IBS News
Irritable Bowel Syndrome - General Background Information
NICE - Clinical practice guideline - Irritable bowel syndrome in adults: Diagnosis and management of irritable bowel syndrome in primary care - National Institute for Health and Clinical Excellence
Released February 2008
For general convenience salient points listed below. It is recommended that all therapists who could be affected by this report should read it. It is however a weighty document.
Hypnotherapists who wish to learn a structured proven method of working with IBS patients can click here for our current IBS workshops.
Michael Mahoney owner of this IBS Register site believes this document could be prove to be a wonderful opportunity for therapists to begin working with the medical profession and enjoy the rewards it brings, having worked closely himself with GPs and consultants and receiving referrals from both primary and secondary care for more than 12 years of his 22 years in practice.
It is hoped these points help the reader to understand the opportunity this report brings.
p.34 IBS most commonly affects people between the ages of 20 and 30 years and is twice as common in women as in men. The prevalence of the condition… is estimated…between 10 and 20%....significant prevalence of IBS in older people. The true prevalence…may be higher than estimated, because…many people with IBS symptoms do not seek medical advice; NHS Direct online data suggest that 75% of people using this service rely on self-care. In England and Wales, the number of people consulting for IBS is extrapolated to between 1.6 and 3.9 million.
p. 564 RECOMMENDATION Referral for psychological interventions (CBT, hypnotherapy and/or psychological therapy) should be considered for people with IBS who do not respond to pharmacological treatments after 12 months and who develop a continuing symptom profile (described as refractory IBS).
p. 375-6 Hypnotherapy Gut-directed hypnotherapy is a specific form of hypnotherapy … that uses the therapeutic qualities of hypnotherapy, such as deep relaxation, and adds gut-specific treatments and suggestions. ‘Gut-directed hypnotherapy’ can be used as a treatment for irritable bowel syndrome.
IBS is ideal for treatment with hypnosis, as there is no structural damage to the body. During hypnotherapy people learn how to influence and gain control of their gut function and then seem to be able to change the way the brain modulates their gut activity (Whorwell 2005).
Firstly, patients are given a brief outline of the anatomy and physiology of the gut and a schematic representation of their symptoms, using a diagram of the colon showing how smooth muscle spasm can give pain, bloating and a disordered bowel habit. Patients are told that the reduction of this spasm and normalisation of smooth muscle activity will reduce pain and bloating and encourage a more normal flow through the bowel.
Hypnosis is induced by a standard technique, then over successive sessions, patients are asked to place a hand on their abdomen and feel warmth; then this warmth is related to reduction of spasm and the ability to alleviate pain and distension; patients are told that bowel habit will normalise as their control gradually improves; they visualise the gut as a meandering river and they can adjust the flow along it to a comfortable setting as one would open and close lock gates on a river.
Patients may be given a self-hypnosis tape to use at home. Ego-strengthening and confidence-building comments can be made at the end of the sessions. Hypnotherapy can be administered to patients individually or as a group.
Currently hypnotherapy is used as a second line therapy option, usually for people with unresolved IBS symptoms, who have failed to respond to a combination of management strategies. It features on the patient care pathway as one of the psychological interventions that primary care clinicians should consider if symptoms persist…
The GDG discussed whether…leaving patients too long may have meant the person was no longer able to respond. In addition, the GDG was keen to determine whether these therapies could be used as first line treatments, as they had potential to enable people with IBS to cope with their symptoms by giving initial treatments which would have long term sustainability. This view was supported by evidence in children with IBS, which showed that hypnotherapy is clinically effective as a first line therapy.