If you have experienced abdominal pain or discomfort, bloating, and/or change in bowel habits for at least six months, then you might have irritable bowel syndrome (IBS).

Irritable bowel syndrome (IBS) is a functional disorder. A person with IBS has symptoms
without any visible physical or organic cause. As such, IBS is not a disease. Although symptoms
of IBS are incredibly distressing, there is no physical damage being done to the gut. Unfortunately, several very serious diseases have similar symptoms. Thus, it is wise to get a diagnosis to exclude these other possibilities.

How is IBS Diagnosed?

The criteria used to diagnose IBS is by exclusion. The physician will test for other diseases that
have similar symptoms first. If tests do not show that there are any physical damage nor markers that indicate an inflammatory disease (such as cancer, Crohn’s disease, Ulcerative Colitis or Celiac disease), then the diagnosis of IBS is given.

It is essential to get a diagnosis for IBS. Diagnosis will ensure that any life-threatening causes for the discomfort have been tested for and ruled out.

One of the methods to diagnose IBS is the Rome Criteria.

The Rome Diagnostic Criteria

1. 3 months of continuous or recurring symptoms of abdominal pain or irritation that

• May be relieved with a bowel movement,
• May be coupled with a change in frequency, or
• May be related to a change in the consistency of stools

2. Two or more of the following are present at least 25% of the time:

• A change in stool frequency (more than 3 bowel movement per day or fewer
  than 3 bowel movements per week)
• Noticeable difference in stool form (hard, loose and watery stools or poorly
  formed stools)
• Passage of mucus in stools
• Bloating or feeling of abdominal distension
• Altered stool passage (sensations of incomplete evacuation, straining, or urgency)

Other Symptoms, not part of Rome Criteria that can be present:

• Nausea
• Fatigue
• Full sensation after even a small meal
• Vomiting

IBS Categories

Irritable Bowel Syndrome can be categorized as IBS-C (primarily constipation), IBS-D (mainly diarrhea), or IBS-A (if it alternates between constipation and diarrhea). The category will influence the type of treatment (and in gut-directed hypnosis, it will influence the kind of direct suggestions used).

Treatments for IBS

There are many treatments for IBS. Treatment generally includes general lifestyle changes, physical activity, diet, and symptom-targeted medication. Patients usually don’t seek hypnotherapy until they have tried all other standard treatments and have found no relief.  Fortunately, hypnosis has proven to be most effective with the worst cases, as well as refractory IBS. The NICE’s guidelines for managing IBS recommends hypnotherapy for these cases.

What is IBS?

Here are some facts to understand about IBS – what IBS is and isn’t:

1. IBS is not a disease. As it has symptoms similar to other gut-related diseases, their
   physician will first rule out those diseases. IBS does not do any physical damage to the
   body. Trust the diagnoses. Instead, IBS is a functional disorder. The gut and digestive system are not functioning optimally leading to pain, bloating, diarrhea, and constipation.
2. IBS is common. Irritable bowel syndrome affects between 10 – 20% of the population.
3. The gut is sensitive to stress. When the body is in stress mode, rushing to work, worrying about finances, or thinking over and over about that relationship conflict, digestion is disrupted. Chronic stress can create chronic disruption and functional disturbances in digestion.
4. Worrying about your health or your digestion makes it worse. As mentioned in the previous point, worry and anxiety can cause stomach upset. When the stomach is upset, catastrophizing about it can lead to further discomfort. It is essential to learn techniques to relax and release anxiety. Guided meditation, breathing exercises, mantras, and hypnotherapy are all great tools to retrain the mind to avoid worry.

What causes IBS?

There are several factors that may initiate gut and abdominal problems as well as maintain them.
Below are the most common but not all of them. For some clients, there appears to be no apparent reason why they experience IBS.

1. Post-infection – there is evidence to suggest that at least in some cases, IBS develops
   following a severe gut infection (stomach bug). It is believed that the infection only initiates
   the response as there is little evidence of IBS sufferers having unusually high levels of
   bacterial or viral infections.
2. Stress or Strong Emotional trigger – Suffers frequently display high levels of stress.
   Continuous parasympathetic states can freeze and irregulate digestion. Additionally, strong
   emotions, such as grief, have been shown to occur at the onset of IBS. There is
   evidence of more substantial than the average personal history of abuse amongst sufferers. Additionally
   to life stressors, symptoms of IBS are responsible for much of the sufferer’s stress, which in
   turn may maintain or worsen the symptoms.
3. Family history – IBS and disorders of the gut tend to run in families. There may be a genetic component to this. Still, it is also believed that the models of illness presented from one generation to the next may also play a factor (focusing on the same symptoms and issues as our parents).

IBS is Not All in Your Head

Hypnotherapy is an effective treatment for IBS. Because it can improve and often eliminate symptoms of abdominal pain, bloating, and irregular bowel movements, many people believe that IBS must, therefore, be psychosomatic. That is not the case. Clients with IBS experience real physical symptoms in their bodies, even though the initial cause and continuing recurrence might be psychological.

Physical Contributors to the Experience of IBS Symptoms

1. Dysregulation of digestive motility – Instead of a smooth flow along the gut with coordinated
   muscular movement the muscles of the muscles work against each other thus
   creating blockages and sudden movements.
2. Exaggerated gastrocolic reflex – consumption of food provokes excretion. The speed of
   this process has become heightened to a level where it appears to be almost simultaneous.
3. Hypervigilance and hypersensitivity – The sufferer has a heightened awareness of the
   sensations of their gut.

Research on Gut-Directed Hypnosis

Fortunately, hypnotherapy has shown to help with both the physical and psychological symptoms and causes of IBS.

Research on Gut-Directed Hypnosis

Whorwell, P.J., Prior, A., & Faragher, E.B. (1984). Controlled trial of hypnotherapy in the treatment of severe refractory irritable bowel syndrome. Lancet, 2, 1232-1234.

Abstract: 30 patients with severe refractory irritable bowel syndrome were randomly allocated to treatment with either hypnotherapy or psychotherapy and placebo. The psychotherapy patients showed a small but significant improvement in abdominal pain, abdominal distension, and general well-being but not in bowel habits. The hypnotherapy patients showed a dramatic improvement in all features, the difference between the two groups being highly significant. In the hypnotherapy group, no relapses were recorded during the 3-month follow-up period, and no substitution symptoms were observed.

Olafur S. Palsson (2015) Hypnosis Treatment of Gastrointestinal Disorders: A Comprehensive Review of the Empirical Evidence, American Journal of Clinical Hypnosis, 58:2, 134-158

Conclusion: Over the past 30 years, an impressive body of clinical tests of hypnosis intervention for GI disorders has accumulated in the scientific literature. The 35 different studies published in scientific journals over this period have, without exception, reported a significant positive impact of hypnotherapy on the bowel symptoms of the GI disorders they have treated. Just under half of these studies were RCTs, and the vast majority of them (14 out of 17) show superiority in clinical outcomes for groups treated with hypnosis compared to a wide range of comparison groups.

With over 25 years of research, hypnotherapy has proven its effectiveness. In 2008, the National Institute for Health and Care Excellence of the UK (NICE) recommended hypnotherapy for people with IBS that do not respond to pharmacological treatments after 12 months and those who develop refractory IBS.

Resources

For more information on learning to become a Gut-Directed Hypnosis practitioner, visit our practitioner page here.

For training in becoming a medical hypnotherapist, consider taking our full training here.

Contact Eva M Clark if you seek individual sessions for IBS.