Irritable Bowel Syndrome (IBS)
Find freedom from symptoms of IBS.
What is IBS and how is it caused?
Irritable Bowel Syndrome (IBS) is a functional gastrointestinal disorder affecting the large intestine. Symptoms can include pain in the abdomen, bloating, constipation, diarrhoea and/or changes in bowel habits. These symptoms may vary from person to person and can be inconsistent, with variability over time. It is one of the most common disorders diagnosed by gastroenterologists.
There are several theories about what causes IBS, but the exact causes remain unknown. Sometimes it can be linked to a prior illness such as gastroenteritis, but currently, research has not proven that direct viruses, bacteria or parasites play a role. Hereditary and genetic links have not been found. Nor are psychological factors the cause of IBS.
Although psychological factors haven’t been found to cause IBS, anxiety, stress and depression have been associated with worsening symptoms. Even people without IBS will often have gut changes when stressed or anxious. Consider the feeling of knots or butterflies in the tummy, having to rush to the bathroom, or feeling bound up when under stress or pressure. Having IBS only intensifies this.
What are the symptoms of IBS?
Symptoms can include:
Abdominal pain and discomfort
Excessive gas
Indigestion
Nausea
Abdominal contractions, spasms, or cramps
Backache
Bloating or swelling
Constipation
Diarrhoea
Go to the NHS website for a full list of symptoms http://www.nhs.uk
What is gut-directed hypnotherapy?
IBS Hypnotherapy, known also as Gut-Directed Hypnotherapy, is an evidence-based treatment designed to treat the symptoms of IBS. Proven effective through clinical trials, with evidence to show ongoing relief from the symptoms of IBS, It has been recommended for IBS by the National Institute of Clinical Excellence (NICE) following research (Whorwell et al, 1984) at Manchester University Hospital. It has been particularly successful in managing chronic IBS when other treatments have not provided relief.
Gut-Directed Hypnotherapy uses hypnosis and visualisation to reprogramme the gut-brain connection to reduce gut sensitivity and relieve the symptoms of IBS. It is:
scientifically proven & evidence-based
long-lasting
free of side-effects
reduces both physical and emotional symptoms
can work even in more severe cases
effective even for sufferers who have failed to respond to other treatments
How does gut-directed hypnotherapy work for IBS?
It works by focusing on the gut-brain axis. The gut-brain axis plays a crucial role in IBS. When we talk about the gut-brain axis, we are referring to the communication network between the brain and the gut (the digestive system).
The brain is constantly receiving information about the gut and under normal conditions, it is an unconscious process; we are blissfully unaware of what is happening. With IBS, the brain is more sensitive to signals, and this alerts the conscious mind. These physical symptoms can quite often induce anxiety, and this can ignite a cycle of symptoms.
Gut-directed hypnosis uses visualisation, along with hypnotic language and suggestions to reframe messages from the digestive system. This allows the brain to reinterpret these messages in a different way, causing less distress and anxiety. We can reduce pain and promote normal gut function by utilising the relaxing effects of hypnosis to reduce feelings of stress and anxiety, which can ease symptoms.
What is the history of gut-directed hypnotherapy
and what research is it based on?
Gut-directed hypnotherapy is an effective treatment for IBS with research supporting it.
The Manchester Model
In the 1980′s, Peter Whorwell, a British Professor of Gastroenterology from Manchester University found that conventional medical treatment was not adequately helping his IBS patients. He began by using hypnotherapy therapeutically, to help his clients relax. However, he was surprised to find that his patients were improving. As a result, he set out to demonstrate his findings, (Whorwell et al, 1984) led a randomised controlled clinical trial on 30 patients with severe refractory IBS symptoms.
The North Carolina Protocol
In the study, 15 patients were assigned to either 7 sessions of hypnotherapy, or psychotherapy with placebo medication. The difference between the two groups was measured after 12 weeks with all 15 hypnotherapy patients reporting improvements in all symptoms, the second group accounted for ‘small but significant changes’, with the exception of bowel habit. The hypnotherapy group also showed consistent results at the three-month follow-up without substitution symptoms.
Another often-cited researcher is Professor Olafur Palsson, an American psychologist, he found gut-directed hypnotherapy to benefit more than 80% of patients with significant, ongoing improvements even at a 10-month follow-up (Palsson, 2006).
There isn’t a specific test for IBS. If you suspect you might have IBS, or are showing some signs and symptoms, you will need to speak to your doctor to eliminate any other possibility. Although gut-directed hypnosis is a powerful tool in the treatment of IBS, you must first speak to your GP. It is of the utmost importance for a proper medical assessment from your doctor to ensure that any abdominal pain, bloating and change in bowel habits are IBS related. Your doctor will likely diagnose IBS by eliminating other medical reasons for your symptoms. With the diagnosis of IBS, you may be prescribed medication, get dietary advice, or offered talking therapies such as CBT on the NHS after 12 months of unresolved symptoms. The NICE guidelines also recommend hypnotherapy as an effective drug-free treatment.
The National Institute for Health & Care Excellence (NICE) in the UK recommends that ‘psychological interventions such as Cognitive Behavioural Therapy (CBT), hypnotherapy and/or other psychological therapy should be considered for people with IBS who are not responding to pharmacological treatments after 12 months and ‘who develop a continuing symptom profile. That said, there is absolutely no need to wait over 12 months to try hypnotherapy but be aware that your doctor may not suggest it as an option until other options have been explored.
I think I have IBS, what should I do?
I’ve been diagnosed with IBS, should I try hypnotherapy?
Perhaps you’ve already tried changing your diet or taking medications, but your IBS symptoms are still getting in the way. Maybe you are feeling frustrated by feelings of anxiety around food and the fear of another painful and embarrassing flare-up. The truth is, for many people, dietary changes and medications don’t do enough because they don’t address the underlying problem.
The symptoms of IBS are caused by faulty messaging occurring between the brain and the gut. Think of the gut-brain axis as a 2-way communication system. With IBS it’s like the children’s game where you whisper something to your neighbour and then your neighbour whispers something to their neighbour, and by the end, the message is completely distorted. What’s happening is the gut is sending the wrong message to your brain, and your brain is sending the wrong message to your gut. These false messages cause your digestive tract to be very sensitive and it can change how your bowel muscles function.
To regain control of your bowel, and reduce the symptoms of IBS, we need to correct these miscommunications. Gut-directed hypnotherapy works to correct these miscommunications by strengthening and retraining this connection. It is an evidence-based approach with 40 years of research behind it and has been proven to be effective with improvement in symptoms in more than 80% of people (Palsson, 2006). This means you can get lasting relief without ever having to change your diet or become dependent on medications.
Sufferers of IBS may also experience low mood and anxiety. Hypnotherapy is also very helpful in helping to reduce anxiety and alleviate low mood.
What does the treatment involve?
Gut-directed hypnotherapy normally involves 5-10 sessions once every fortnight until the mid-point review (sessions may vary based on the client’s needs). We will discuss your treatment plan in the first session and again in session 5. Gut-focused hypnotherapy utilises hypnosis specifically designed to treat functional gut disorders such as IBS. For more information about hypnosis and hypnotherapy, follow this link.
You will also receive a self-hypnosis recording which to use daily. This is an important component and crucial to your success. The audio is designed to reinforce positive change, promote relaxation, and help you to learn self-hypnosis skills to maintain your results and utilise if flare-ups occur.
What is the IBS4IBS programme?
The gut-directed hypnotherapy approach, studied by Professor Whorwell, was developed further into the IBS4IBS hypnotherapy program developed by Helen Brenner, an intensive care nurse, counsellor, and hypnotherapist. She designed, set up and led the only NHS Primary Care IBS Hypnotherapy service in the country and used it with 97% effectiveness in UK clinics (Brenner, 2012). The IBS4IBS program is based on this protocol.
Can hypnosis be used alongside other treatments for managing IBS?
Absolutely. Hypnotherapy may improve the response to other treatment modalities, such as medication or dietary interventions.
Is hypnotherapy a recognised treatment for IBS?
Hypnotherapy for IBS is recognised by:
The American College of Gastroenterology
The British Society of Gastroenterology
World Gastroenterology Organisation
The UK National Institute for Health and Care Excellence (NICE)
The American Gastroenterological Association
The Canadian Association of Gastroenterology
The Japanese Society of Gastroenterology
Who am I and how can I help?
I am a solution-focused clinical hypnotherapist and practitioner of the IBS4IBS program. I have a background in health services with over a decade of experience in Allied Health (Occupational Therapy). The IBS4IBS program was developed using evidence-based protocols used within the NHS to specifically treat IBS patients with hypnotherapy.
Is online gut-directed hypnotherapy effective?
Online hypnotherapy for IBS can be effective. A study (2019) published in the International Journal of Clinical and Experimental Hypnosis found no statistically significant difference between online hypnotherapy and in-person hypnotherapy; both online and in-person groups reported improvements in their IBS symptoms. (Hasan et al, 2019)
Another study (Hasan, 2019) of IBS patients showed that 65% of subjects responded to online hypnotherapy (on Skype) with significant improvement compared to 76% for in-person treatments. Online sessions are a sensible way of accessing treatment; particularly if symptoms are making it difficult to travel.
When will I see the results?
Clients can see improvements quite quickly. Sometimes extra sessions may be required for the best results, sometimes less. We will discuss your treatment plan on the first visit and again at the midpoint. Treatment is always client-led. If you feel your symptoms have become manageable in fewer than 10 sessions, then that will be what you require. I want your treatment to be as brief and effective as possible.
Does it work for everyone?
I don’t have a magic wand, but evidence shows that most sufferers can benefit from treatment, however, with any treatment modality, success cannot be guaranteed.
Can everyone be hypnotised?
Hypnosis is a natural state, and we experience altered states of consciousness each and every day in the form of focus, daydreaming or light naps. Click here to learn more about hypnosis.
Are there any other benefits of gut-directed hypnotherapy?
Reduced anxiety and stress
Better Sleep
Boosts overall wellbeing
More self-confidence
Increased productivity
Will all my symptoms go away?
While some clients may achieve complete relief, some only achieve a reduction in symptoms. However, these reductions in symptoms can be enough for those clients to get on with their lives again. And it’s important to note that even if the treatment does not improve the symptoms entirely, it has been shown to improve their coping and quality of life.
What improvements will I see with gut-focused hypnotherapy?
Get back to work or school Have less time off work Be more productive at work Less GP consultations for IBS and non-colonic symptoms.
How long does gut-directed hypnotherapy last?
A study looking at the improvement of symptoms found that 73% of patients who underwent hypnotherapy for IBS experienced improvement in their IBS symptoms lasting 4 years on average, however in some, as long as seven years. (Lindfors et al, 2012)
A separate study found that 81% of patients who responded positively to hypnotherapy had maintained a reduction in symptoms five years from the completion of the study, with the rest (19%) experiencing a slight reduction in the improvement of symptoms. (Gonsalkorale et al, 2003)
Long term benefits
(Whorwell, 1984)
83% of those who had a positive treatment outcome were well after 1-5 years
59% were taking no medication
42% who were on medication were taking them less often.
79% consulted their GP/hospital consultant less often or not at all.
49% consulted their GP less often about other symptoms.
Can the symptoms return?
Studies show that treatment success can be maintained for up to seven years. Because the study data only followed patients for up to 7 years (Lindfors et al, 2012) there aren’t numbers to establish more long-term figures. Looking at the research we can see that the benefits of gut-directed hypnotherapy can last for years, and in a minority of people, the symptoms were mild. In the case of a relapse or a flare, a couple of follow-up sessions may be all that is needed to get back on track.
References
Bremner H. Designing and delivering a hypnotherapy service for irritable bowel syndrome in primary care. Frontline Gastroenterol. 2012 Jul;3(3):210-215. doi: 10.1136/flgastro-2011-100095. Epub 2012 May 21. PMID: 28839667; PMCID: PMC5517275. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5517275/
Gonsalkorale, W.M., Miller, V., Afzal, A., Whorwell, P.J., 2003. Long term benefits of hypnotherapy for irritable bowel syndrome. Gut 52, 1623–1629. https://doi.org/10.1136/gut.52.11.1623
Hasan, S.S., Pearson, J.S., Morris, J., Whorwell, P.J., 2019. SKYPE HYPNOTHERAPY FOR IRRITABLE BOWEL SYNDROME: Effectiveness and Comparison with Face-to-Face Treatment. International Journal of Clinical and Experimental Hypnosis 67, 69–80. https://doi.org/10.1080/00207144.2019.1553766
Lindfors, P., Unge, P., Arvidsson, P., Nyhlin, H., Björnsson, E., Abrahamsson, H., Simrén, M., 2012. Effects of Gut-Directed Hypnotherapy on IBS in Different Clinical Settings—Results From Two Randomized, Controlled Trials. American Journal of Gastroenterology 107, 276–285. https://doi.org/10.1038/ajg.2011.340
Palsson, O.S., 2006. Standardized Hypnosis Treatment for Irritable Bowel Syndrome: The North Carolina Protocol. International Journal of Clinical and Experimental Hypnosis 54, 51–64. https://doi.org/10.1080/00207140500322933
P J Whorwell, A Prior, E B Faragher: Controlled trial of hypnotherapy in the treatment of severe refractory irritable bowel syndrome, Clinical Trial Lancet. 1984 Dec 1;2(8414):1232–4. doi: 10.1016/s0140–6736(84)92793–4. https://pubmed.ncbi.nlm.nih.gov/6150275
The National Institute for Care and Excellence: Guidance, Irritable bowel syndrome in adults: diagnosis and management. https://www.nice.org.uk/guidance/cg61