Treating IBS with Hypnotherapy

I, like many people, used to consider IBS (Irritable Bowel Syndrome) as an illness that just caused minor, irritating symptoms but since meeting quite a few people whom suffer from it I now know just how debilitating it can be.

At this years conference of the National Council of Hypnotherapy I was lucky enough to attend several lectures by the UK’s leading researcher and physician in IBS; Dr Peter Whorwell:

Dr Peter Whorwell is Professor of Medicine and Gastroenterology at the University Hospital of South Manchester and Director of the South Manchester Functional Bowel Service, he is also an expert and advisor on functional gastroinstestinal disorders, with over 260 papers published. Speaking on the subject of IBS, Peter’s unit has shown how hypnotherapy can be useful in helping relieve the symptoms of these disorders and continues to research the mechanisms behind this phenomenon and its possible future applications. His unit cares for patients from acrosss the UK.

During his lecture it became obvious to me that my preconceptions of IBS were limited. Hearing about sufferers who were house-bound, because of their need to stay close to a toilet, and how many serious sufferers had considered suicide, because of the way the illness had affected the quality of life, profoundly affected me.

IBS is a multifactorial illness which means that there are many causes. Dr Whorwell believes there may be a genetic link. Apart from the visceral sensitivity (sensitivity of the colon/gut) and exaggerated gastro-colonic reflex (increased level of contraction of the colon/gut) there are other ‘referred’ symptoms such as:

  • Wind
  • Nausea
  • Thigh pain
  • Back ache
  • Lethargy
  • Urinary Sypmtoms
  • Gynaecological

Dr Whorwell measures all of these symptoms in his patients as well as the Quality of Life (NHS QoL Questionnaire SF56) and the levels of Anxiety and Depression (NHS Hospital Anxiety & Depression Questionnaire).

One of the most interesting points I picked up from the lectures was that up to 55% of sufferers were made worse by eating natural fibre. Proprietary fibre such as fibogel was slightly better. Lactulose was found to exaggerate symptoms but Imodium was found to be a great benefit to those IBS sufferers with loose bowels. On this point Dr Whorwell pointed out that Imodium is an extremely safe drug and that a dependancy on it, although not encouraged, is perfectly acceptable. If, during the course of treatment, the patient is able to reduce their dependancy from 20 capsules of Imodium per day to ‘just’ 10 then this is seen as an improvement.

Dr Whorwell’s patient’s diet sheet excludes wheat fibre but refined wheat is allowed (e.g. white bread). Unfortunately coffee and chocolate are also excluded. Probiotic products have also been shown to help as have antidepressants. When clients get to see Dr Whorwell they are a little confused if antidepressants are mentioned because they are generally sick and tired of people telling them that IBS is a psychological disorder. Dr Whorwell explains that the antidepressants are used because of the phsysiological changes they make. His research has also shown that the Tricyclic antidepressants such as amitriptyline (Elavil, Endep, Tryptanol, Trepiline) and nortriptyline (Pamelor) have been shown to be most effective.

When a client has seen Dr Whorwell and fully informed about what IBS is he tests their suitability for hypnotherapy. Many people do not want to be hypnotised and therefore exlude themselves from this part of the therapy. After an explanation of hypnosis and some standard suggestibility tests each patient is introduced to a hypnotherapist (probably the only hypnotherapists in the country employed by the National Health Service).

The Hypnotherapy sessions are gut focussed and consist of twelve weekly sessions. Each session includes a standard induction and deepener followed by a script that is based on the client laying their hands upon their tummy and feeling the warmth spread through their gut. This warmth and focus is to normalize the gut functions.

Dr Whorwell’s research has shown that there is a 60% to 80% response rate and that all symptoms, non-colonic, and otherwise are improved and this improvement is sustained over long periods. Each patient is taught self-hypnosis so that they can practice themselves.

This controlled research shows improvements such as:

  • Modifies Motility
  • Modifies visceral sensitivity
  • Improves Quality of Life
  • Less time off work
  • Back to work
  • Less GP consultations
  • Reduced medication needs

To have someone as respected in the mainstream medical profession such as Dr Whorwell ratify the efficacy of hypnotherapy is superb and I hope that we see much more of it in the future.

Read more about Dr. Whorwell’s approach in this BBC news article:

There are many reports available that also ratify the effectiveness of hypnotherapy. Here is the abstract of one such report on reducing non-cardiac chest pain:

Non-cardiac chest pain (NCCP) is an extremely debilitating condition of uncertain origin which is difficult to treat and consequently has a high psychological morbidity. Hypnotherapy has been shown to be effective in related conditions such as irritable bowel syndrome where its beneficial effects are long lasting. AIMS: This study aimed to assess the efficacy of hypnotherapy in a selected group of patients with angina-like chest pain in whom coronary angiography was normal and oesophageal reflux was not contributory. PATIENTS AND METHODS: Twenty eight patients fulfilling the entry criteria were randomised to receive, after a four week baseline period, either 12 sessions of hypnotherapy or supportive therapy plus placebo medication over a 17 week period. The primary outcome measure was global assessment of chest pain improvement. Secondary variables were a change in scores for quality of life, pain severity, pain frequency, anxiety, and depression, as well as any alteration in the use of medication. RESULTS: Twelve of 15 (80%) hypnotherapy patients compared with three of 13 (23%) controls experienced a global improvement in pain (p = 0.008) which was associated with a significantly greater reduction in pain intensity (p = 0.046) although not frequency. Hypnotherapy also resulted in a significantly greater improvement in overall well being in addition to a reduction in medication usage. There were no differences favouring hypnotherapy with respect to anxiety or depression scores. CONCLUSION: Hypnotherapy appears to have use in this highly selected group of NCCP patients and warrants further assessment in the broader context of this disorder.

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