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Irritable
Bowel Syndrome, also known as spastic colon, colitis, or nervous
stomach, is a baffling and complex set of gastrointestinal symptoms that
affects 15% to 20% of the population (approximately 20 million people).
It is characterized by intermittent abdominal cramping, constipation,
diarrhea, a combination of both constipation and diarrhea, pain and
bloating. Some IBS patients report having both constipation and diarrhea
in the same day. Two thirds of the patients are women. It is the second
most cited reason for missed work days. It accounts for approximately
half of all visits to gastroenterologists.
The causes
of IBS are unknown. A diagnosis of IBS is actually a diagonis of
exclusion--you rule out everthing else. Since IBS symptoms overlap a
number of other, potentially life-threatening conditions, it is imperative
that the person see his/her physician or a gastroenterologist, to receive
a proper diagnosis. While it is not clear what causes it, we know that
people with IBS have changes in the way sensations are perceived in the
colon. There are some anatomical changes in the lining of the colon and to
the nervous system of the colon. What causes these changes is unknown.
Symptoms range in severity from an occasional mild episode to a
debilitating, life-altering illness which prevents the individual from
working or from functioning normally. The symptoms are exacerbated by
stress, changes in diet and changes in daily routine, among many other
things. Some people are so sensitive they must eat virtually the same
foods, in the same proportions, at the same times each day or suffer the
consequences. Until recently, IBS was thought to be simply a
"nervous" disorder and was not taken as seriously as it
deserved. While IBS will not kill you, it is far more than just a
nuisance.
Traditional treatment consists of fiber therapy,
antispasmodic medications and antidepressants. Fiber is added to the diet
both through the use of bulking type laxatives and a high fiber diet.
These are just as important for those people whose chief complaint is
diarrhea as it is for constipation. Antispasmodic medications, such as
Bentyl, reduce the spasms in the gut. Antidepressants, in this case,
actually function on the nervous system of the gut to reduce its
sensitivity to pain and other sensations rather than acting as emotional
antidepressants. However, anyone who has suffered from the symptoms of IBS
for any length of time justifiably presents with some degree of
depressions. It is important to note that only 25% of the people who
suffer with IBS symptoms respond to traditional treatments. That means
that 75% do not seem to improve with traditional treatments or do not
improve enough to actually feel better.
However, the evidence is overwhelming that IBS symptoms
do respond to hypnosis. Not only do they respond, but they respond
dramatically! The research evidence to support this is so dramatic and so
overwhelming that Adriane Fugh - Berman, MD, chair of the National Women's
Health Network in Washington, D.C., says that hypnosis should be the
treatment of choice for severe cases of IBS. In my practice, so far, 100%
of the clients I have treated with hypnosis have shown marked improvement
in their symptoms. Seven of the first eight clients (the number in the
first phase of a three-stage research project) became symptom free during
the six sessions. While the eighth subject did not become symptom free in
the standard six session regimen, his symptoms did improve significantly
in the number of symptoms, duration and severity. He has continued his
sessions to gain even greater relief. All of these clients had refractory
(meaning that had not responded to drug and diet therapy) IBS symptoms for
greater than four years. Most reported that the symptoms had started in
childhood. Clients ranged in age from 35 to 50 years old. Although all of
them were on multiple medications, including steroids, bulking laxatives
and on special diets, none of them had gained relief from their symptoms.
For instance, Melinda is a 35 year old special
education teacher. When Melinda first came to my office, she had recently
been released from the hospital for a particularly severe episode of
uncontrolled diarrhea. She was on high dosages of multiple medications.
She reported that the medications had too many side effects, and that in
spite of them, she had not seen much improvement in her symptoms. While
she was no longer experiencing fecal incontinence, she still had watery
stools several times a day. When asked to rank her symptoms on a scale of
zero to ten, with ten being the worst and zero indicating the absence of
symptons, she ranked them as follows: diarrhea 5; abdominal pain 7;
bloating 8; fatigue 8. At the beginning of the sixth and final sessions
she ranked the same symptoms as follows: diarrhea 0; abdominal pain 0;
bloating "maybe 2"; fatigue 0. She reported these results in
symptom improvement in spite of higher levels of stress caused by the
unexpected deaths of two close friends. Working in conjunction with her
physician, Melinda is now off medications for her IBS symptoms.
Jackie characterized her symptoms as a "panic attack of the
bowels". After only two sessions, she reported that her symptoms had
improved so much that she "actually got out with (her) family and
went a few places" for the first time in over four years. She cannot
remember when she did not have IBS symptoms. Now, she reports that she
"feels better upon awakening than I have in years". She no
longer has abdominal pain upon awakening. Even though she had one period
of diarrhea in a time of unduly high stress, she still had no pain
associated with it. Working in conjunction with her physician, Jackie has
come off all the drugs she was on prior to starting the program and has
not had a return of her symptoms even though her stress levels remain
high.
Susan, a financial specialist, during her first visit
characterized her symptoms as: pain 10; gas 7; bloating 10; constipation
10; and diarrhea 2. By the middle of the program, she reported her
symptoms as follows: pain 0; gas 1; bloating 0; constipation 0-1; diarrhea
0. By the end of the program, she reported zeros in all categories.
The common
thread among these people is that they had unabated IBS symptoms which
interfered with their daily living. None of them actually believed
hypnosis would work to alleviate their symptoms. However, they were so
desperate for relief they were willing to try anything. They were
desperate for hope, for an alternative to learning to live with
debilitating symptoms. Now, due to hypnotherapy treatment for their
symptoms, they have been able to return to a much more normal lifestyle.
The
hypnotherapy program I used with this people was modified from the
research done by gastroenterologist P. J. Whorwell, MD, in Manchester,
England, and Dr. Olafur Palsson's research done at Eastern Virginia
Medical Center. The clients came for six to eight sessions spaced two
weeks apart. The hypnosis portion of their session was tape recorded and
they were instructed to play the tape for themselves daily until the next
session. All suggestions and imagery was "gut specific" and
incorporated information on how a normal gastrointestinal system
functions. Suggestions were made about the intestines being coated with a
special protective coating to insulate it from irritants, etc. At the last
session, subjects were taught self hypnosis techniques and given
instructions on how to formulate their own self hypnotic suggestions.
There is no doubt in the world literature that hypnosis
is a highly effective treatment for IBS symptoms. In today's climate of
managed care, hypnosis represents a brief therapy which is benign,
inexpensive and non-invasive. Since IBS symptoms fluctuate, you have to
evaluate the results over a long period of time. What Dr. Whorwell, Dr.
Palsson and I all found to be true is that the greater number of sessions,
the longer lasting relief the client gets. While many clients will report
symptom relief after one to two sessions, unless they come for multiple
sessions spaced over a period of three to four months, they will notice a
gradual "creeping back" of their symptoms. Clients following the
multi-session approach have maintained their symptom improvements for up
to three years after the sessions ended - so far.
In today's insurance climate of managed care, hypnotherapy for IBS
symptoms is being enthusiastically embraced. It is imperative however,
that you work closely with the client's personal physicial and that you
not accept clients who have not gotten a definite diagnosis of IBS.
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