IBS (Irritable Bowel Syndrome)
IBS: What is it?
IBS (Irritable bowel syndrome) is a common functional gut disorder. It is diagnosed after doctors have excluded other serious organic diseases. More common amongst women, IBS can develop from young teenage and adulthood.
IBS: What causes it?
The exact causes of IBS are unknown. Following a food-related illness, the sensitivity of the gut canbe increased. This can affect your body’s ability to digest food and can increase your awareness of pain in the digestive tract. Stress and anxiety create chemical (adrenaline) changes that interfere with digestive functioning increasing some of the symptoms.
IBS: What are the common symptoms?
IBS is characterised by bloating, constipation, diarrhoea, flatulence and pain/cramps. Some of these symptoms can be made worse after eating food or eating certain foods that the IBS sufferer believes is exacerbating the condition.
IBS: Living with IBS symptoms
Having treated many IBS patients using hypnotherapy, IBS sufferers have a lifestyle that is preoccupied with the need to go to the toilet. It can undermine their self-confidence.
In the home, IBS sufferers can feel more relaxed because you have access to your own toilet and your family are (usually) sympathetic to your condition. The number of flare-ups can be greatly reduced because there is general acceptance in the home. However, you can still be preoccupied with the urgent need to go to the toilet during “peak times” especially if the house has guests.
Having gone to the toilet, you constantly feel that your bowels are not completely empty and that you have to go to the toilet again. You can also pass mucus when emptying your bowels.
In your desperation, you can mistakenly blame the food as a cause of your IBS symptoms particularly when under stress. The IBS diet can then be severely restricted, depriving you of essential nutrients. This may cause other health issues when dealt with subjectively.
Leaving the house:
Stress and anxiety can make the IBS symptoms worse particularly when leaving the house. The proximity of the toilet is a constant worry, “toilet watching” for reassurance. Certain modes of transport e.g. public transport are usually avoided if possible. Suitable toilets are landmarked on a known journey, in case the toilet is needed. Unknown journeys or journeys where stopping the vehicle when required can be problematic e.g. motorways. There can be a feeling of claustrophobia.
Having arrived at a destination, social anxiety can add to the agony. “What will they think?” is a question that you would rather not consider. If visiting somebody’s house there is the embarrassment of “messing up” their toilet. The time that you might be absent and smell of the faeces (with nervous diarrhoea) further adds to IBS sufferer’s predicament. An air freshener is an essential item when flying.
Some IBS sufferers prefer to meet in a public place to disguise these issues. There is some relief from being able to hide in larger public toilets. It’s no wonder that IBS sufferers can feel housebound (agoraphobic) in an attempt to control your feeling of embarrassment associated with your condition.
The constant preoccupation with one’s bowel movements can make certain formal situations unbearable to manage. Even a family occasion with a fixed schedule can be a worry e.g. a wedding, not wanting to disturb the procession.
Work meetings can keep the IBS sufferer distracted about when the meeting will finish in case the toilet is needed. Claustrophobia can develop in these situations, feeling trapped within your own anxiety. Interviews and exams tend to be stressful events in themselves. Anticipatory anxiety can keep the IBS sufferer “toilet bound” leading up to the big events.
Claustrophobia is again an issue in venues with formal seating e.g. cinema. An aisle seat is needed in case of the need to leave the cinema. When the cinema is full and a centre seat allocated, it can be difficult to concentrate on the film.
Accidents and near-misses:
Some IBS sufferers have had an “accident” whilst away from home and fear repeating the situation. It can be traumatising, effecting how you handle future events to prevent a reoccurrence. Even if you have had a “near-miss”, you can develop a series of coping rituals similar to that encountered by OCD (obsessive compulsive disorder) sufferers. You become preoccupied with prevention and “control”. Inevitably, depression can be linked to long-term IBS.
Some IBS patients have OCD issues with “contamination” when using public toilets. This may have been the initial trigger for the IBS. These anxiety conflicts can mean that the sufferer rarely leaves the house. Not surprisingly, when I have treated hypnotherapy patients with these anxieties, I have treated them at their home.
IBS: Approaches to treatment
Most IBS patients will have explored a number of treatment options with various health professionals. These can include the use of prescribed medication to counter your type of IBS symptoms. Antispasmodics and antidepressants are used to alleviate cramping or pain, laxatives for constipation or anti-diarrhoeal medication is used for diarrhoea.
Dietary changes can involve an objective assessment of your diet to ease related symptoms. This can mean eliminating certain problem foods where there is intolerance. Or it can involve increasing or reducing the amount of fibre in the diet. Eating habits are also reviewed to ensure you are eating at regular intervals.
Lifestyle issues can also be explored where a change can influence a benefit. Light cardio-vascular exercise for example is considered helpful for the digestive system.
IBS: Research shows that Hypnotherapy can help to treat IBS symptoms
Hypnotherapy has been used to treat IBS within the National Health Service. Professor Peter Whorwell, a consultant gastroenterologist from Manchester has been researching the use of hypnotherapy in the treatment of IBS for over 20 years. In his research using 12 sessions of Skype hypnotherapy, 40% fewer subjects had severe IBS symptoms following their Skype hypnotherapy treatment. Skype hypnotherapy was used instead of face to face hypnotherapy where travelling to the hospital was deemed as traumatic for the IBS sufferer.
In other research in the use of hypnosis in the treatment of IBS, MJ Ford and A Dobbin conclude that “Hypnotherapy reduces patient anxiety and improves symptom control in the majority of patients with refractory IBS…Benefits extend well beyond symptom control and include improvements in quality of life and reduction in emotional distress.” (p. 297)
In February 2008, the National Institute of Clinical Excellence, who advise the NHS on effective treatments suggested to doctors that “Referral for psychological interventions (cognitive behavioural therapy [CBT], hypnotherapy and/or psychological therapy) should be considered for people with IBS who do not respond to pharmacological treatments after 12 months” (See 220.127.116.11).
IBS: How can hypnotherapy treat IBS?
The causes of IBS remain unknown. However, stress and anxiety are considered to exacerbate symptoms of IBS. Following your doctor or consultant’s diagnosis of stress-related IBS symptoms, hypnotherapy can then be used to treat your IBS symptoms.
Reduction of stress
When under stress, adrenaline is released and effects the functioning of the gut. Blood is diverted away from the digestive system to essential “fight or flight” responses. By combining relaxation breathing techniques that you can use for yourself, the stress responses can be reduced, allowing the gut to function in a relaxed state.
Some of your lifestyle issues will also be explored to help you manage your stress in a more effective way.
Reduction of anxiety
Living with IBS symptoms (see above) can create an anxious lifestyle dominated by “toilet” worry and panic behaviour. Hypnotherapy helps you to be more receptive to suggestions. It can be used to reframe past anxious experiences that are creating your avoidance. Hypnotherapy can also help you to visualise dealing with new situations with confidence.
Reduction of pain, discomfort and bloating
The reduction of pain, discomfort and bloating symptoms can be related to your levels of stress and anxiety. Hypnotherapy can also use specific pain management techniques to lower your awareness of pain and cramping.
Bloating and distension can be eased by relaxing muscles of the digestive tract, making it easier to expel excess gas.
IBS: IBS gut-directed hypnotherapy
Gut-directed hypnotherapy or gut focused hypnosis is a treatment that is incorporated into the general hypnotherapy treatment. Gut-directed hypnotherapy focuses specifically on visualisation techniques targeted at the gut’s own nervous system (Enteric nervous system). Suggestions are aimed specifically at this neural pathway which can become disrupted or overactive following acute IBS. The aim is to positively influence communication between the brain to the gut and from the gut back to the brain. In Professor Whorwell’s words, with gut directed hypnotherapy “you are controlling your gut, rather than your gut controlling you.”
I have been trained to use gut-directed hypnotherapy techniques.