visceral hypersensitivity and functional GI disorders
 12 February 2018 
Depression and aggressive IBD
 12 February 2018 
Variability in interpretation of endoscopic findings impacts patient management
 09 February 2018 
Treatment of choice for anastomotic stricture in IBD
 09 February 2018 
PRO measurement information system 
 09 February 2018 
Overall disease severity indices for IBD
 08 February 2018 
Prediction of endoscopically active disease

 08 February 2018 
Steroid-refractory acute severe ulcerative colitis
 08 February 2018 
Decision aid used by IBD patients
 07 February 2018 
Ursodeoxycholic acid combined with bezafibrate for itching
 07 February 2018 
Change in microbiome in gastritis vs gastric carcinoma
 07 February 2018 
Colorectal cancer and primary sclerosing cholangitis-IBD
 06 February 2018 
Risk of death after liver transplantation
 06 February 2018 
Crohn’s disease vs refractory pouchitis
 06 February 2018 
Support for functional dyspepsia symptom diary
 05 February 2018 
Helicobacter spp influence on GI tract 
 05 February 2018 
No link found between severe reflux and all-cause mortality 
 05 February 2018 
Psychological distress in PPI non-responders
 02 February 2018 
Assessing psychosexual impact of IBD
 02 February 2018 
Decrease in overall mortality with cholera vaccination
 02 February 2018 
Diagnostic performance of fecal immunochemical tests
 01 February 2018 
Screening frequency with family histories of colorectal cancer
 01 February 2018 
IBD and sport participation
 01 February 2018 
Life with a stoma 
 31 January 2018 
Aprepitant and gastroparesis 
 31 January 2018 
Anesthesia risk in colonoscopy
 31 January 2018 
GED-0301 for Crohn's Disease
 30 January 2018 
Intestinal dysbiosis and allergic diseases in infants
 30 January 2018 
Fructans and IBS symptoms in children
 29 January 2018 
Dosing calculator for therapy optimization in IBD
 29 January 2018 
Glecaprevir–pibrentasvir for in HCV
 29 January 2018 
Food allergen injections in eosinophilic esophagitis
 29 January 2018 
Reliability of the IBD index
 26 January 2018 
Tofacitinib vs biological therapies for ulcerative colitis
 26 January 2018 
Optimizing selection of biologics in IBD
 26 January 2018 
Nutritional risk and laparoscopic-assisted gastrectomy outcomes
 25 January 2018 
Patient-reported outcome measure for functional dyspepsia

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2018 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us