Hypnotherapy and Irritable Bowel Syndrome

Introduction This assignment will explore the condition Irritable Bowel Syndrome (IBS). Its definition, symptoms and causes will be examined, taking into account both the physical and psychological factors. The treatment of IBS will be explored, describing the conventional treatments used to manage the symptoms of IBS and in more detail the use and benefits of psychological interventions like hypnotherapy of which a variety of techniques can be used to manage symptoms and provide relief.A conclusion will form the final part of this assignment, summing up the reasons for and benefits of hypnotherapy as a treatment for Irritable Bowel Syndrome.

Any scripts designed to be used to relieve and manage the various symptoms of IBS will be included in the appendices. What is Irritable Bowel Syndrome? Irritable Bowel Syndrome (IBS) is one of the most common disorders of the digestive system. It is usually a disorder of the large intestine (colon), although other parts of the intestinal tract, even up to the stomach can be affected.The main functions of the colon include the absorption of water, dehydrating the contents to create a soft well-formed stool; and then movement of that stool to the point where it can evacuated from the body (Ross and Wilson 1990). This movement occurs by rhythmic contractions of the colon. When IBS occurs, the colon does not contract normally, instead it seems to contract in a disjointed and at times violent manner.

The contractions may be exaggerated and continued, sometimes lasting for prolonged periods of time.One area of the colon may contract with no regard to another and at other times there may be little or no activity at all. These abnormal contractions result in changing bowel patterns with constipation being the most common. Symptoms vary between individuals, but the following are common symptoms of IBS: •Abdominal pain and discomfort •Abdominal contractions, spasms or cramps •Diarrhoea •Constipation •Bloating •Nausea •Excess wind •Vomiting •Indigestion IBS sufferers may experience a combination of some of these symptoms, with one symptom in particular occurring more regularly or with greater severity.Symptoms vary from the mild, where they don't really affect someone's quality of life, to the serious, prompting the sufferer to seek medical help. IBS is known as a ‘syndrome’ as it is a cluster of symptoms without a specific identifiable cause.

The organisation IBS Network estimates that it affects one third of people in the UK at some point and to some extent, and one in ten people have symptoms bad enough to visit their doctor, it is twice as common in women as in men (NHS 2010). IBS is often uncomfortable and distressing, but does not damage the bowel, or cause any more serious gut disorders.Causes of Irritable Bowel Syndrome The exact cause of IBS is unknown, and as IBS sufferers usually have no physical abnormalities in the bowel, it has been suggested that there is a strong link between IBS and stress. Stress may not cause IBS but it can make symptoms worse, 50% of sufferers associate the onset of IBS with a stressful time in their life (Magowen 2011).

With IBS, the nerves and muscles in the bowel are hyper-sensitive. The muscles may contract too much when you eat, causing diarrhoea, or the nerves may be overly sensitive to the bowel distending with food/stools after a meal, causing cramps.The bowel has a rich supply of nerves that are in communication with the brain, and it is thought that with IBS there is a disturbance in this interaction between the gut, the brain and the autonomic nervous system. As we know the brain and autonomic nervous system are directly affected by stress, it is so thought that this may have a knock on effect on the bowel, causing it to become irritated and over sensitive to stimuli, therefore for suffers of IBS the ordinary stress and strains of living somehow result in colon malfunction.

As well as stress other common psychological and emotional factors ssociated with IBS include anxiety, depression, low confidence and self-esteem, negative thoughts and patterns of behaviour and social phobias. Treatment of Irritable Bowel Syndrome Because Irritable Bowel Syndrome is such a loose collection of symptoms, there is no one definitive 'cure' for IBS. However, there are a number of self-help treatments that can alleviate and improve symptoms. Conventional medical treatments of IBS involve changes to life style and dietary awareness, pharmacological intervention, stress management and psychological therapies such as hypnosis.Diet changes such as increasing the amount of soluble fibre by eating more fruit, vegetables and wholegrain foods, and drinking plenty of water can be extremely beneficial in helping the symptoms of IBS. Foods that could be potential irritants and trigger symptoms, and which should be avoided, include caffeine, alcohol, spicy foods, wheat and citrus fruit.

Eating smaller, more frequent meals may also be beneficial in preventing the exaggerated reflex action of the colon. A change in diet is one key way to control the symptoms of IBS. However, there is no "one size fits all" diet for people with IBS.The diet that will work best depends on a person’s individual symptoms and how they react to different foods.

It may be helpful to keep a food diary and record whether certain foods make the condition better or worse, avoiding certain foods once any triggers have been identified (see Appendix 1 for IBS eating tips). There are certain antispasmodic medications that can be used to help relax the muscles in the wall of the colon thereby reducing the bowel pressure. Since stress and anxiety may play a role in these symptoms, it can at times be helpful to use a mild sedative, often in combination with an antispasmodic.Physical exercise, too, is helpful. During exercise the bowel typically quietens down. If exercise is used regularly and if physical fitness or conditioning develops, the bowel may tend to relax even during non-exercise periods.

The benefits of physical exercise of course extend far beyond the intestine and can be recommended for general health maintenance. Use of Hypnotherapy and Other Psychological Interventions Hypnotherapy is well documented for its benefits of relieving the psychological effects of IBS (IBS Network 2001, IBS Health 2009).In fact hypnotherapy, cognitive behavioural therapy and other psychological therapies are recommended if after twelve months there is no improvement from conventional drug therapy (NICE 2008). Hypnotherapy can help to reduce stress levels and inappropriate behaviour patterns, which in turn can help reduce the physical symptoms associated with irritable bowel syndrome. In addition it can help manage the pain and discomfort many sufferers experience as a result of the condition.

Hypnotherapy could help with IBS in the following ways: Helping you to relax, easing the symptoms if they are triggered by stress •Teaching you powerful creative visualisation techniques to imagine relief for your symptoms •Programming in a new, positive reaction to stress triggers •Helping you to develop greater confidence, calmness, self-esteem and positive body image when your IBS has affected these One of hypnotherapy's greatest benefits is its well-established ability to reduce the effects of stress. Your state of mind can have a direct impact on your physical well-being, even when you're in the best of health.If you're struggling with IBS, the tension, anxiety, and depression that comes from living with an incurable illness can actually undermine your immune system and further compromise your health. Dr Roland Valori, Gastroenterologist and editor of Frontline Gastroenterology believes that hypnotherapy has a powerful effect and works partly by helping patients to relax, he believes that IBS sufferers often face difficult situations in their lives and hypnotherapy can help them to respond to these stresses in a less harmful way, ‘’of the relaxation therapies available, hypnotherapy is the most powerful" he said (BBC News 2010).Total relaxation can be achieved through hypnosis by using the Progressive Muscle Relaxation technique, a popular relaxation tool for use in stress management. Hypnotherapy can then determine if there are any subconscious triggers for IBS.

The stress and negative feelings that may be experienced because of the IBS can be replaced with more positive thoughts and coping strategies, clearing the mind of negative attitudes and providing comfort by working with the subconscious mind. In helping to reduce levels of stress and anxiety hypnotherapy enables IBS sufferers to focus on the positive aspects of their life.In learning self-hypnosis techniques patients can gain more control over their thoughts, feelings and behaviours, enabling them to deal positively with any situation in a relaxed and calm manner. Hypnotherapy can also enable patients to develop greater confidence, calmness, self-esteem and a positive body image, when their IBS has affected these.

Hypnotherapy can also be very beneficial in helping relieve specific symptoms of IBS, for instance pain management to help deal with the abdominal discomfort and cramps.It is well documented that hypnotherapy can relieve virtually all types and degrees of pain (National Health Network 2001, Hypnosis Network 2011). A particularly useful pain management technique that can be used with IBS sufferers is the glove anaesthesia technique. A client with IBS can be hypnotised and asked to imagine placing one of their hands into a very cold surface until the hand eventually becomes numb. This feeling of numbness can then be transferred by placing the numbed hand onto the tummy (or indeed anywhere else) to relieve the discomfort (see Appendix 2 for example of glove anaesthesia script).Another specific technique that can be used in hypnotherapy to relieve symptoms of IBS uses metaphorical imagery.

While under hypnosis clients with IBS can be guided by using metaphors, for example for relief of constipation, the hypnotherapist may suggested imagining logs flowing freely along a river, or for diarrhoea to imagine the logs blocking up the river. Perhaps the most important aspect of treatment for IBS is reassurance. For most patients, just knowing that there is nothing seriously wrong is the best treatment of all, especially if they can learn to deal with their symptoms on their own.Other forms of psychological and complementary therapies reported to be beneficial in helping with Irritable Bowel Syndrome include Cognitive Behavioural Therapy (CBT), Meditation, Massage and Craniosacral Therapy (IBS Health 2002). CBT is a talking therapy which is based on the principle that the way that you feel depends partly on the way that you think, studies have shown that if you train yourself to react differently to your IBS by using relaxation techniques and staying positive, you should see a decrease in your pain levels (IBS Health 2002).As an ethical therapist I would need to bear in mind that although hypnotherapy can help IBS, it is a medical condition.

Diagnosis of IBS is actually a diagnosis of exclusion; that is, all possible causes of the symptoms must first be eliminated before a diagnosis can be made. Since IBS symptoms overlap a number of other, potentially life threatening conditions, it is imperative that any client attending for hypnotherapy treatment sees their doctor or gastroenterologist to receive a proper diagnosis. ConclusionThis assignment has explained in detail the condition Irritable Bowel Syndrome (IBS), its definition, causes and debilitating physical and psychological effects. The main body of this assignment has concentrated on the use of Hypnotherapy and concludes that it is an immensely effective tool which is uniquely suited to the treatment of IBS. The ability to reduce stress related attacks, eliminate pain, provide relief of symptoms and emotional healing should make Hypnotherapy the first choice of treatment for sufferers of IBS.

If patients can relieve and prevent their symptoms then they will have effectively cured themselves of the disorder and will be able to live an IBS free life. ? References BBC News (March 2010) Hypnotherapy ‘can help’ irritable bowel syndrome. http://www. news.

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