medical hypnotherapy for ibs
Gut-directed hypnosis. Hypnotherapy for Irritable Bowel Syndrome. An Effective Alternative Therapy
Living with irritable bowel syndrome (IBS) can be very stressful. Add to that all the experimentation with diets and medication and other alternative treatments and the stress and problems in the gut only seems to get worse! Is hypnotherapy for IBS just another alternative treatment?
Hypnotherapy for irritable bowel syndrome has several advantages in its favor to what you’ve already tried. First, it is meant to relax the body and mind. Just that can have an amazing effect on the gut. Additionally, gut-directed hypnosis, the technical term for hypnotherapy for IBS, has been proven in research to be between 70 to 90% effective in reducing the severity of symptoms. That, for any type of treatment, is a fantastic track record. And best of all, it works for those patients that don’t respond to the standard medical care of IBS.
Definition of Hypnosis Irritable Bowel Syndrome
IBS is a disorder of the digestion and gut. Symptoms of IBS include discomfort and pain in the gut, constipation, diarrhea, and gas or bloating. It can produce significant physical discomfort and disrupt your normal life to the point that many chose to stay home to avoid activities and environments that might lead to loss of control or risk public humiliation.
It is estimated that up to 20% of the Western populations experience IBS. The majority are women.
Irritable Bowel Syndrome is not a disease. It is a functional disorder of the lower gastrointestinal tract. IBS is a group of symptoms that have no physiological or anatomical cause identified. What this means is that, though IBS symptoms are incredibly distressing, there is no physical damage being done to the body that is causing these symptoms.
What is causing these physical discomforts are functional processes of the gut:
- Digestive motility (how the muscles in the gut move food through). With IBS it can be blocked, slowed down, or be sudden.
- Gastrocolic reflex (the speed at which taking food in and needing to go to the restroom). With IBS this reflex is sped up to where it appears to be almost simultaneous.
- Sensitivity. Some sufferers of IBS are extremely aware of the sensations of the gut and can experience severe pain during normal gut processes.
How is IBS Diagnosed?
Before starting any alternative treatments, you must first be diagnosed by a doctor that what you are experiencing is Irritable Bowel Syndrome (IBS). The diagnosis is made by excluding other conditions as there are no specific tests for IBS. Most conditions tested can be ruled out by blood tests as long as there are no red flags of serious conditions that require immediate medical attention. Additionally, your doctor needs to rule out celiac disease.
If you’ve been diagnosed with IBS, your doctor will have already checked and found that you do not have any of the red flags for other diseases. That means that what you are experiencing is functional and, fortunately, that can be managed very well with hypnotherapy!
If you’ve been diagnosed with Functional Abdominal Pain (FAP), it means that you experience recurrent abdominal pain with no other symptoms. If you have other symptoms such as abnormal bowel movements (diarrhea, constipation or both), it is considered IBS. Both are considered functional disorders and both respond very well to alternative therapies that address how the GI system functions and the effect of stress. Hypnotherapy can do both.
Irritable Bowel Syndrome Causes
There is no known cause of IBS. The current consensus is that most patients experienced gut changes after a strong emotional trigger (such as grief or sexual abuse), high density of life stressors (a change in school or an ongoing stressful job), or an illness such as a violent stomach bug. And the symptoms did not go away. Also, it seems to run in families (its thought to be more a childhood learning to focus on tummy troubles than a genetic predisposition). There are also incidents in which people find no obvious reason for their struggles with diarrhea, constipation, stomach pain or all the above.
Though nobody knows what causes IBS, this does not mean it cannot be controlled. Worrying about your IBS can cause more stomach upset (nausea, knots, pain… just as worrying about an exam). Often the worry about it’s cause will lead to focusing more on any symptoms that indicate additional tummy issues and that focus leads to even more discomfort. It’s kind of like the chicken and the egg. It doesn’t matter which came first, however, what matters is regaining control.
Treatments – Hypnosis – Irritable Bowel Syndrome
As the mechanisms for experiencing IBS are unclear and complex, IBS has proven a difficult treatment target for conventional medical approaches. Most conventional treatments have only 10-15% effectiveness above the placebo response, and at best are only effective for half of the patients. Most treatments try to target the most predominant symptoms (such as diarrhea or pain) but have little evidence of effectiveness for IBS in general (American College of Gastroenterology Functional Gastrointestinal Disorders Task Force, 2002).
Some of the most frequent treatments are
- Soluble Fiber
- Dietary exclusion and food intolerance
Less than half of IBS patients are satisfied with the outcome of standard medical treatment (Thompson, Heaton, Smyth, & Smyth, 1997). Thus extensive efforts have been made to identify alternative IBS therapies that can complement conventional medicine and improve outcomes. Of these, psychological treatments have proven most promising.
Can Mind-Body Therapies affect IBS Symptoms?
Of all the psychological treatments- biofeedback, behavioral, cognitive and cognitive-behavioral therapy, relaxation training, psychodynamic therapy, and hypnosis – CBT and hypnosis have proven most effective in controlled studies. They have a substantial impact on the symptoms of irritable bowel syndrome.
Hypnosis and IBS
The use of hypnosis, as an alternative IBS therapy, when patients that do not respond to standard medical care is not new (you can find its history here). There are well over 30 years of studies that demonstrate its effectiveness both for IBS as well as FAP (functional abdominal pain). One randomized and placebo-controlled study that attracted a lot of attention when it was published was from Whorwell and his colleagues in Manchester in 1984. Their study showed that the hypnosis group had a 95% success rate after three months of treatment and the group continued to show improvement a year and a half after the treatment was completed. Since then, at least 15 other studies have shown positive outcomes with hypnosis. The only published research on hypnotherapy for IBS was in 1994 at the University of Carolina.
“Hypnosis should be the treatment of choice for cases of IBS which have not responded to conventional therapy,” – Adriane Fugh-Berman, MD, chairman of the National Women’s Health Network, Washington D.C
The NIH (National Institute of Health) has recognized that hypnosis may help with IBS. The American Journal of Gastroenterology review of psychological therapies concluded that hypnotherapy is beneficial for IBS symptoms. In the UK, where most of the research has been done, NICE (The National Institute for Health and Care of Excellence in the UK) directly recommends it for patients who have not responded to standard medical care.
Why Use Gut-Directed Hypnosis for the Treatment of IBS?
Gut-directed hypnosis can help irritable bowel syndrome in two key ways. First, it teaches you how to control physical symptoms with positive thoughts and techniques. What is known as ‘mind over matter.’ The second is learning to focus on feeling calmer, more confident and in control, ‘if you don’t mind, then it doesn’t matter,’ allows symptoms to fade and seem less important.
What is the Typical Protocol of Gut-Directed Hypnotherapy?
Hypnosis treatment of IBS typically consists of 7 to 12 individual therapy sessions spaced over 3-months. Children tend to do very well with 4 to 6 sessions. The treatments substantially reduce all central symptoms of IBS (abdominal pain, bloating or distention, and bowel dysfunction such as diarrhea or constipation). Abdominal pain is one of the symptoms most greatly reduced by an average of 50% or more. Additionally, these treatments also reduce symptoms of depression, anxiety, and improve quality of life. And the benefits of gut-directed hypnosis last for years. Up to 81% of those that initially improved from treatment fully maintained their relief up to 5 years after hypnosis. (Gonsalkorale, Miller, Afzal, & Whorwell, 2003)
What Can You Expect in Each IBS Hypnotherapy Session?
Each treatment session begins with a hypnotic induction (a way to help you focus inward similar to meditation) followed by suggestions to help you physically relax. Then therapeutic suggestions and imagery focused on either managing symptoms, on mental states or both are given. Finally, the client is brought back out of trance typically through a slow counting and re-alerting. Medical hypnotherapy is very gentle. Most clients experience deep relaxation, sometimes a sense of floatiness, heaviness or warmth, but never experience being totally unconscious, blacked out, or somehow controlled by the therapist.
Between therapy sessions, clients are asked to listen to hypnosis audios regularly for the duration of the treatment course. The daily use of hypnosis at home is considered to be an important part of the treatment.
Children and Hypnosis Irritable Bowel Syndrome
Though the use of hypnosis for IBS was proven since the 80’s, it was not clearly demonstrated to work as effectively with children until 2007 (you can read the study at the Royal Dutch Hospital for Children Amsterdam here). This study demonstrated that hypnotherapy could be used effectively with children as well. What’s even more meaningful of the study was that the children studied had very severe cases of IBS and FAP (functional abdominal pain). The children had experienced their symptoms for an average of 3 years, did not respond to previous medical care, and had either FAP, IBS or both with an average of two bouts of pain a day. After six sessions of “gut-directed hypnotherapy” over a three month period, the group that received hypnosis showed 84% improvement (30% improved and 54% no longer experiencing symptoms). What’s even more impressive is that the improvements increased with time to 96% a year after treatment.