According to the NHS 1 in 10 of the UK population currently suffers from Irritable Bowel Syndrome (IBS), with 1 in 5 likely to suffer at some point in their life. Women in particular are more likely to be affected, being twice as likely as men to suffer from the condition.
For those struggling with IBS the symptoms can be painful and upsetting. In addition to the discomfort caused by bloating, stomach cramps, diarrhoea or constipation, sufferers also have to contend with the potential embarrassment that a sudden onset of symptoms can have.
Although there is no cure for IBS, treatment conducted at the University Hospital of South Manchester shows that hypnosis can bring relief for many sufferers.
What is Irritable Bowel Syndrome?
IBS has no known organic cause and is considered a disorder of the gut-brain axis. Although onset of the condition can be as a result of an infection, for many people the symptoms are made worse by stressful situations as well as negative feelings and emotions. Clients who are more sensitive to emotional troubles, or who struggle with anxiety in particular, can be more prone to IBS. In fact, research shows that about 60% of IBS sufferers also meet the criteria for one or more psychiatric disorder. Unfortunately, a vicious cycle is developed, whereby sufferers become anxious about their condition, leading to more discomfort and more anxiety. For example, someone who has IBS which causes diarrhoea can become very anxious about making motorway journeys because of the fear of not getting to a toilet in time if an an attack comes on.
IBS sufferers are also thought to be more sensitive to any discomfort in the gut. When under stress or anxiety, the flight or fight response is triggered, which leads to the digestion system slowing down or stopping. This can lead to bloating, intestinal pain, feelings of nausea and “butterflies” (which is caused by extra sensitivity in the gut).
So, although IBS isn’t caused by stress or anxiety, you can see that the symptoms are very similar and that the body’s response to stress is likely to increase the symptoms and discomfort of IBS sufferers.
What is known to help?
Anyone dealing with IBS, or who thinks that they have IBS, needs to visit their GP for a proper diagnosis and advice about what might help alleviate symptoms. For many people stress management can be key in reducing symptoms. Techniques such as hypnosis, mindfulness, yoga or simple breathing techniques can be helpful as well as psychological treatments such as Cognitive Behavioural Therapy. Moderate exercise is also known to improve symptoms, and of course can also be a great stress reliever.
Because the symptoms vary so much between different sufferers, dietary advice will depend on how someone responds to different foods. However, general advice from the NHS includes:
- having regular meals and taking your time when eating
- drinking at least eight cups of fluid a day
- restricting your tea and coffee intake to a maximum of three cups a day
- reducing the amount of alcohol and fizzy drinks you drink
- reducing your intake of resistant starch, which is often found in processed or re-cooked foods
- limiting fresh fruit to three portions a day
- if you have diarrhoea, avoid Sorbitol (an artificial sweetener)
For those who require it, there are also a number of medications that can be used to treat IBS including antispasmodics, which can reduce stomach cramps; laxatives, to relieve constipation; and antimotility medicine to relieve diarrhoea.
Gut Directed Hypnotherapy for IBS
At the University Hospital of South Manchester, Professor Peter Whorwell and his colleagues have conducted hypnosis based IBS treatment for hundreds of patients. Their research shows hypnotherapy helped 71% of patients and their improvements lasted 5 years. In fact so effective is the treatment that in February 2008 the National Institute of Clinical Excellence (NICE), which gives guidance to the NHS on effective treatments, reported that there was good evidence that hypnotherapy was an effective treatment for IBS and that it could be recommended for chronic IBS.
The treatment, described as Gut-Directed Hypnotherapy, differs from other approaches because it aims to teach patients hypnotic skills to control and help normalise gut function, rather than just as a way of creating relaxation or reducing psychological stress. This is particularly beneficial as many IBS patients who struggle with physical symptoms can be put off by a psychological approach and the idea that “it is all in your head”.
The treatment lasts a maximum of 12 sessions, with many patients requiring fewer sessions, and patients are usually seen weekly. Although there is a treatment structure, the therapists highlight the importance of individualising treatment to best meet the needs of patients. After the initial assessments are completed patients are taught a simple hypnotic induction, creating a feeling of deep relaxation. It is explained to patients that hypnosis is a skill that can be learnt, practiced and developed. It is also explained that using hypnosis is a way of helping them to tap into and direct the unconscious mind’s ability to regulate bodily functions and to control the gut.
A hypnotic “anchor” is also developed during these early sessions, linking the word “calm” to the feelings of relaxation and wellbeing created through hypnosis. Patients are taught to use the word “calm” at other times and places whenever they want to feel calm and relaxed. Patients are also given recordings of sessions that they can use at home in between sessions.
As the treatment progresses a variety of techniques are used to help patients to start to take control of their gut and to reduce and eliminate unpleasant symptoms. For example, patients use hypnosis to create a comfortable, healing warmth on their abdomen. This technique is useful for soothing discomfort in the gut. Another technique involves asking patients to use their imagination to picture an image which represents their gut working normally. This imagery could be literal or metaphorical, such as imagining a gentle flowing stream. By focusing on this positive image patients are able to influence the functioning of the gut.
Patients are also taught how to use hypnosis to rehearse the type of situations that can lead to fear of anxiety. For example, in the case of patient who is anxious about motorway journeys they can use hypnosis to imagine themselves driving in their car feeling relaxed, calm, comfortable and in control.
Finally, for clients who require it, additional help is offered around improved breathing patterns, helping them to breath deeper and slower, as well as identify lifestyle changes such as incorporating short breaks throughout the day. At the end of treatment patients are offered “top-up” sessions if symptoms should flare up. Although many patients appreciate the offer, knowing they have extra support if they need it, very few of the patients actually take the therapists up on their offer.
Although hypnosis is not a cure for IBS it is a proven treatment which can greatly reduce symptoms and help patients go back to a “normal life”. I’m pleased to say that I can now offer treatment based upon the Manchester model for anyone struggling with IBS.
If you are interested in finding out more please contact me on 0161 298 7070 or [email protected]
photo credit: beautiful young woman drinking water in the morning via photopin (license)