How Can Hypnotherapy Help With Irritable Bowel Syndrome?

Research shows that hypnosis can help IBS as part of a multifaceted approach.

Posted Apr 15, 2020

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If you’ve experienced Irritable Bowel Syndrome (IBS), a condition which affects the gastrointestinal (GI) system, you’ll know how uncomfortable and disruptive it is. When your symptoms – which may include constipation, diarrhea, bloating, and a feeling of not having fully emptied your bowels – are most severe, you may have to take time off work and avoid certain social situations. Many people with IBS suffer from anxiety, depression, lethargy, and headaches1. So, although it’s not life-threatening, it’s certainly an unpleasant and disruptive condition to live with. 

There’s no single diagnostic test for IBS, with a diagnosis being based on presentation of a combination of symptoms. And there’s no definitive cure, either. Instead, changes to lifestyle and diet – including following a low FODMAP2 diet – can help manage the condition and alleviate the worst of the symptoms. Medication may also be prescribed to control diarrhea, constipation, and bloating. 

One intervention which has been the focus of a considerable body of research in recent years and which is recommended as a treatment for IBS by the National Institute of Health and Care Excellence (NICE) in the UK is hypnotherapy. How does hypnotherapy, which works with the mind, help with a condition which affects the gut?

Firstly, we need to understand how the brain-gut axis works, as it plays a crucial role in both the causes and treatment of IBS. Usually, when we think about our brain, we are thinking about the Central Nervous System (CNS), which is made up of the brain and spinal cord. However, it’s also useful to consider the role of the Enteric Nervous System (ENS). The ENS is made up of more than 500 million neurons which control movement, secretions, and blood flow in your gut and is located entirely in the walls of the GI tract. You might think that the CNS and the ENS are performing two separate roles, but in fact they are very closely connected by the vagus nerve which runs from the base of the brain, through the neck, and into the stomach, reaching all the way to the gut. The vagus nerve is like an information super-highway between your gut and brain which sends signals from your gut to your brain and from your brain to your gut3.  

Research into the brain-gut axis has shown that stress can inhibit the signals sent through the vagus nerve and cause gastrointestinal problems, such as IBS4. Stress can also affect the types of microbes present in the gut5. Information sent through the vagus nerve results in increased or decreased movement through the GI tract. What we think – and whether those thoughts lead us to a ‘rest and digest’ or ‘fight or flight’ state – directly impacts what is happening in our gut at any time. We don’t know exactly why people with IBS experience a greater response in their gut to stress than other people, but we do know that people with IBS often have other psychiatric and psychological conditions, including anxiety and depression, and IBS patients often have increased levels of hormones involved with the stress response. In many cases, people with IBS have experienced a life trauma, and a history of sexual abuse is more common in patients with IBS6. The way in which IBS is affected by emotions might be linked to the intensity of the emotion and how a person responds to that emotion. Feelings of anger, aggression, and excitement appear to increase colonic movement while hopelessness and happiness lead to a decrease in colonic movement7

This clearly demonstrable link between thought, emotion, and gut function has led to a considerable body of research into the effectiveness of hypnotherapy in the management and improvement of IBS which shows that not only does hypnotherapy lead to an improvement in symptoms, but it also helps people improve their confidence, self-esteem, and mood, with long-lasting effects8.  Much of the research has focused on ‘gut-directed’ hypnotherapy which attempts to improve the functioning of the gut by activating the parasympathetic or ‘rest and digest’ state and improving gut movement. Using imagery and positive suggestion, research has shown that hypnotherapy can reduce hypersensitivity in the gut9 and positively affect motor function10.  More recent research has also shown that hypnotherapy can help people to identify and modify the negative emotional responses which are causing or exacerbating their IBS. By experiencing, under hypnosis, the effects of this helpful emotional response, and by following up the work done during sessions with self-hypnosis and relaxation, people have experienced improvement in their IBS symptoms. Cognitive Behavioural Therapy (CBT) is also recommended by NICE as a treatment option for IBS and an individualized, ‘hypnosis-CBT’ approach can help someone with IBS to identify the emotional triggers and responses which may make their condition worse and find alternatives to their normal triggers and responses11.

Far from being a condition which is confined to the gut, IBS benefits greatly from therapeutic interventions. Hypnotherapy has an advantage over talking therapies in terms of focusing not only on the link between thoughts, emotions, and gut function but in being able to encourage a relaxation response and reduce stress and anxiety levels generally, with the help of ongoing self-hypnosis. From group hypnosis to Skype hypnosis to individualized CBT hypnosis, hypnotherapy looks likely to gain in popularity as people become aware of its effectiveness in treating IBS. 

References

1. Lindfors, P. (2012) Implementation of gut-directed hypnotherapy for irritable bowel syndrome in clinical practice. University of Gothenburg

2. https://www.monashfodmap.com/

3. Lindfors, P. (2012) Implementation of gut-directed hypnotherapy for irritable bowel syndrome in clinical practice. University of Gothenburg

4. Sahar,T, Shalev, AY, Porges, SW (2001) Vagal modulation of responses to mental challenge in posttraumatic stress disorder, Biol Psychiatry, April, 1, 49(7), 637-43

5. Desbonnet, L, Clarke, G, Traplin, A, et al (2015) Gut microbiota depletion from early adolescence in mice: implications for brain and behaviour. Brain, behaviour and immunity, 48, 165-173

6. Creed, F, Guthrie, E, Ratcliffe, J, et al (2005) Reported sexual abuse predicts impaired functioning but a good response to psychological treatments in patients with severe irritable bowel syndrome. Psychosomatic Medicine, 67 (3), 490-99

7. Chang, L. (2011) the role of stress on physiological responses and clinical symptoms in irritable bowel syndrome. Gastroenterology, 140: 761

8. 

8. Lindfors, P. (2012) Implementation of gut-directed hypnotherapy for irritable bowel syndrome in clinical practice. University of Gothenburg

9. Ford, AC, Lacy, BE, Talley, NJ (2017) Irritable Bowel Syndrome, N. Engl J. Med, 376, 2566-78

10. Creed, F, Guthrie, E, Ratcliffe, J, et al (2005) Reported sexual abuse predicts impaired functioning but a good response to psychological treatments in patients with severe irritable bowel syndrome. Psychosomatic Medicine, 67 (3), 490-99

11. Phillips-Moore, JS, Talley, NJ, Jones, MP (2015) The mind-body connection in irritable bowel syndrome: a randomised controlled trial of hypnotherapy as a treatment, Health Psychology Open, January-June, 1-14