Why Hypnotherapy for IBS?

An Introduction to IBS and Hypnotherapy for those who might want some background information:

There are strong researchfindings that heighten the role of hypnotherapy (and thus due to the use of metaphor, guided imagery) in terms of long-term recovery/management.

Aggarwal A, Cutts TF, Abell TL, Cardoso S, Familoni B, Bremer J, Karas J. 'Hypersensitivity in functional gastrointestinal disorders' (Gastroenterology. 1994 Apr; 106 (4):1114-8) in their conclusions stated that their findings suggested specific associations between the autonomic nervous system, predominant physicalsymptoms, colon transit time, and psychological factors in patients with irritable bowel syndrome. Those symptoms in irritable bowel syndrome are associated with specific autonomic nervous system abnormalities; in particular overactivity of the sympathetic nervous system being reported in diarrhoea-predominant IBS. The authors therefore suggested that hypnotherapy may contribute to symptom relief via sympathetic autonomic nervous system alterations. Mayer, EA. in the paper ‘The Neurobiology of Stress and Gastrointestinal (GI) Disease’. (Gut 47: 861-869, 2000) in the section on changes in autonomic nervous system responses reportedthat in the most common functional GI disorders, IBS and functional dyspepsia, persistent alterations of autonomic responsiveness are likely to play a role in altered bowel habits and alterations in gastric emptying, respectively.

IBS symptoms are demonstrated through the autonomic nervous system's control of the intestines, primarily the colon. The enteric nervous system (which is part of the autonomic nervous system) and embedded in the lining of the gastrointestinal tract – has been described as a "second brain" (Gershon MD (July 1999). ‘The enteric nervous system: a second brain’. Hosp Pract (Minneap) 34 (7): 31–2, 35–8, 41–2). The enteric nervous system can operate autonomously and it normally communicates with the central nervous system through the parasympathetic and sympathetic nervous systems.

From the work of Mayer (2000) and also of Aggarwal et al (1994) we can see that the control of the symptoms of IBS would appear to be dominated by the sympathetic nervous system - one related more to anxiety, fear and stress than its name suggests. Thus the sufferer's stress and anxiety is effectively being expressed through the colon going into spasm.

Hypnotherapy, and techniques such as guided imagery, with the specific gut targeted therapy/visualisations switch the nervous control of the colon to the parasympathetic nervous system one of calmness and much reduced anxiety – reducing the frequency of the colon going into spasm and ensuring the slower transit of digested food through normal peristalsis (waves of contraction and relaxation) that progress the contents ofthe colon along its length at a slow speed to allow for the absorption of liquid.

The effectiveness of hypnotherapy as a treatment of Irritable Bowel Syndrome has been rigorously tested -especially that of the 'Manchester Model'. As the audit of hypnotherapy as an intervention in the treatment of IBS, Whorwell (et al) 2002 concluded that the benefits of treatment by drugs were lost shortly after the treatment stopped which contrasted sharply to hypnotherapy where they were found to be long-lasting. This study was of the treatment of a statistically important 250 patients. The therapeutic gains were shown in the same study to have lasted for 5 years (measurement date).

The success rate for hypnotherapeutic interventions is about 80% of people gaining an 80% improvement in their bowel habit, reduction of pain, occurrence of diarrhoea. The gains are slightly higher for women than men.

It has also been demonstrated through research in 1998 [Galovoski and Blanchard] that an individual's hypnotic ability (i.e. how deeply you enter trance) is not a factor in determining a successful outcome in treatment for IBS; clients don't have to have any special hypnotic skill/ability to gain from a hypnotherapy intervention for treating IBS.

Duncan Murray

www.solent-hypnotherapy.co.uk