Showing posts with label research. Show all posts
Showing posts with label research. Show all posts

Friday, September 12, 2014

Irritable bowel syndrome大腸激躁症


Irritable bowel syndrome (IBS) is a common disorder that affects the large intestine (colon). Irritable bowel syndrome commonly causes cramping, abdominal pain, bloating, gas, diarrhea and constipation. IBS is a chronic condition that you will need to manage long term.

Only a small number of people with irritable bowel syndrome have severe signs and symptoms. Some people can control their symptoms by managing diet, lifestyle and stress. Others will need medication and counseling.


The signs and symptoms of irritable bowel syndrome can vary widely from person to person and often resemble those of other diseases. Among the most common are:
  • Abdominal pain or cramping
  • A bloated feeling
  • Gas
  • Diarrhea or constipation — sometimes alternating bouts of constipation and diarrhea
  • Mucus in the stool
For most people, IBS is a chronic condition, although there will likely be times when the signs and symptoms are worse and times when they improve or even disappear completely.
Symptoms that may indicate a more serious condition include:
  • Rectal bleeding
  • Abdominal pain that progresses or occurs at night
  • Weight loss

MIND: Tailored Gut directed Hypnotherapy for IBS

Hypnosis has been shown to be an effective treatment for irritable bowel syndrome (IBS) in a number of clinical studies. Hypnotherapy for IBS involves progressive relaxation, and then suggestions of soothing imagery and sensations focused on the individual’s symptoms. Improvements in overall well-being, quality of life, abdominal pain, constipation, diarrhea, and bloating have been noted.

Contrary to many portrayals in fiction, a clinical hypnotherapist has no power over the hypnotized person. The person is typically aware of what happens both during and after the hypnosis session. The treatment is generally comfortable and also can be effective when people are treated in groups.

Research has found that hypnotherapy may help improve the primary symptoms of IBS. It may also help relieve other symptoms suffered by many people with IBS such as nausea, fatigue, backache, and urinary problems. Hypnotherapy appears to offer symptomatic, psychological, and physiological benefit.

However, hypnosis should not be regarded as a cure-all. Up to 25% of patients fail to respond. Even when people do improve, conventional approaches to treatment should not always be ignored. It is still important that lifestyle factors such as diet are also taken into account. In addition, some people may find that an occasional loperamide or laxative, depending on the bowel habit abnormality, may be required.

Do the effects of hypnotherapy last once a course of treatment has been completed? 
Research on the long-term follow up of patients who have benefited shows that after a period of between 1 and 5 years, most remain well with many requiring no further medication at all.

Hypnotherapy can be a time-consuming and costly approach in the short term. However, as a result of the sustained benefits of treatment, it has been calculated that it becomes cost effective within 2 years when compared to conventional approaches.

How to Select a Hypnotherapist?

1) Does this person have formal training and significant experience in clinical hypnosis and psychology field? Using hypnosis with good success requires considerable skill and knowledge. In general, 50 hours or more of certified workshop training in hypnosis would be good, although less is sometimes adequate.

2) Does this person know the details of successful hypnosis treatment protocols for IBS? Hypnosis in itself is probably not sufficient to treat IBS effectively. Specific gut-directed hypnotherapy method need to be included.

Hypnosis is just one of many in the treatment options for IBS. Other psychological methods, cognitive therapy in particular, are also effective options. Hypnosis may be especially suitable when severe chronic symptoms continue after standard medical management approaches have been tried. It has become clear that in such cases, hypnosis treatment can often produce major improvement that can last for years.

Research about how clinical hypnotherapy can help Irritable Bowel Syndrome:

The Efficacy of Hypnotherapy in the Treatment of Irritable Bowel Syndrome: A Systematic Review and meta-analysis

This study provides clearer evidence that hypnotherapy has beneficial short-term effects in improving gastrointestinal symptoms of patients with IBS.

Efficacy, tolerability, and safety of hypnosis in adult irritable bowel syndrome: systematic review and meta-analysis. 

This meta-analysis demonstrated that hypnosis was safe and provided long-term adequate symptom relief in 54% of patients with irritable bowel syndrome refractory to conventional therapy.

BRAIN Perspective: EEG biofeedback for IBS

Individuals who suffer from Irritable Bowel Syndrome (IBS) may experience a range of symptoms, from mild annoyance to severe, debilitating distress. Symptoms can range from chronic, mild dysregulation of gut motility to episodes of diarrhea or constipation that incapacitate the patient and cause loss of time at work, withdrawal from family activities, and even hospitalization. It is estimated that about 20% of North Americans suffer from IBS, with twice as many women than men diagnosed each year.

Research in neuroscience has revealed that the intestinal tract and the brain are intimately related in terms of hormonal activity and autonomic nervous system connections. This is referred to as the "Gut-Brain Connection." Individuals with IBS frequently present with evidence of abnormal high frequency brain wave activity in the frontal lobes where emotional regulation occurs.

These unbalanced brain waves can be altered with Neurofeedback training (see box on right) to correct the abnormal activity and either partially or completely relieve the symptoms of IBS.

Neurotherapy/EEG biofeedback training begins with a brain assessment procedure to locate the sources of unbalanced brain wave activity. Following this, training begins and may last for 10 to 15 sessions. Each session may last for 30-40 minutes. We use symptom checklists, clinical history and patient reports to assess the progress of treatment.

How it works?
EEG biofeedback training for Irritable Bowel Syndrome (IBS) is a way of learning how to control your brain's electrical activity in order to alleviate the distress of IBS. EEG biofeedback training can significantly reduce or even eliminate IBS symptoms and painful sensations in patients who have an underlying dysregulation of the Autonomic Nervous System ("Fight/Flight/Freeze" emotional response).

The technique is simple and painless: Brainwave sensors are attached to the scalp at strategic locations and the information from the brain is processed digitally with sophisticated computer programs. Audio or visual displays give feedback to the patient about the frequency and amplitude of the brain activities that are implicated in IBS sensations. Music or video feedback allows the patient to become successful in changing the brain wave patterns and as a result, the IBS is greatly relieved or eliminated.

What is EEG biofeedback? 
EEG biofeedback training is a simple, painless learning technique that involves teaching your brain waves to become more functional and effective. The most comprehensive definition of EEG biofeedback comes to us from the International Society for Neurofeedback and Research (ISNR). Go to for more information.

EEG biofeedback does not involve either surgery or medication and is neither painful nor embarassing. When provided by a licensed professional with appropriate training, generally trainees do not experience negative side-effects. Typically trainees find NFT to be an interesting experience. EEG biofeedback training operates at a brain functional level and transcends the need to classify using existing diagnostic categories. It modulates the brain activity at the level of the neuronal dynamics of excitation and inhibition which underly the characteristic effects that are reported.

Research demonstrates that EEG biofeedback is an effective intervention for ADHD and Epilepsy. Ongoing research is investigating the effectiveness of EEG biofeedback for other disorders such as Autism, headaches, insomnia, anxiety, substance abuse, TBI and other pain disorders, and is promising.


腹脹、腹鳴、腹瀉、便秘、肚子疼痛不適,大概是所有人都曾經驗過的症狀,但許多人無論怎麼吃藥、看醫師,問題就是無法改善,每天都得面臨不斷跑廁所、或「大」不出來的痛苦,這些人都是大腸激躁症(Irritable Bowel Syndrome)的受害者。大腸激躁症,或稱為大腸急躁症、腸躁症、刺激性腸症候群、急躁性腸症候群、腸躁症候群,指的都是一種腸道的功能性異常;就和其五花八門的中文譯名一樣,這種疾病的症狀也相當複雜,有人易腹瀉、有人易便秘、有人則腹瀉與便秘交錯發生。

1.        腹部絞痛
2.        腹部脹氣、鼓脹
3.        腹瀉、便秘、或腹瀉與便秘交互出現
4.        常與情緒反應有關,如工作忙碌時、重大考試前都會加重症狀
5.        雖長期受腸胃症狀困擾,通常體重並不會減輕,也不會有嚴重的併發症
1.        要先就醫檢查,排除其他症狀相似的疾病,如:乳糖耐受不良、大腸癌等。
2.        調適心理、適應壓力,若是可能盡量避免給自己太過的壓力。
3.        正常的作息,規律的運動。
4.        避免刺激性的飲食,如:菸、酒、咖啡、茶葉等。
5.        攝取足量的高纖維性食物。
6.        若症狀仍持續,應考慮調整神經傳導物質,以恢復自律神經之正常生理功能。
大腸激躁症不是『器質性腸胃科疾病』,而是屬於『功能性疾病』( functional disorder )之一』。---所有功能性疾病皆由『自律神經失調』所引起,自律神經系統分佈至各內臟器官,管理各內臟器官的功能運作,一旦自律神經失調,則其所調控的內臟出現其相關疾病(例如:大腸激躁症 )。所以,大腸激躁症的治療不能從腸胃科取向去做,應從自律神經取向方能治本。
1.        改變飲食習慣:不談公事、輕鬆進食、細嚼慢嚥。
2.        改變食譜:不吃乳製品、油脂食物、酒精、咖啡因的飲料。食物力求低脂、少糖、少鹽、適度的蛋白質、高纖維食物。
3.        生活減壓:壓力與腸子的蠕動有密切的關係。尤其每天在壓力鍋當中打滾的人們,更是有機會罹患大腸激躁症。每天工作八小時當中,找空檔舒緩身心。勤練肌肉鬆弛術、靜坐,平衡身心靈。
4.        天天運動:運動除了強身之外,更可以放鬆心情,消除鬱悶的情緒,強化腸胃的機能。
5.        正常的作息、充足的睡眠。
6.        改變個性:完美主義的人,容易給自己壓力,也常出現焦慮、憂鬱或身心症狀。所以改變對事物的看法與態度,降低標準,隨遇而安,腸胃自然沒承受太多的壓力。
7.        尋找適當的醫療:激躁性腸症並非一般拉肚子,幾天就可以康復的 。必須有耐心的就醫,配合腸胃科與精神科藥物方能奏效。

(Clinical Hypnotherapist Hiro Koo: 催眠在临床研究上,临床催眠对IBS大腸激躁症的疗效是受承认和备受肯定的。)


Thursday, September 4, 2014


EEG Biofeedback for PAIN AND HEADACHE meets all of the criteria for Level 4: Efficacious 


Explanation of Efficacy Levels

Biofeedback and neurofeedback therapies have continued to develop over the last 40 years. Today there are myriad disorders for which is used. Large research grants have funded studies on neurofeedback therapy for a variety of disorders. These studies consistently report positive results.

In 2001, a Task Force of the Association for Applied Psychophysiology and Biofeedback and the Society for Neuronal Regulation developed guidelines for the evaluation of the clinical efficacy of psychophysiological interventions. The board of directors of both organizations subsequently approved these guidelines.

A low efficacy rating does not mindicate that neurofeedback is not effective for the disorder, only that an insufficient number of studies have been completed for conclusive results. 

Level 1: Not Empirically Supported
Supported only by anecdotal reports and/or case studies in nonpeer-reviewed venues. Not empirically supported.

Level 2: Possibly Efficacious
At least one study of sufficient statistical power with well-identified outcome measures but lacking randomized assignment to a control condition internal to the study.

Level 3: Probably Efficacious
 Multiple observational studies, clinical studies, wait-list controlled studies, and within-subject and intrasubject replication studies that demonstrate efficacy.

Level 4: Efficacious
a. In a comparison with a no-treatment control group, alternative treatment group, or sham (placebo) control utilizing randomized assignment, the investigational treatment is shown to be statistically significantly superior to the control condition, or the investigational treatment is equivalent to a treatment of established efficacy in a study with sufficient power to detect moderate differences, and
b. The studies have been conducted with a population treated for a specific problem, for whom inclusion criteria are delineated in a reliable, operationally defined manner, and
c. The study used valid and clearly specified outcome measures related to the problem being treated, and
d. The data are subjected to appropriate data analysis, and
e. The diagnostic and treatment variables and procedures are clearly defined in a manner that
permits replication of the study by independent researchers, and
f. The superiority or equivalence of the investigational treatment has been shown in at least two independent research settings.

Level 5: Efficacious and Specific
Evidence for Level 5 efficacy meets all of the criteria for Level 4. In addition, the investigational treatment has been shown to be statistically superior to credible sham therapy, pill, or alternative bonafide treatment in at least two independent research settings.

Disclaimer: All the articles, documents or publications mentioned by or linked on this site have been provided as a public service. There is absolutely no endorsement of any statement made in any of these documents, articles, or publications.

Research studies:
Bazanova, O.M., Aftanas, L.I. (2010).Individual EEG alpha activity analysis for enhancement neurofeedback efficiency: Two case studies.  Journal of Neurotherapy14(3), 244 – 253.
Coger, R., & Werbach, M. (1975). Attention, anxiety, and the effects of learned enhancement of EEG alpha in chronic pain: A pilot study in biofeedback. Chapter in B. L. Drue, Jr. (Ed.), Pain Research and Treatment. New York: Academic Press.
Gannon, L., & Sternbach, R. A. (1971). Alpha enhancement as a treatment for pain: A case study. Behavior Therapy & Experimental Psychiatry, 2, 209-213.
Ham, L. P., & Packard, R. C. (1996). A retrospective, follow-up study of biofeedback-assisted relaxation therapy in patients with posttraumatic headache. Biofeedback & Self-Regulation, 21(2), 93-104.
Jensen, M.P., Sherlin, L.H., Hakimian, S., Fregni, F. (2009). Neuromodulatory approaches for chronic pain management: Research findings and clinical implications.Journal of Neurotherapy 13(4), 196 – 213.
Jensen, M. P., Grierson, C., Tracy-Smith, V., Bacigalupi, S. C., Othmer, S. (2007).  Neurofeedback treatment for pain associated with complex regional pain syndrome. Journal of Neurotherapy, 11(1), 45-53. 
Lehmann, D., Lang, W., & Debruyne, P. (1976). Controlled EEG alpha feedback training in normals and headache patients. Archives of Psychiatry, 221, 331-343.
Matthew, A., Mishm, H., & Kumamiah, V. (1987). Alpha feedback in the treatment of tension headache. Journal of Personality & Clinical Studies, 3(1), 17-22.
McKenzie, R., Ehrisman, W., Montgomery, P. S., & Barnes, R. H. (1974). The treatment of headache by means of electroencephalographic biofeedback. Headache, 13, 164-172.
Pelletier, K. R., & Pepper, E. (1977). Developing a biofeedback model: Alpha EEG feedback as a means for pain control. International Journal of Clinical & Experimental Hypnosis, 25, 361-371.
Rosenfeld, J. P., Dowman, R., Heinricher, N., & Silvia, R. (1984). Operantly controlled somatosensory evoked potentials: Specific effects on pain processes. Chapter in B. Rockstroh, T. Elbert, W. Lutzenberger, & N. Birbaumer (Eds.), Self-Regulation of the Brain and Behavior. Berlin: Springer-Verlag, pp. 164-179.
Rosenfeld, J. P., Silvia, R.,Weitkunat, R., & Dowman, R. (1985). Operant control of human somatosensory evoked potentials alters experimental pain perception. Chapter in H. L. Fields, R. Dubner, & F. Cervero (Eds.), Advances in Pain Research and Therapy, Volume 9: Proceedings of the Fourth World Congress on Pain. New York: Raven Press, 343-349.
Sime, A. (2004). Case study of trigeminal neuralgia using neurofeedback and peripheral biofeedback. Journal of Neurotherapy, 8(1), 59-71.
Siniatchkin, M., Hierundar, A., Kropp, P., Kuhnert, R., Gerber, W-D., & Stephani, U. (2000). Self-regulation of slow cortical potentials in children with migraine: An exploratory study. Applied Psychophysiology & Biofeedback, 25(1), 13-32.
Tansey, M. A. (1991). A neurobiological treatment for migraine: The response of four cases of migraine to EEG biofeedback training. Headache Quarterly: Current Treatment & Research, 90-96.


Thursday, August 21, 2014

Menopause-related hot flashes treatment in Malaysia

Hypnosis is an effective treatment for menopause-related hot flashes and night sweats, new research finds.
The alternative therapy reduced hot flashes by as much as 74% in the study conducted by researchers at Baylor University’s Mind-Body Medicine Research Laboratory and funded by the National Institutes of Health.
Only hormone therapy, which many women can’t take or want to avoid, is more effective for treating the most common symptom of menopause, says researcher Gary R. Elkins, PhD.
“If you compare this treatment with off-label use of antidepressants or other non-hormonal therapies, it works as well or better,” he says.

Hot Flashes, Night Sweats

Hot flashes are a sudden rush of heat, followed by facial flushing and sweating, often followed by chills and clamminess. The progression is familiar to most women of a certain age.
Hot flashes and night sweats are the most common symptoms of menopause, affecting some 80% of women.
They are linked to declining estrogen levels, but it remains unclear just why the sudden lack of estrogen sends the body into thermal mayhem, and why some women are more affected than others.
Hormone therapy is a very effective treatment for menopause-related hot flashes, but concerns about risks have limited its use among women.
“There is certainly a need for non-pharmacologic treatments for hot flashes and night sweats,” says North American Menopause Society (NAMS) Executive Director Margery Gass, MD.

Hypnosis and Hot Flashes

In an earlier study, Elkins and his Baylor colleagues showed that hypnosis dramatically reduced hot flash and night sweat frequency in breast cancer patients with treatment-related symptoms.
In the newly published study, they set out to determine if the alternative treatment would do the same in women whose symptoms were related to menopause.
A total of 187 postmenopausal women who reported having at least seven hot flashes a day, or 50 a week, were recruited for the trial.
Half the women were given self-hypnosis training that consisted of five, 45-minute weekly sessions.
During the sessions they received suggestions for mental imagery designed to minimize the intensity of their hot flashes, such as images of a cool place. The women were also given a recording of the hypnotic induction, and they were asked to practice self-hypnosis at home daily.
The rest of the women had an equal number of sessions with a clinician, but hypnosis training was not given.
Instead, clinicians talked to the women about their symptoms and gave them encouragement about how to deal with them. These women were also asked to listen to a recording each day at home, but their recording simply had information about hot flashes.
The study participants kept "hot flash frequency" diaries, and they also wore small sensors on their bodies that recorded their hot flashes.

Hot Flashes Less Frequent and Intense

After 12 weeks:
  • Women in the hypnosis group reported 74% fewer hot flashes on average, compared with 17% fewer among the other women.
  • The skin sensors showed a 57% reduction in hot flashes among the hypnosis group, compared to a 10% reduction in the non-hypnosis group.
  • The women treated with hypnosis were far less likely than the other women to report that their hot flashes interfered with their daily lives and sleep.
“Many women do not want to take hormone therapy or any drug for hot flashes,” Elkins says. “This study shows that an alternative, non-drug treatment can be highly effective.”
Elkins recommends that women who want to try the treatment seek out a qualified practitioner affiliated with either the American Society of Clinical Hypnosis or the Society for Clinical and Experimental Hypnosis.
Gass says she would like to see Elkins’ findings duplicated, but she adds that hypnosis could prove to be a badly needed new treatment for hot flashes.
“This will certainly appeal to women who want to avoid drugs and who want a treatment that has few, if any, side effects,” she says.
The study, which was published this week in the journal Menopause, was funded by the NIH’s National Center for Complementary and Alternative Medicine.


Wednesday, August 20, 2014

Tinnitus Treatment Malaysia (Non Drug Approach)

It is important to keep in mind that tinnitus is a symptom, not a disease. As such, the optimal treatment strategy should be directed toward eliminating the disease, rather than simply alleviating the symptom. Also, because tinnitus may be symptomatic of a more serious disorder, it is important to try to find the medical cause before deciding on treatment.

Preventing and Minimizing Tinnitus

Here are a few things patients can do to help prevent and minimize tinnitus:
  • Reduce exposure to extremely loud noise
  • Avoid total silence
  • Decrease salt intake
  • Monitor one's blood pressure
  • Avoid stimulants such as caffeine and nicotine
  • Exercise
  • Reduce fatigue
  • Manage stress
  • Educate yourself
While there is no known cure for most forms of tinnitus, there are many management options available and most tinnitus sufferers can find varying degrees of relief from one or a combination of the following.


There is no single medication that works on all tinnitus patients. 

Counseling or Cognitive-Behavioral Therapy

Regardless of the cause of tinnitus, if a person is not bothered by the tinnitus, it ceases to be a problem. Psychological intervention aimed at successfully reducing the stress, distress and distraction associated with the tinnitus can be very productive and often produces the most attainable goals.

Stress Management

The very high correlation between stress and tinnitus disturbance underscores the need to maintain one's composure and logic when trying to cope with tinnitus. Relaxation, guided imagery and self-hypnosis are examples of self-help methods used to help combat the stress, anxiety and sleep disturbances associated with tinnitus.

Other Treatment Options

Other options that may help patients with tinnitus include:
  • Support Groups — Local peer support groups offer emotional support to patients and a place to discuss and share treatment techniques.
  • Dental Treatment — Jaw joint disorders, called temporomandibular (TMD), may exacerbate tinnitus. Splints and exercises may relieve these problems.
  • Nutritional Counseling — All tinnitus patients should maintain a balanced diet.
  • Biofeedback Training— Biofeedback is a technique of making unconscious or involuntary bodily processes detectable by the senses in order to manipulate them by conscious mental control. Biofeedback with counseling can help relieve stress patterns that can worsen the perception of tinnitus.
  • Alternate Approaches — Although there is no scientific data showing consistent benefit from approaches such as hypnosis, acupuncture, naturopathy, chiropractic care and many herbal preparations, some patients do perceive a benefit.
Reviewed by health care specialists at UCSF Medical Center.

Research study: How EEG biofeedback training can help for Tinnitus
Biofeedback-based behavioral treatment for chronic tinnitus: 
results of a randomized controlled trial.

The effects of neurofeedback on oscillatory processes related to tinnitus.

EEG biofeedback for subjective tinnitus patients.

EEG biofeedback for treating tinnitus.

Tuning the tinnitus percept by modification of synchronous brain activity.

Chronic tinnitus: which kind of patients benefit 
from an outpatient psychotherapy ?

Research study: How hypnotherapy can help for Tinnitus

Role of hypnotherapy in the treatment of debilitating tinnitus.

Effectiveness of Ericksonian hypnosis in tinnitus therapy: preliminary results.

Effectiveness of combined counseling and low-level laser 
stimulation in the treatment of disturbing chronic tinnitus.

Ericksonian hypnosis in tinnitus therapy.

Effects of relaxation therapy as group and individual 
treatment of chronic tinnitus.

Hypnosis for Tinnitus.