Let the Mind Help Tame an Irritable Bowel

Let the Mind Help Tame an Irritable Bowel

If you’ve ever had butterflies in your stomach or an attack of nerves that sent you racing for the bathroom, you already know that the intestinal tract has a mind of its own. The millions who suffer from irritable bowel syndrome, or I.B.S., perhaps know it best. I.B.S., with its symptoms of bloating, abdominal pain, flatulence, diarrhea or constipation or an alternating cycle of the two, can seriously impair the ability to work and enjoy leisure activities. Up to 15 percent of the population is affected, though only half seek medical help. The gut and brain are intimately connected, with more nerve cells in the intestines than in the spinal cord. The gut has been called the body’s second brain, containing 95 percent of the body’s neurotransmitter serotonin and direct nerve connections to the brain.

So it is no surprise that this common disorder of intestinal function has a strong mind-body connection. This does not mean I.B.S. is a psychosomatic condition caused by emotions, but rather that emotional upsets can aggravate symptoms in someone with a hyper-reactive bowel. It also means that learning to minimize stress and emotional disturbances can reduce the symptoms of I.B.S., perhaps more effectively than medications, recent research has indicated. Yet much educational material about this condition underplays the mind-body connection and the vital role that emotional retraining can play in controlling it.

This is perhaps an overreaction to the past when most patients with I.B.S. were told there was nothing physically wrong with them — it was all in their heads. After all, they had no obvious organic cause like a tumor, infection or ulcer. In the modern era of medicalization, the pendulum swung the other way. Gastroenterologists […]

Prevention of Recurring Ulcers

Prevention of Recurring Ulcers

Hypnotherapy and the Prevention of Recurring Ulcers

An ulcer is a wound that develops inside the body where acid and digestive juices eat away at the mucous lining. Duodenal ulcers are ulcers in the duodenum which is the upper part of the small intestine that connects to the stomach. Symptoms of a duodenal ulcer include heartburn, burning in the throat, and abdominal pain. These symptoms are most likely to occur a few hours after eating and are more likely to occur when acidic foods are ingested.

Treatment of duodenal ulcers is highly effective with the use of drugs such as ranitidine, H2 receptor antagonists, and tripotassium dicitratobismuthate. However studies have shown that anywhere from 60% to 90% of people who suffer from duodenal ulcers relapse within one year of treatment.

According to an article published in the UK medical journal The Lancet, a study was performed to test whether hypnotherapy would play a role in preventing relapses in people who suffered from duodenal ulcers. The study consisted of 30 people of which 14 were female, 16 were men, and the average age was 40. All participants had been diagnosed with the disease through an endoscopy. They also experienced relapses with the most recent relapse being within the past six months.

Treatment for the thirty participants included taking the drug ranitidine. The ulcer was given time to heal and was shown to have healed through an endoscopy. All participants continued to take the drug for ten more weeks. The patients were divided into two groups.

One group received seven hypnosis sessions and was given a recording of the sessions to listen to on their own. The other group did not receive hypnosis during their sessions. The participants […]

By |July 8th, 2009|Anxiety, Digestive Disorders, Stress|Comments Off on Prevention of Recurring Ulcers

Substance induced anxiety disorder: Anxiety due to substance abuse

Anxiety due to substance abuse

Substance induced anxiety disorder: Anxiety due to substance abuse

Severely depressed or anxious people are at high risk for alcoholism, smoking , and other forms of addiction. Anxiety disorders are highly prevalent among people with alcoholism. It should be noted, moreover, that long-term alcohol use can itself cause biologic changes that may actually produce anxiety and depression.

Substance-induced anxiety disorder may be experienced by individuals with no preexisting psychopathology as well as those who have a history of erratic or maladaptive behavior. On the other hand, these episodes usually occur in individuals with preexisting anxiety about drug use, especially novice users or in experienced users who have taken more than their usual dose.

Anxiety may be secondary to physical disorders, such as neurologic disorders (eg, brain trauma, infections, inner ear disorders), cardiovascular disorders (eg, heart failure, arrhythmias), endocrine disorders (eg, overactive adrenal or thyroid glands), and respiratory disorders (eg, asthma, chronic obstructive pulmonary disease). Anxiety may be caused by use of drugs, such as alcohol, stimulants, caffeine, cocaine, and many prescription drugs. Also, drug withdrawal is commonly associated with anxiety.

  • The patient has prominent anxiety, compulsions, obsessions or panic attacks.
  • History, physical exam or laboratory data substantiate that either – these symptoms have developed within a month of substance intoxication or withdrawal or – medication use has caused the symptoms.
  • No other anxiety disorder better accounts for these symptoms.
  • The symptoms cause clinically important distress or impair work, social or personal functioning.
  • The symptoms don’t occur solely during a delirium.

The essential features of substance-induced anxiety disorder are prominent and persistent feelings of anxiety that are judged to be due to the direct physiological effects of intoxication or withdrawal from a substance. Prominent anxiety, Panic Attacks, or obsessions or […]

By |July 8th, 2009|Anxiety, Hypnotherapy|Comments Off on Substance induced anxiety disorder: Anxiety due to substance abuse

Irritable Bowel Syndrome

Irritable Bowel Syndrome

Irritable Bowel Syndrome (IBS) is a heterogeneous condition with varying severity and symptomology.  At least one in four of the general population is affected at some time in their lives (Jones 1992, Harvey 1983, Cook 1987).  Despite the condition being classed as ‘non-serious’, it has serious cost implications to the UK National Health Service and Health Insurance Providers throughout the world, due to  frequent presentations to general practitioners, hospital physicians and other specialist services (Talley 1995).  The diagnosis is often reached by exclusion of diagnosable physical abnormalities and organic disease (Latimer 1983).  But according the World Health Organization (1979), “health, which is a state of complete physical, mental and social well being and not merely the absence of disease or infirmity, is a fundamental human right”

As a clinical hypnotherapist I have taken great interest in the management of this disorder as I have experienced the distress and frustration this client group feel in the search for relief from symptoms which have a severe impact on their lifestyle.  With conventional medical treatment being of little proven benefit (Houghton 1996) there is a need to look beyond treating the symptoms to addressing the cause.  In the holistic view of illness, physical disease is only one of several manifestations of basic imbalance of the organism, other manifestations may take the form of psychological and social pathologies (Capra 1983 p131).

The fact is that holistic approach to medical and psychological care is required in the management of IBS, but that the psychological aspect is not universally accepted by the medical profession or the client group with clients feeling there is a stigma attached to this aspect of care.  As a clinical Hypnotherapist I have an impact on […]

Irritable bowel symptoms worsen during menstrual cycle

Irritable bowel symptoms worsen during menstrual cycle

Having a period significantly worsens symptoms of irritable bowel syndrome (IBS) and lowers pain thresholds, finds research in Gut.

It has previously been shown that the menstrual cycle has no effect on rectal sensitivity of normal healthy women, despite the fact that they have looser stools at the time of menses.In patients with irritable bowel syndrome (IBS) however, the menstrual cycle may have a greater role, as such patients often report a significant worsening of their IBS symptoms with menses.In order to test whether this is the case, a balloon catheter was inserted into the rectum of 29 women aged between 21 and 44, who had been diagnosed with IBS according to the Rome I criteria.

Rectal responses to distention of the balloon during Days 1-4 (menses), 8-10 (follicular phase), 18-20 (luteal phase), and 24-28 (premenstrual phase) were assessed to detect changes in sensitivity and other sensations, such as urge.A general symptom diary was kept by the women during the course of the study, to evaluate abdominal pain and bloating (using a visual analogue scale), and frequency and consistency of bowel habits.Throughout the study the levels of anxiety and depression of the subjects were also assessed using the hospital anxiety and depression questionnaire.

The researchers found the women reported abdominal pain and bloating as being significantly worse during menses compared with most other phases of the cycle.Bowel habits became more frequent, and patients tended to have a lower general well-being – although there was no evidence that they were more depressed or anxious at this time.Their rectal sensitivity was also significantly increased at the time of their period, more so than during […]

Probiotic alleviates IBS

Probiotic alleviates IBS

Probiotic mixture alleviates IBS symptoms

Probiotic alleviates IBS and even a slight symptom reduction could have positive public health consequences, reports September’s Alimentary Pharmacology & Therapeutics. Irritable bowel syndrome (IBS) is a gastrointestinal disorder of unknown etiology.The effect of probiotics in this syndrome remains unclear. Dr Korpela and colleagues investigated whether a probiotic mixture is effective in alleviating irritable bowel syndrome symptoms.

The probiotic mixture contained Lactobacillus rhamnosus GG, L. rhamnosus LC705, Bifidobacterium breve Bb99 and Propionibacterium freudenreichii ssp. and Shermanii JS. The researchers included a total of 103 patients fulfilling the Rome I or II criteria in this 6-month, randomized, double-blind placebo-controlled trial. The patients received a probiotic capsule or a placebo capsule daily, and the team recorded gastrointestinal symptoms and bowel habits.

At the end the total symptom score, consisting of abdominal pain, distension, flatulence, and borborygmi (Rumbling sounds caused by gas moving through the intestines (stomach “growling”)) was 8% points lower in the probiotic group. The reduction in total symptom score represents a median reduction of 42% in the symptom score of the probiotic group compared with 6% in the placebo group. In individual symptoms, the team found that borborygmi was milder in the probiotic group. The researchers noted that for the rest of the symptoms there was a non-significant reducing trend.

Dr Korpela’s team commented, “The results indicate that this probiotic mixture is effective in alleviating irritable bowel syndrome symptoms.” “Considering the high prevalence of irritable bowel syndrome and the lack of effective therapies, even a slight reduction in symptoms could have positive public health consequences.”

Source: Aliment Pharmacol & Ther 2005: 22(5): 387  29 August 2005

Quality of life low with IBS

Quality of life low with IBS

Quality of life with IBS is low compared to other chronic diseases

The latest European Journal Gastroenterology reports that IBS patients treated with mebeverine experience low quality of life, and suffer from severe pain.

Irritable bowel syndrome (IBS) is a prevalent functional gastrointestinal dysmotility disorder.Dr Maarten ten Berg and colleagues estimated the burden of illness of a patients suffering from IBS in the Netherlands.

Patients identified at community pharmacies, using mebeverine as a proxy for IBS, were given a questionnaire. The questionnaire included the Rome II criteria for IBS, questions on the predominant type of stool during complaints, and severity of symptoms. Questions were also asked about generic and disease-specific quality of life, current health status, and loss of productivity.

The research team identified 375 users of mebeverine, of which 169 patients met the Rome II criteria for IBS, and were included in the study.The team noted that 58% of the IBS patients reported severe abdominal pain and complaints.The researchers found that generic and disease-specific quality of life outcomes showed impairment on all dimensions.

Current health status in IBS patients using the Euro quality of life-5D score was perceived on 62% of full health. A calculation of health status in these patients based on the Short Form-6D algorithm showed a comparable score of 0.67, with 1 being full health. The team observed that the loss in productivity of IBS patients was about 2 days per month.

Dr ten Berg’s team commented, “This study confirmed that the burden of illness of IBS in the Netherlands is substantial.” “IBS patients treated with mebeverine experienced low quality of life, and suffered from severe pain.” “Based on these results, more attention for […]

Improved pain management of IBS for children

Improved pain management of IBS for children

Hypnotherapy improves pain management of IBS for children

Functional abdominal pain and irritable bowel syndrome (IBS) are highly prevalent in childhood. Pain intensity scores decreased in the hypnotherapy group from 14 to 1 Gastroenterology.The team found that a substantial proportion of patients continue to experience long-lasting symptoms.Gut-directed hypnotherapy has been shown to be highly effective in the treatment of adult irritable bowel syndrome patients.

Dr Arine Vlieger and colleagues from the Netherlands undertook a randomized controlled trial and compared hypnotherapy with standard medical therapy in children with functional abdominal pain or irritable bowel syndrome.The team assessed 53 pediatric patients, age 8 to 18 years, with functional abdominal pain or irritable bowel syndrome.The team randomized 31 patients to either hypnotherapy or 22 to standard medical therapy.

Hypnotherapy consisted of 6 sessions over a 3-month period.Patients in the standard medical therapy group received standard medical care, and 6 sessions of supportive therapy. Pain intensity, pain frequency, and associated symptoms were scored in weekly standardized abdominal pain diaries at baseline, during therapy, and 6 and 12 months after therapy.

The researchers found that pain scores decreased significantly in both groups from baseline to 1 year follow-up.Pain intensity scores decreased in the hypnotherapy group from 14 to 1, and in the standard medical therapy group from 14 to 8.

The research team found that pain frequency scores decreased from 14 to 1 in the hypnotherapy group, and from 14 to 9 in the standard medical therapy group.The team observed that hypnotherapy was highly superior, with a significantly greater reduction in pain scores compared with standard medical therapy.At 1 year follow-up, successful treatment was accomplished in 85% of the […]

Therapy for Irritable Bowel

Therapy for Irritable Bowel

Therapy? Hypnosis for Irritable Bowel?

Some people may cope better with irritable bowel syndrome (IBS) with help from cognitive behavioral therapy and hypnosis, three new studies show.

The studies were presented in Los Angeles, at Digestive Disease Week 2006, an international meeting of doctors, researchers, and academics.

One of the studies used cognitive behavioral therapy to teach IBS patients new ways to handle their condition. The other two studies tested hypnosis in IBS patients who hadn’t been helped by other treatments.

Cognitive behavioral therapy and hypnosis were each linked to improvements in gastrointestinal symptoms, the studies show.

Not ‘Hocus-pocus’

The hypnosis researchers included Magnus Simren, MD, of Sahlgrenska University Hospital’s internal medicine department in Gothenburg, Sweden.

Hypnotherapy is already used to treat IBS patients, mainly at a few highly specialized gastrointestinal centers, Simren told reporters in a conference call. His team used two more common settings: a university hospital and a county hospital.

Exactly how hypnosis helps IBS isn’t clear. Simren, a gastroenterologist, admits having his doubts that patients would give it a try.

“When I started with this, I was a little bit afraid that patients would be hesitant, that they would think this is hocus-pocus. But they are very open-minded to this,” he says.

“When I speak to the patient, I tell them that this is a way that you can get control over your symptoms,” says Simren. “They are quite satisfied with that explanation.”

Hypnosis Studies

Simren’s hypnosis studies had a combined total of 135 IBS patients. The patients’ average age was 41; most were women.

In both studies, participants were split into two groups. One group got 12 weekly one-hour hypnotherapy sessions focused on gut-related problems. For comparison, […]

Therapy Benefits IBS

Therapy Benefits IBS

Cognitive Therapy Benefits IBS

Cognitive behavioral therapy and hypnotherapy have been successfully used in the treatment of a variety of chronic syndromes, including common functional disorders of the gastrointestinal tract, such as irritable bowel syndrome. New research presented today at Digestive Disease Week® 2006 (DDW) again asserts that these therapies may have a powerful impact on the digestive system including improving symptoms of lower GI tract disorders. DDW is the largest international gathering of physicians and researchers in the fields of gastroenterology, hepatology, endoscopy and gastrointestinal surgery.

“These studies illustrate the intricate ties between the digestive tract and other major body systems,” said Emeran Mayer, M.D., professor of medicine, physiology and psychiatry, University of California, Los Angeles. “Physicians must recognize these connections to help treat patients more effectively.”

A Randomized Controlled Trial of Therapist-Administered vs Minimal-Therapist-Contact Cognitive Behavioral Treatment for Moderate to Severe IBS

Preliminary research funded by the National Institutes of Health shows that behavioral therapy may be quite effective in treating symptoms of irritable bowel syndrome (IBS) unresponsive to standard medications and dietary agents. However, it can be an expensive and time-consuming option. Study authors from the University at Buffalo, State University of New York condensed a behavioral treatment program into a four session patient-administered format with minimal therapist contact in an attempt to reduce the costs and time-commitment for patients. Researchers found that even though the four-session program required less therapist time, it was as effective as the 10-week, clinic-based program in relieving the range of GI symptoms of IBS.

Researchers randomly assigned 59 patients to receive a 10-week; clinic-based behavioral treatment (CBT); a four-session behavioral program (MC-CBT); […]