Hypnotherapy for Irritable Bowel Syndrome: The Research - Part 2

It is IBS Awareness month so I thought it would be an apt time to write a couple blog posts on Irritable Bowel Syndrome and how hypnotherapy can help with it. In the first post I talked about a number of research studies which have been conducted over the years which show the efficacy of hypnotherapy for IBS. I purposely left out the details of the research conducted at Manchester by Dr Whorrel et al. In this post, I will be talking about the approach used within this research. I utilise many of the methods outlined in the research with my clients and they have benefited greatly from it.

The researchers in Manchester have studied gut-directed hypnotherapy for many years now and it has shown some great results. It led to the inclusion of hypnotherapy in the NICE guidelines so that GPs and Consultants can now recommend IBS patients have hypnotherapy to help with their symptoms.

The rationale behind using hypnosis for IBS was to help participants learn mental skills and techniques to develop control over the physiological mechanisms influencing the gut that they are not normally under conscious control of.

In 2009, a German researcher called Karin Meissner gave eighteen healthy volunteers a placebo pill on three occasions together with different verbal suggestions depending on which pill they received. One group were given a placebo pill and were told “This pill is a stimulant to your stomach. You will feel your stomach churning within the next 5 to 10 minutes, and this will reach a peak in about 15–20 minutes, at which time you may feel some heavy stomach contractions. Then it will wear off gradually, and be gone after 30–40 minutes”; the second group were given a placebo pill and told "This pill is a relaxant to your stomach. You will feel your stomach full and heavy within the next 5-10 minutes, and this will reach a peak in about 15-20 minutes, at which time you may feel bloated. Then it will wear off gradually, and be gone after 30–40 minutes“; and the third group were given a pill and told “This pill has no effect. We use it as a control, a mere sugar pill, to see the effects of just taking a pill on stomach activity. You won't feel anything.” The research showed that those who took what they thought to be the “gastric stimulant”, experienced an increase in movement through the gut, while those who took what they were led to believe as the “gastric relaxant”, experienced slower movement through the gut. Although not directly studying hypnotherapy or IBS, this piece of research does illustrate the power of the mind and how it can be used to control the physiological mechanisms involved in digestion and gut motility and therefore help with the symptoms of Irritable Bowel Syndrome.

One of the things I love about the Manchester approach is that they emphasise the importance that participants take an active involvement in the process. They are taught a variety of techniques that they develop by practising them daily over the course of the therapy (typically up to 12 sessions over a 3 month period). Gonsalkorale et al state that they “emphasize that the person is becoming in control of the gut. This would seem to be a crucial part of our approach, since so many patients do feel out of control, and it has been shown in general that a sense of self-efficacy and an internal locus of control are vital in the success of any psychological intervention. It is generally our experience that a particularly passive, helpless patient does not do well. We also emphasize the importance of practice in order to develop these hypnotic skills, just as one would have to in learning a musical instrument, for example, and that it is not the therapist doing all the work.”

The sessions that the participants received focused on a number of techniques to help with stress reduction, a known trigger of IBS symptoms, in addition to confidence building so that they felt able to feel in control of their condition. More specific techniques aimed at controlling and normalizing how the gut is functioning were also taught to the participants, such as creating warmth in the hand which can then be used to sooth and comfort the stomach area as well as using imagery to regulate and control the flow of the gut. Participants also spent time mentally rehearsing themselves in situations that in the past they might have feared or avoided due to their IBS symptoms but now with normal gut function. Other aspects were looked at too depending on the individual.

The rate of progress for the participants differed as you would expect, but most reported some initial benefits after a few sessions and of course a more significant improvement throughout the course of therapy.

Participants of the gut-directed hypnosis at Manchester, as well as my own clients, have derived a considerable amount of benefit from learning these techniques. They have experienced improvements in their bowel symptoms of IBS, their mental wellbeing and quality of life. Hypnosis is not a cure for IBS and cannot guarantee that you will never have symptoms again but you can definitely achieve a good reduction in symptoms and gain more control over the condition and life generally.

I have seen a number of clients over the years who come to have hypnotherapy for their IBS thinking that it will miraculously get rid of their symptoms without them having to put any effort in to it at all, just like popping a pill. It doesn’t work like that unfortunately and as you can see above, the patients who benefit most from this approach are those which put in the time and effort to learning and practising the techniques taught to them during the process. Hypnotherapy can be a real game changer for those suffering from IBS if they choose to engage fully in the process.

If you are suffering with IBS in Bristol and would like to find out more about how Hypnotherapy can help you, please visit my dedicated IBS webpage on my website.

Related Posts: Hypnotherapy for Irritable Bowel Syndrome: The Research - Part 1
Hypnotherapy Provides Support for Irritable Bowel Syndrome Sufferers

References: - Gonsalkorale, W. M. (2006) Gut-Directed Hypnotherapy: The Manchester Approach for Treatment of Irritable Bowel Syndrome, International Journal of Clinical and Experimental Hypnosis, 54:1, 27-50
- Gonsalkorale, W. M. & Whorwell, P. J. (2005) Hypnotherapy in the treatment of irritable bowel syndrome. Eur J Gastroenterol Hepatol 17:15–20
- Gonsalkorale, W. M., Toner, B. B., Whorwell, P. J. (2004) Cognitive change in patients undergoing hypnotherapy for irritable bowel syndrome. J Psychosom Res. Mar;56(3):271-8
- Meissner, K. (2009) Effects of placebo interventions on gastric motility and general autonomic activity. Journal of psychosomatic research 66 (5), 391-398

Hypnotherapy for Irritable Bowel Syndrome: The Research - Part 1

It is IBS Awareness month so I thought it would be an apt time to write a couple blog posts on Irritable Bowel Syndrome and how hypnotherapy can help with it. In this first post I am going to talk about some of the research studies which have been conducted over the years showing the efficacy of hypnotherapy for IBS.

Here in the UK in Manchester, Peter Whorrell et al have been carrying out extensive research in to the efficacy of hypnotherapy in treating Irritable Bowel Syndrome (IBS). I have isolated this particular researcher as I feel that his research was a turning point in hypnosis gaining ground in the medical world in modern society and a step closer to it being actually recommended by GPs. The results of Whorrell’s studies enabled hypnotherapy to make it on to the NICE guidelines for treating IBS. The NICE guidelines are evidence based guidelines which all medical professionals must follow when treating patients. So for example, if a patient was to go see their GP about a digestive complaint and they were diagnosed with IBS, then the GP must follow the NICE guidelines as to what treatment to provide, refer or recommend to the patient. Often The Royal Society of Medicine opines that the NHS should make use of hypnotherapy more widely and it is my hope that it will start to features more on the NICE guidelines as a recommended therapy for various mental health issues and dealing with some physical conditions.

Below are just a handful of research studies that stood out for me and highlight how powerful our mind can be at helping with issues relating to our physiology as well as our mental health.

“Symptoms Improved Significantly for Nine in Ten”
Dr Roland Valori, editor of Frontline Gastroenterology and a Gastroenterologist at Gloucestershire Royal Hospital, referred some of his patients for hypnotherapy. He said of the first one hundred of his patients treated with hypnotherapy, symptoms improved significantly for nine in ten. Dr Valori studied the first one hundred cases he referred for hypnotherapy and found that the symptoms stopped completely in four in ten cases with typical Irritable Bowel Syndrome. He says in a further five in ten cases patients reported feeling more in control of their symptoms and were therefore much less troubled by them.

“Hypnotherapy Alleviated Symptoms in 40% of Those Affected by IBS”
A recent Swedish paper, published in the American Journal of Gastroenterology, outlined 138 patients with IBS who received hypnotherapy treatment for one hour a week over twelve weeks. The research showed that hypnotherapy alleviated symptoms in forty per cent of those affected by the digestive condition. One of the researchers, Magnus Simrén, said "The treatment involves the patient learning to control their symptoms through deep relaxation and individually adapted hypnotic suggestions. The idea is for the patient to then use this technique in their everyday life."

“85% of Those Who Had Hypnosis Still Felt Benefits up to Seven Years Later”
Another Swedish paper, published in Scandinavian Journal of Gastroenterology, examined two hundred and eight patients who had previously received hypnotherapy. The research showed that 85 per cent of those who had been helped by hypnosis still felt the benefits of the treatment up to seven years later and that the majority still actively use the self-hypnosis techniques learnt in their everyday lives. The group also showed that the use of the healthcare system as a result of stomach and bowel symptoms had also reduced by seventy percent. The study concluded “gut-directed hypnotherapy in refractory IBS is an effective treatment option with long-lasting effects”.

“Hypnotherapy is Effective in Improving Both Symptoms and Quality of Life”
Impaired quality of life and psychological distress are common in irritable bowel syndrome (IBS) and may be associated with unhelpful thinking patterns. Hypnotherapy is effective in improving both symptoms and quality of life in patients with IBS, and this study was designed to determine whether this improvement is reflected in cognitive changes. Seventy eight IBS sufferers were assessed in this study. before and after having twelve sessions of hypnotherapy, they completed various questionnaires to assess their levels of anxiety, depression and other cognitive dysfunction. Hypnotherapy resulted in improvement of symptoms, quality of life and a reduction in anxiety and depression. IBS-related thinking also improved, so less negative thoughts about bowel function, symptoms, needing to use/find a bathroom etc.

This is just a few of the more recent research papers published but there are many more which provide further evidence for the efficacy of hypnotherapy for Irritable Bowel Syndrome.

As a member of the Professional Hypnotherapy Network (PHN), I have access to the International Journal of Clinical and Experimental Hypnosis. In this peer reviewed journal, a paper was published on the Manchester Approach (the work of Dr Whorell et al) to treating irritable bowel syndrome with hypnotherapy. I have been following a protocol very similar to this with my IBS clients and they have found it very useful. I have purposely not detailed that research in this post but will talk more about the approach used within the study in more detail in a future post.

If you are suffering with IBS in Bristol and would like to find out more about how Hypnotherapy can help you, please do get in touch. For more information, visit my Hypnotherapy of IBS page on my website.

Related posts:
Hypnotherapy Provide Support for Irritable Bowel Syndrome Sufferers

References:
- 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. The American Journal of Gastroenterology 107, 276–285
- Lindfors, P., Unge, P., Nyhlin, H., Ljótsson, B., Björnsson, E.S., Abrahamsson, H., Simrén, M. (2012) Long-term effects of hypnotherapy in patients with refractory irritable bowel syndrome. Scandinavian Journal of Gastroenterology 47(4):414-20]

Valori’s information came about as a result of an interview and as such I have not been able to find a paper that details the study he carried out. However, one paper he published does looking at the interactions between brain and gut and how it helps us to understand how hypnosis helps alleviate bowel symptoms. I include the reference to that paper below:
- Valori, R. (1992) Small intestinal motility. Current Opinion in Gastroenterology vol 8, issue 2

Hypnotherapy Provides Support for Irritable Bowel Syndrome Sufferers

Sarah Mortimer Hypnotherapy is marking Gut Week 2011 (22-28 August) by highlighting how the therapy can help clients cope with the symptoms of IBS (Irritable Bowel Syndrome).

According to the organisers of Gut Week, about a third of the population experience IBS at some time in their lives. The condition affects the large bowel and symptoms might include abdominal pain and spasms, diarrhoea, constipation, bloating and excess wind. It can also involve an urgent need to visit the toilet and even incontinence if you don’t get there in time.

In 2008, NICE published guidelines for GPs for the diagnosis and management of IBS. Once diagnosed, the guidelines recommend 12 months of traditional treatments ranging from dietary advice through to anti-diarrhoea or anti-constipation medications as appropriate, or even low dose antidepressants to reduce pain and spasms. If the IBS has not responded to this treatment, it is classed as 'intractable'.(1)

In such cases, NICE recommends Hypnotherapy as an option to help the condition. In fact there are a small number of Hypnotherapists specialising in IBS working within NHS hospitals. According to the NHS on-line portal, NHS Choices, which offers information about how to make choices about your health:

“Hypnotherapy has been shown to help some people with IBS to reduce their symptoms of pain and discomfort... You can have Hypnotherapy as an outpatient in some NHS hospital pain clinics, or you can learn self-hypnosis techniques to do at home.”

Dr Roland Valori, editor of Frontline Gastroenterology, said of the first 100 of his patients treated with hypnotherapy, symptoms improved significantly for nine in 10. He said that although previous research has shown Hypnotherapy is effective for IBS sufferers, it is not widely used. Back in June, the Royal Society of Medicine announced that they were seeking to make hypnosis more widely used within the NHS.

IBS is more common in women than men and may be aggravated by stress and life changes. Hypnotherapy can help to alleviate symptoms often by addressing the underlying anxiety. It also gives you the tools to be able to cope better so that stress no longer triggers IBS symptoms. Hypnotherapy also helps to manage any pain that might be experienced as a result of the condition.

Sarah Mortimer would always recommend that a client seeks advice from their GP if they are experiencing any bowel symptoms to ensure there is nothing more sinister going on. In the event that traditional treatments for IBS prove ineffectual, Hypnotherapy has been shown to be beneficial. Many hypnotherapists who are members of the AfSFH like Sarah, receive referrals from local Gastroenterologists and GPs as they understand that Hypnosis can help alleviate the symptoms of IBS, especially where anxiety is involved.

If you would like to find out more about how Hypnotherapy can help you with Irritable Bowel Syndrome, then please contact Sarah on 07851 307 062 or email to book a free initial consultation. Find out more about Sarah Mortimer Hypnotherapy.

(1)Adapted from an article “Hypnotherapy for Irritable Bowel Syndrome (IBS) is Evidence-Based and Highly Effective”, January 12th, 2011 by Helen Bremner