Hypnosis for IBS
By: Peter Whorwell, MD, Professor of Medicine and Gastroenterology, University of Manchester, UK
Irritable bowel syndrome (IBS) would seem to be a disorder that might be amenable to treatment with hypnosis. There is no structural damage and the various possible underlying mechanisms such as disordered motility and visceral (internal) sensitivity might be susceptible to modulation by the mind. Thus, nearly 20 years ago, we undertook the first controlled trial of hypnotherapy in this disorder. The results were extremely encouraging and eventually led us to developing a hypnotherapy unit dedicated to the provision of this service.
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Several years ago we published an audit of the first 250 patients treated and found that hypnosis not only helps the symptoms of IBS but also significantly improves quality of life.1 Interestingly, it also relieves the additional symptoms from which so many patients with IBS suffer such as nausea, lethargy, backache, and urinary problems. This is in sharp contrast to the medications currently available for IBS, which often help one or two symptoms if at all.
However, hypnosis should not be regarded as a panacea as up to 30% of patients fail to respond. Even when patients do improve, conventional approaches to treatment should not necessarily be ignored. Therefore it is still important that lifestyle factors such as diet are also taken into account. In addition, some patients may find that an occasional loperamide or laxative, depending on the bowel habit abnormality, maybe required.
Unfortunately, most patients, especially those with severe symptoms, require multiple sessions of treatment. In our unit, we allow up to 12 sessions which therefore results in this being a time consuming and costly approach in the short term. However, as a result of the undoubted sustained benefits of treatment, it has been calculated that it becomes cost effective within 2 years when compared to conventional approaches. As new (and likely expensive) drugs now in development for IBS reach the market, hypnotherapy may become a more viable option from the financial point of view.
Hypnotherapy therefore appears to be a realistic option in the treatment of conditions such as IBS. Our success has been reproduced by others, but the technique has, so far, not been generally adopted. This is probably because of the unfounded suspicion that surrounds the subject coupled with the fact it is not something with which most physicians or gastroenterologists are especially familiar. Hopefully these negative attributes will decline with time, especially if the success of the technique continues to be supported by a strong evidence base.
The hypnosis treatment described in this article was conducted by therapists who were following a rigorous treatment protocol in the treatment of patients diagnosed with IBS. Treatment involves generally seven to twelve sessions with a qualified therapist.
Many individuals practice hypnosis but not all are qualified to treat medical conditions. Care should be taken in finding a qualified hypnotherapist to treat IBS. A list of clinicians in the U.S. who use a treatment protocol standardized by Olafur S. Palsson, Psy.D, et.al., from the Department of Medicine, University of North Carolina, Chapel Hill, may be found at this web site: http://www.ibshypnosis.com/IBSclinicians.html
Gonsalkorale WM, Houghton LA, Whorwell PJ. Hypnotherapy in irritable bowel syndrome: a large scale audit of a clinical service with examination of factors influencing responsiveness. Am J Gastroenterology 2002 94 954-961.