Olafur S. Palsson, Psy.D., Research Associate, Department of Medicine, University of North Carolina at Chapel Hill states that the standard medical methods currently used to treat irritable bowel syndrome (IBS) are of some help to the majority of people with the disorder. However, up to half of IBS sufferers are dissatisfied with the results of standard medical management, and many continue to have frequent symptoms after seeing doctors about them.
In recent years, other alternatives have been sought to help these individuals. There has been growing interest in the possibility of using the mind to soothe the symptoms of IBS. Mental states clearly affect the way the gut behaves in people with IBS, and in fact, also in people who have no gastrointestinal problems.
Although IBS is probably not caused by stress directly, it is well established from research that psychological stress increases the symptoms of many people who have the disorder.
If the mind can have such a powerful negative influence on the intestinal tract, it would seem to make sense that the mind could be used to have a positive or calming influence on the intestines. Several psychological methods to treat IBS symptoms have been tested in formal research studies, including biofeedback, cognitive therapy, psychodynamic (insight-oriented) therapy, and hypnosis treatment. It is unclear, to date, which of these psychological treatment methods is most effective, for they have generally not been tested side by side.
However, cognitive therapy and hypnosis treatment have had the highest reported success rates in repeated formal research studies, with improvement seen in 80% or more of all treated patients in some studies.
Hypnosis for IBS
The results of the first formal research study on hypnosis treatment for IBS were published in the Lancet in 1984. The investigators, Dr. Peter Whorwell and his group in Manchester in England, reported remarkable success from a seven-session hypnosis treatment of 15 patients with severe IBS problems who had not responded to any other treatment. All 15 patients treated with seven sessions of hypnotherapy improved, with dramatic improvement seen in all the central symptoms of IBS.
The researchers furthermore showed that this therapeutic impact was not merely due to belief or expectancy of improvement, because a comparison group of 15 IBS patients who were instead treated with the same number of psychotherapy sessions and also received placebo pills (pills with no medication) showed only slight improvement.
This was a powerful demonstration of the impact hypnotherapy could have on IBS, and led to considerable subsequent interest in this approach to IBS treatment. Since this first report, more than a dozen other published research reports have confirmed that hypnosis treatment is effective in treating IBS.
Generally, the treatment procedures reported in the literature consists of 4 to 12 sessions (shorter treatment than 7 sessions may be a bit less effective). Hypnosis sessions are typically conducted weekly or once every other week, last 30-40 minutes and consist of induction of hypnosis followed by deep relaxation and the use of gut-directed imagery and suggestions. Patients are commonly given short CD or audiotape hypnosis home exercises to use during the course of treatment in addition to the sessions with the clinicians.
The experience to date may be outlined as follows:
Reported success rates range from approximately 70-95% in all studies with any significant number of patients [for example, in the work of the Manchester group in England and our studies.
The improvement enjoyed from this treatment often lasts at least two years after the end of treatment .
All major IBS symptoms improve from this kind of treatment (abdominal pain, diarrhea/constipation, and bloating).
There are some indications that individuals with certain characteristics are somewhat less likely to benefit from this kind of treatment: People with very little hypnotizability (perhaps 15% of all people), persons with psychiatric disorders, and maybe (according to one report) males with diarrhea-predominant type of IBS.
This treatment can be effective also when people are treated in groups.
In addition to effects on physical symptoms, the treatment commonly improves psychological well being and life functioning substantially and can have long-term positive effects in reducing disability and health care costs and improving the quality of life of IBS patients.