Irritable Bowel Syndrome

Over a decade of scientific research has shown hypnotherapy to be an effective choice for alleviating the symptoms of Irritable Bowel Syndrome. Hypnotherapy routinely produces positive results in over 71% of the people who use it.

Researchers from Withington Hospital, Manchester, found hypnotherapy helped 71% of patients - and its effect lasted up to five years after treatment. The research, based on 200 patients, is published in the journal Gut.

The main theory behind the success of hypnosis for IBS is that the relaxation improves blood flow to the gut, something that stress tends to inhibit and so improves digestion and the movement of food through the bowel.

 
Visualising your digestive system as a river may not seem the most obvious way of treating an illness.

But that is exactly how hypnotherapists at a unique centre in Withington Hospital, Manchester, have been helping people with Irritable Bowel Syndrome (IBS). The condition can leave people in constant discomfort and can cause severe pain. And it can prevent them from working or socialising normally.

Dr Peter Whorwell, the gastroenterologist who founded the centre, devised the "river" concept. The aim is to make the river flow smoothly. If there is a blockage or a flood, they are asked to visualise a way the problem can be solved.

Sessions with a therapist, interspersed with home practice using a CD, are aimed at "retraining" a patient's gut and eradicating their problems. Since IBS affects everyone differently, the therapy is tailored to each patient. So someone with constipation may visualise rocks which are blocking the river and have to be removed, while someone with diarrhoea may want to shore up the banks to prevent the river running so swiftly.

The therapy has proved highly effective, with a recent study showing it had helped 71% of patients for up to five years after their course of treatment. Vivien Miller, one of the team of hypnotherapists at the centre, said:

"We are helping people control what's going on in their bodies, and telling them they can control their symptoms."

Constant worry

The centre is the only one of its kind in the UK and treats around 160 patients from across the country each year. IBS affects between 10 to 15% of the UK's population. Most will only have minor symptoms - but a fifth of them will suffer from faecal incontinence.

"We had to stay in the closet to begin with and doctors can still be a bit sniffy about it."

'No stage-show'

He stresses the hypnotherapy he and his team use is nothing like the TV or stage hypnotists who make people dance like chickens or take their clothes off. And he says it is no cure-all.

"I give a lot of lectures to sceptical doctors. A lot of hypnotists take things very seriously and say they can cure anything. I don't. But IBS is a nuisance to treat. There are no treatments that are effective, so I thought we should try hypnotherapy."

He added:

"People are suspicious because they have seen stage hypnotists. But you cannot be hypnotised against your will. And you won't act out of character while you're hypnotised."

Dr Whorwell is trying to spread the word to other doctors around the country. But he says many are still reluctant to use the technique. There are two theories for why hypnotherapy works for IBS. One is that by making people less anxious, it in some way makes the bowel less sensitive, thereby reducing symptoms. Another suggests hypnotherapy may have an impact on a part of the brain which processes pain called the anterior cingulate cortex (ACC).

One study showed patients could put their hands into boiling hot water without registering pain after being hypnotised, when they had earlier experienced intense pain. The hypnotherapy reduced the amount of activity in the ACC.

Choice

While many doctors may still be a little suspicious of using hypnotherapy, Dr Whorwell says patients have no such qualms.

"They are falling over themselves to have the therapy, particularly the younger ones. Many are on antidepressants, because they have the effect of lessening pain sensations at low doses. But if you're 25 and you had the option of a long-term course of antidepressants or having hypnotherapy that will put you right, which would you choose?"

Hypnotherapy seems to be an effective long term treatment for irritable bowel syndrome, research finds.

IBS is a very common disorder affecting up to 15% of the population at any one time, but is difficult to treat. Researchers from Withington Hospital, Manchester, found hypnotherapy helped 71% of patients - and its effect lasted up to five years after treatment. The research, based on 200 patients, is published in the journal Gut.

The majority of patients found that hypnotherapy reduced the severity of their IBS symptoms, and continued to do so for years. Even those who said the effect began to wear off with time, found that the deterioration was slight.

Cost effective

Hypnotherapy also seemed significantly to reduce levels of anxiety and depression - however, the effect here did begin to tail off slightly over time. But patients also said they took fewer drugs and did not need to see their doctors as often after they had had a course of hypnotherapy.

The researchers say the sustained improvements in most of the patients cannot be attributed to other treatments as fewer than one in 10 patients attempted alternatives after completing their hypnotherapy sessions. Previous research has shown hypnotherapy to have a beneficial effect on IBS in the short term - but not over a longer period.

Critics say hypnotherapy is an expensive treatment. But the researchers argue that the cost would be more than offset by a reduction in demand for prescription drugs.

Lead researcher Dr Wendy Gonsalkorale told BBC News Online:

"While other studies have shown that symptoms have improved by the end of the course of treatment, the real significance is our finding that these effects are sustained after treatment sessions have finished, rather than patients just reverting back to their original state. We firmly believe that hypnotherapy should be available as a standard treatment for all patients with IBS."

Effect unclear

Dr Gonsalkorale said it was unclear what caused IBS, and why hypnotherapy should help. However, she said the condition was possibly linked to problems with muscle movement, or to increased sensitivity of the gut lining.

She said hypnotherapy may help the patient to gain better control over the way their gut works by influencing the release of hormones, or the nerve links between the gut and the brain. It may also alter the way that the brain responds to incoming pain messages.

"For some patients, psychological factors and stresses may play a role in triggering or at least exacerbating symptoms. Whether or not they are the primary cause is still very debatable. Hypnosis can be used as a form of relaxation, to reduce stress. But it is not the whole story by any means. We know also that the therapy alters the way patients think about their symptoms."

Dr Mark Cottrill, a trustee of the IBS Network and a GP in Wigan, told BBC News Online his practice had employed the services of a hypnotherapist to treat IBS patients for a short time.

"She proved extremely popular and within months she had a three to four month waiting list," he said.

Symptoms of Irritable bowel syndrome

Patients undergo 12 sessions of hypnotherapy

Just let go and relax

Dr Peter Whorwell devised the idea of using hypnotherapy to treat IBS