Manage and Master IBS Symptoms with Gut Directed Hypnotherapy

by Jane Pendry

Gut Directed Hypnotherapy is recognised by the medical profession as one of the most effective psychological treatments for Irritable Bowel Syndrome, commonly referred to as IBS? Jane uses the protocol developed, and successfully trialled, by Professor Whorwell, Professor of Medicine & Gastroenterology, University of Manchester.

Over their lifetime, one in five people is likely to be affected by Irritable Bowel Syndrome.

What is IBS, and how does hypnotherapy help?

As most people reading this know what IBS is, let’s start with how Sense-Ability tried and tested Gut Directed Hypnotherapy can reduce symptoms.

This article also explores the causes, symptoms and experiences of having IBS, as well as the evidence for Gut Directed Hypnotherapy.

What is Gut Directed Hypnotherapy?

Gut Directed Hypnotherapy focuses on calming the digestive system to reduce symptoms such as bloating, cramps and diarrhoea associated with IBS. While it’s not a cure, hypnotherapy is a proven therapy that allows people to gain more control over their IBS.

The Gut Directed Hypnotherapy protocol was developed by Gastroenterologist and IBS Specialist, Professor P J Whorwell, who extensively researched the effects of hypnotherapy on IBS and functional gut disorders.

His research, and the research done by others in his field, demonstrates that up to 70% of patients respond well to treatment, with the beneficial effects lasting for at least five years.

Although Jane at Sense-Ability follows the Gut Hypnotherapy protocol, she also works within the Solution Focused framework which allows clients to create a vision of a better future, the life they will lead as the IBS settles down. This makes her approach unique.

Hypnotherapy is not a cure but can help to reduce symptoms and make them more manageable.

How Hypnotherapy helps IBS?

The digestive system becomes less reactive and symptoms lessen.
Physical symptoms like pain, bloating and urgency are dominant.
Bowel habits become more regular and predictable,
Stress and anxiety that exacerbate symptoms lessens.
Clients feel calmer and more in control of their lives.
Everyday life is improved as sufferers generally feel mentally and physically more in control.
As life becomes more predictable, clients enjoy work, socialising and exercise again.

What Happens in a Gut Directed Hypnotherapy Session?

You, the client don’t have to do much. Just listen and allow your mind to wander. It’s a rather easy and pleasant process.

Before hypnosis Jane assesses your experience of symptoms with various scales, including daily pain.

Measuring pain and progress

The Solution Focused conversation explores your Best Hopes, and what’s been good or better each week, including the experience of pain. Jane shares the VAS pain scale to use a measure of your experience over the week.

Unlike Solution Focused Hypnotherapy, which uses indirect suggestions, Gut Directed Hypnotherapy uses direct suggestions. These are directed to your gut health.

A safe and natural state

Jane guides you into the safe and natural alpha brain wave state we call trance through a guided meditation. There’s nothing other-worldly about it. It’s a perfectly natural, everyday state. Something like day-dreaming.

Metaphors

Everyone uses different metaphors to describe their IBS experience. Things like;

A balloon inflating
A clamp tightening
A metal fist clenching my guts
Stabbing pains - like knives
Knots in the stomach
A heavy weight on my tummy

Professor Whorwell’s direct language patterns, and metaphors, shaped around your experience, actively seek to soothe your gut.

Jane includes your metaphors within the language patterns eg describing the metal first releasing, a balloon deflating, or knots unravelling. The mind usually responds well to metaphors and these really can help the process of reducing symptoms.

Relaxing and calm

Therapy sessions are relaxing and calming. You will be able to hear my voice, but it might seem to fade away at times, or you find your attention wondering. Outside noise and activity fades into the background. After each session you are likely to feel calmer and more comfortable.

Always in control

You are always in control. You can open your eyes, speak or move when you want.

The Protocol

Following the initial assessment, Jane will discuss what diagnosis you have, if any. If there has been no diagnosis, Jane will ask you to see your doctor to rule out any other medical conditions. The doctor will advise on diet and medication.

Jane is a complementary health practitioner who works alongside medical professionals, and she cannot diagnose, not dies she claim to cure.

Up to six sessions

The protocol includes up to six sessions, but for some people 3 or 4 are sufficient. Each session lasts about an hour. The hypnotherapy element is about half an hour.

Homework

Jane will ask you to practise any skills or use any tools introduced in sessions eg breathing exercises, listening to a recording or self hypnosis - in between sessions. This is an essential part of your treatment, and help ensure symptoms stay under control long after sessions are completed.

Jane records sessions and you may purchase these each week. The first recording is included as part of the coat of the course. You may wish to but one or two more of the content is tailored to you.

What is Irritable Bowel Syndrome or IBS?

Well, firstly it’s not all in your head!

IBS has a biological element, and a psychological element, and is called a bio-psychological disorder. It’s not all in your head. Hypnotherapy works with the body and mind. It is calming the nervous system in very tangible, physiological ways that soothe and calm the gut through the gut brain axis, while simultaneously reducing stress and anxiety.

Usually, people diagnosed with IBS experience a combination of symptoms: one may be more dominant and intense than others, and symptoms may be mild to intensely debilitating, prompting sufferers to seek medical help. Living with these unpleasant symptoms can lead to anxiety, depression or social isolation, creating a vicious cycle of stress and discomfort.

Symptoms vary

Irritable Bowel Syndrome symptoms can be very uncomfortable but do vary enormously. Symptoms can include

Abdominal pain and discomfort
Abdominal contractions, spasms or cramps
Backache
Bloating or swelling
Constipation
Diarrhoea
Excessive wind
Indigestion
Nausea

The NHS website records a full list of symptoms http://www.nhs.uk

So what is IBS, and how does hypnotherapy help?

What Causes IBS?

It’s not absolutely clear what causes IBS. One explanation is that food may be passing through the gastrointestinal tract too fast, causing diarrhoea. Equally, food may be passing through the GI tract far too slowly, causing constipation. In some cases, for much of the time, food may not be passing through at all.

Oversensitive to messages from the gut

Another hypothesis is the brain becomes oversensitive to messages from the gut. Mild indigestion is interpreted as severe abdominal pain.

Often a flare up of IBS starts after a stressful event. Other triggers for IBS include: alcohol, fizzy drinks, chocolate, drinks with caffeine, processed snacks (crisps and biscuits), and fatty or fried food.

No test for IBS

Diagnosing IBS is difficult. There isn’t a specific test. Often the doctor will exclude other causes first, for example IBDs (Inflammatory Bowel Diseases) such as Crohn’s or ulcerative colitis. Inflammatory markers in blood tests identify these conditions. It’s one reason why anyone suffering IBS symptoms should see their doctor in the first instance. However, psychological stress is definitely a key factor in the development of IBS.

Hypnotherapy is a known complementary therapy for IBS, alongside prescribed medical therapies. Evidence shows that IBS is a combination of both irritable bowel and ‘irritable’ brain.

What Role does Stress play in IBS?

There is no doubt stress plays a significant part in IBS. An episode may start after a particularly stressful episode in your life.

What comes first, the IBS or the stress?

Does IBS cause anxiety; or does anxiety trigger IBS? According to the authors of the paper ‘Impact of psychological stress on irritable bowel syndrome in the World Journal of Gastroenterology: “There is strong evidence that IBS is a stress-sensitive disorder. Therefore, the treatment of IBS should pay much attention to managing stress and stress-induced responses.”

Stress contributes to IBS

There is no doubt that stress and anxiety are contributory factors in IBS. And equally, debilitating IBS is likely to cause stress and anxiety. They feed off each other.

Stress and anxiety are the mind and body’s distress signals warning of imminent danger. Modern life is full of low level threats and stresses: school, work, technology, not to mention pandemics and politics, mean we are surrounded by narratives or experiences that continuously trigger the stress response and have the potential to create prolonged anxiety.

The brain and the central nervous system, CNS, automatically control your entire nervous system. The CNS consists of the sympathetic and parasympathetic nervous systems. In addition, the enteric nervous system is thought to controls much of the gastrointestinal system.

The role of the parasympathetic and sympathetic systems

The sympathetic and parasympathetic nervous systems usually work together. The parasympathetic system can be thought of as the “rest and digest” system because it automatically controls basic body functions like urination, defecation, digestion, tear production, and saliva production.

The sympathetic nervous systems controls fight, flight and fright responses in an effort to keep us safe. The system is activated by real and present dangers. Unfortunately, stress and anxiety, which can develop over time, also activate the fight, fright and flight response.

The brain gut connection

Stress and anxiety release hormones that increases the heart rate in order to pump more blood to our muscles when we are under threat. The same hormones seem to aggravate IBS symptoms as well as affect our microbiome - the balance of gut bacteria in our stomachs. Amazingly hypnotherapy can also positively affect the microbiome.

IBS causes disturbances in the balance between the brain and the gut, triggering the gut to become overactive. This may result in diarrhoea and the sensation of a stomach churning feeling. In some people, brain signals become underactive, causing the gut to slow down and become sluggish. The result is inevitably constipation, gas, and abdominal discomfort.

…this gentle drug-free therapy is likely to alleviate IBS symptoms

How Does Hypnotherapy Help IBS?

Hypnotherapy relaxes the central nervous system, raises mood, reduces anxiety and stress, and helps people create new habits and healthy behaviours making it an ideal therapy to help IBS.

Does that mean IBS is psychological?

No. IBS is not psychological. However, psychological factors exacerbate the physical symptoms.

Three researchers reporting in the World Journal of Gastroenterology (WJG) concluded, “Evidence from clinical and experimental studies showed that psychological stresses have marked impact on intestinal sensitivity, motility, secretion and permeability, and the underlying mechanism has a close correlation with mucosal immune activation, alterations in central nervous system, peripheral neurons and gastrointestinal microbiota.”

As hypnotherapy changes the emotional triggers that reduce stress, this gentle drug-free therapy is likely to alleviate IBS symptoms. By inducing a deeply relaxed state and using suggestions that reduce anxiety and increase confidence and wellbeing, gut sensitivity is also likely to be reduced.

What’s the Evidence?

Peter Whorwell, Professor of Medicine & Gastroenterology, University of Manchester, has analysed and explored the application of hypnotherapy to manage and treat IBS since the 1980s. Through his pioneering research, Professor Whorwell demonstrated that over 60% of IBS sufferers who undertake hypnotherapy see long-term improvement. In many cases, symptoms disappear with no recurrence.

NB: It’s important to note here that Dr Whorwell’s process involved strict protocols and direct hypnosis and is not the same as Sense-Ability Solution Focused approaches. It’s necessary to have strict protocols in order to research a given therapy. The downside is the medical therapist can’t be flexible and tailor therapy to each client. The good news is we know hypnotherapy is effective.

Hypnotherapy included in NICE guidelines

Thanks largely to Professor Whorwell’s research, hypnotherapy is listed in the National Institute for Clinical and Care Excellence (NICE) Care Excellence (NICE) guidelines as one of the evidence-based treatments for IBS.

NICE recommend that, “People living with IBS who do not respond to pharmacological treatments after 12 months, [should] consider a referral for psychological interventions, such as cognitive behavioural therapy (CBT), hypnotherapy, and/or psychological therapy.”

The type if hypnotherapy recommended is not clear. However we know all hypnotherapy does reduce stress, calms the central nervous system and tones the vagus nerve so is likely to help with most stress related illness. Dr Whorwell’s therapy takes place over several weeks so it’s also important to note the benefits may take time to be fully realised.

The difference between CBT and psychological therapies, and hypnotherapy, is that the latter requires rather less effort and is an enjoyable and relaxing process in and of itself.

Of course, you don’t need to wait 12 months to try hypnotherapy, but your doctor may not suggest this until other therapies have been tried.

Gastroenterology Research

Three researchers reporting in the World Journal of Gastroenterology (WJG) state that, “Psychological stress is an important factor for the development of irritable bowel syndrome (IBS). More and more clinical and experimental evidence showed that IBS is a combination of irritable bowel and irritable brain.” It makes sense, therefore, that a complementary therapy for IBS known to actively reduce stress and anxiety will have a positive impact on IBS symptoms.

Complementary therapy for IBS is effective

The review article in the WJG concludes: “Due to the failure of traditional pharmaceuticals, e.g., laxatives and secretagogues, to give permanent relief, non-pharmacological approaches are now getting more and more attention. They include physician-patient relationship and placebo, patient education, utility of hypnotherapy, cognitive behavioural therapy, dietary modification including probiotics, exercise, and biofeedback.”

Of these, hypnotherapy is absolutely proven to reduce anxiety and stress without drugs and with commitment, but little conscious effort. Solution Focused Hypnotherapy also helps people change habits such as modifying diet and increasing exercise.

Studies on hypnotherapy are unusual in the world of medical research, which is largely funded by government agencies or big pharma. Nevertheless, Cochrane, a journal producing systematic reviews of primary research in human health care and policy, confirmed that some studies do indicate that hypnotherapy was effective in treating IBS symptoms including abdominal pain. Although these small studies are interpreted with caution.

Medical Treatments and Guidance

Doctors diagnose IBS by eliminating any other medical reason for the symptoms. If you have a diagnosis, your doctor may prescribe medication to reduce the symptoms or offer talking therapies such as CBT on the NHS. The NICE guidelines also recommend hypnotherapy as an effective drug-free treatment.

Diet

Those with diarrhoea may need to cut down on the insoluble fibre (wholegrain bread, bran, cereals, and nuts and seeds). Those with constipation are likely to be advised to increase intake of soluble fibre and water. Where there is persistent or frequent bloating, a low FODMAP (Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyol) diet is often advised.

FODMAP carbohydrates (fruits and vegetables, animal milk, wheat products, and beans) aren’t easily broken down and absorbed by the gut and can start to ferment quickly, releasing gases that lead to bloating. People with IBS may try keeping a food diary to identify those foods that appear to trigger an episode. Prebiotics and probiotics to increase healthy gut bacteria are also worth researching.

…and exercise

For many moderately strenuous exercise also brings symptom relief. Anti-spasmodic drugs may be prescribed. The doctor may suggest laxatives for constipation or antimotility medicines for diarrhoea.

Speaking to your Doctor

If you suspect IBS, or are showing some signs and symptoms, you may want to see an accreditedhypnotherapist to see if it helps. Your hypnotherapist will still advise you to speak to your doctor in the first instance to eliminate any other possibility.

Because of the impact of IBS, sufferers may also experience depression and anxiety. Solution Focused Hypnotherapy is also very helpful in helping to reduce anxiety and alleviate low mood.

Choosing Hypnotherapy

Solution Focused Hypnotherapy ensures the client remains in control.

The Solution Focused conversation, which takes place at the beginning of each session, enables clients to explore, determine and create essential incremental changes to their lifestyle, which are reinforced by gentle hypnotherapy with open suggestions - generally not commands which the unconscious mind can resist - that helps change thoughts, actions and reactions.

Getting things in perspective

Ultimately, re-engaging with life more fully and creating a healthier work life balance, with appropriate support, enables IBS sufferers to get their issue in perspective. As mental and physical health improve through Solution Focused conversations, so it becomes easier to make those necessary changes to diet while creating healthier habits that lead to optimum health, naturally and easily.

Calming the central nervous system

Calming the central nervous system, increasing the flow of serotonin and creating a more helpful cycle of positive thought, positive action and positive interaction helps to keep IBS symptoms at bay leading to a much better quality of life all round.

About six one hour sessions of hypnotherapy usually makes a significant difference.

Occasional follow-up sessions may also be needed. Progress will be monitored through the sequence of sessions.

To find out more about how Sense-Ability Hypnotherapy & Coaching can help you with Irritable Bowel syndrome, as well as stress, anxiety and work life balance, contact me at:

Jane Pendry
Sense-Ability Hypnotherapy & Coaching
jane@sense-ability.co.uk
07843 813 883
www.sense-ability.co.uk

Please Note

* Please note Jane Pendry does not diagnose or claim to cure.

Sense-Ability therapies are complementary approaches that promote and support self healing. Jane does not explore how or why traumas were created and does not offer counselling, or traditional talking psychotherapy which require different specialised training and supervision. For more on these services see The British Association for Counselling & Psychotherapy.

Jane has the right to refuse treatment where she believes there is a risk of harm or where she believes Sense-Ability therapies conflict with your current treatment programme with a medically trained professional or a clinical psychotherapist.

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