IBS is a common condition affecting one in four of the population, half of which have it so severe that it prevents them from working.
Within the field of evidence-based medicine, hypnotherapy has been proven to be 70% effective in treating this condition.
Hypnotherapy is non intrusive, safe, comfortable and a cost effective modality to complement mainstream medicine. Some in the profession would in this case argue it is ‘alternative’ treatment since the medical profession are generally at a loss with this condition. The job of the hypnotherapist is to help the client to control their gut rather than their gut control them.
As a specialist in this area, it is my understanding that sufferers have the need for understanding and an empathetic approach. Sufferers who consider hypnotherapy currently tend to do so as a ‘last resort’ rather than a first approach after diagnosis. The medical profession are becoming more aware of the benefits of hypnotherapy from a specialist in the field. As a clinical based practitioner, my hypnotherapy practice receives referrals from general practitioners, gastroenterologists and specialist gastro nurses.
Just dealing with the symptoms of IBS is not enough, the individual has to learn to rebuild internal energy, many sufferers feel drained emotionally, life issues and responsibilities continue to deplete inner emotional strength, leading in some cases to anxiety or even some forms of depression. Before the sufferer even thinks of working through the IBS, they invariably need an emotional ‘top up’, they need their batteries charged, after perhaps years of pain and discomfort, of being told by various medical professionals that there is nothing that can be done, even though intrusive and sometimes painful examinations have been undergone, many sufferers feel emotionally drained. Work and family relationships can be eroded and strained, social life and love life can be virtually non-existent, concentration and recall, may be almost impossible compared to how it used to be, confidence and self-esteem of the individual is often very low and the ability to see things in perspective is greatly reduced. Therefore to tell a sufferer that they must do this or that, without preparing for the journey is almost certain failure.
Hypnotherapy, when conducted correctly can increase self-esteem, confidence, and allow the sufferer to begin a journey of self improvement and management, by changing their thoughts, changing negative thoughts and feelings for positive ones and thereby equip themselves emotionally to move away from the symptoms and thoughts of IBS and begin moving forward, a journey that many sufferers have or are taking at this moment, with positive changes.
IBS Symptom Checklist
- Do you often experience painful abdominal spasm?
- Do you often try to empty your bowels but are unable to do so are find it difficult?
- Do you often notice a sensation of not being able to fully empty your bowels?
- After defecation, do you often feel that have not fully emptied your bowels?
- Do you often experience diarrhea or loose stools?
- Do you often experience bloating?
- Do you often experience flatulence or excess wind?
- Do you find abdominal pain or discomfort is relieved after emptying your bowels?
- Have you noticed mucus or slime in your stools?
- Do you often experience anxiety and/or depression?
- Have you recently experienced significant stress?
- Have you noticed any of the following symptoms? Reoccuring fever, blood in your stools, unexpected weight loss, any recent changes in bowel habits.
Irritable bowel syndrome is an erratic and unpredictable disturbance of the digestive system. The national institute for healthy and clinical excellence (NICE) states that IBS is a possible diagnosis only when a person reports to having either abdominal pain or discomfort or bloating plus a change in bowel habits for at least six months.
There’s a book called The Second Brain written by Dr. Michael Gershon, M.D. and neurobiologist (Harper/Collins, 1999). Gershon was researching the entire gut, and he discovered, in a nutshell, two major things. The first is that there is a whole set of nurons in the gut, from the esophagus all the way to the anus. A lot of the neurons are concentrated more in the somach or the solar plexus area, and actually accumulate emotional memories. The second point that he madeis that 95% of serotonin, which is a neurotransmitter, is made and stored in the gut area. Before this, most people, especially scientists who studied the head brain, thought that neurotransmitters, including serotonin, were made and stored in the head brain.
Deficiency of serotonin will cause depression, suicidal thoughts, insomnia and other disorders.
The enteric nervous system: the brain in the gut
The gut has a mind of its own, the “enteric nervous system”. Just like the larger brain in the head, researchers say, this system sends and receives impulses, records experiences and responds to emotions. Its nerve cells are bathed and influenced by same neurotransmitters. The gut can upset the brain just as the brain can upset the gut.
The gut’s brain or the “enteric nervous system” is located in the sheaths of tissue lining the esophagus, stomach, small intestine and colon. Considered a single entity, it is a network of neurons, neurotransmitters and proteins that zap messages between neurons, support cells like those found in the brain proper and a complex circuitry that enables it to act independently, learn, remember and, as the saying goes, produce gut feelings.
The gut’s brain is reported to play a major role in human happiness and misery. Many gastrointestinal disorders like colitis and irritable bowel syndrome originate from problems within the gut’s brain. Also, it is now known that most ulcers are caused by a bacterium not by hidden anger at one’s mother.
Details of how the enteric nervous system mirrors the central nervous system have been emerging in recent years, according to Dr. Michael Gershon, professor of anatomy and cell biology at Columbia-Presbyterian medical Centre in New York. He is one of the founders of a new field of medicine called “neurogastroenterology.”
The gut contains 100 million neurons – more than the spinal chord. Major neurotransmitters like serotonin, dopamine, glutamate, norephinephrine and nitric oxide are in the gut. Also two dozen small brain proteins, called neuropeptides are there along with the major cells of the immune system. Enkephalins (a member of the endorphins family) are also in the gut. The gut also is a rich source of benzodiazepines – the family of psychoactive chemicals that includes such every popular drugs as valium and xanax.
In evolutionary terms, it makes sense that the body has two brains, said Dr. David Wingate, a professor of gastrointestinal science at the university of London and a consultant at Royal London Hospital. “The first nervous systems were in tubular animals that stuck to rocks and waited for food to pass by,” according to Dr Wingate. The limbic system is often referred to as the “reptile brain.” “As life evolved, animals needed a more complex brain for finding food and sex and so developed a central nervous system. But the gut’s nervous system was too important to put inside the newborn head with long connections going down to the body,” says Wingate. Offspring need to eat and digest food at birth. Therefore, nature seems to have preserved the enteric nervous system as an independent circuit inside higher animals. It is only loosely connected to the central nervous system and can mostly function alone, without instructions from topside.
This is indeed the picture seen by developmental biologists. A clump of tissue called the neural crest forms early in embryo genesis. One section turns into the central nervous system. Another piece migrates to become the enteric nervous system. According to Dr. Gershon, it is only later that the two systems are connected via a cable called the vagus nerve.
The brain sends signals to the gut by talking to a small number of “command neurons,” which in turn send signals to gut interneurons that carry messages up and down the pike. Both command neurons and interneurons are spread throughout two layers of gut tissue called the “myenteric plexus and the submuscosal plexus.” Command neurons control the pattern of activity in the gut. The vagus nerve only alters the volume by changing its rates of firing.
The plexuses also contain glial cells that nourish neurons, mast cells involved in immune responses, and a “blood brain barrier” that keeps harmful substances away from important neurons. They have sensors for sugar, protein, acidity and other chemical factors that might monitor the progress of digestions, determining how the gut mixes and propels its content.
As light is shed on the circuitry between the two brains, researchers are beginning to understand why people act and feel the way they do. When the central brain encounters a frightening situation, it releases stress hormones that prepare the body to fight or flee. The stomach contains many sensory nerves that are stimulated by this chemical surge – hence the “butterflies.” On the battlefield, the higher brain tells the gut brain to shut down. A frightened running animal does not stop to defecate, according to Dr. Gershon.
Fear also causes the vagus nerve to “turn up the volume” on serotonin circuits in the gut. Thus over stimulated, the gut goes into higher gear and diarrhea results. Similarly, people sometimes “choke” with emotion. When nerves in the esophagus are highly stimulated, people have trouble swallowing.
Even the so-called “Maalox moment” of advertising can be explained by the interaction of the two brains, according to Dr. Jackie D. Wood, chairman of the department of physiology at Ohio State University in Columbus, Ohio. Stress signals from the head’s brain can alter nerve function between the stomach and esophagus, resulting in heartburn.
In cases of extreme stress, Dr. Wood says that the higher brain seems to protect the gut by sending signals to immunological mast cells in the plexus. The mast cells secrete histamine, prostaglandin and other agents that help produce inflammation. This is protective. By inflaming the gut, the brain is priming the gut for surveillance. If the barrier breaks then the gut is ready to do repairs. Unfortunately, the chemicals that get released also cause diarrhea and cramping.
There also is an interaction between the gut brain and drugs. According to Dr. Gershon, “when you make a drug to have psychic effects on the brain, it’s very likely to have an effect on the gut that you didn’t think about.” He also believes that some drugs developed for the brain could have uses in the gut. For example, the gut is loaded with the neurotransmitter serotonin. According to Gershon, when pressure receptors in the gut’s linking are stimulated serotonin is released and starts the reflexive motion of peristalsis. A quarter of the people taking prozac or similar antidepressant medications have gastrointestinal problems like nausea, diarrhea or constipation. These drugs act on serotonin, preventing its uptake by target cells so that it remains more abundant in the central nervous system.
Gershon also is conducting a study of the side effects of prozac on the gut. Prozac in small doses can treat chronic constipation. Prozac in larger doses can cause constipation – where the colon actually freezes up. Moreover, because prozac stimulates sensory nerves, it also can cause nausea.
Some antibiotics like erythromycin act on gut receptors to produce ascillations. People experience cramps and nausea. Drugs like morphine and heroin attach to the gut’s opiate receptors, producing constipation. Both brains can be addicted to opiates.
Victims of Alzheimer’s and Parkinson’s diseases suffer from constipation. The nerves in their gut are as sick as the nerve cells in their brains. Just as the central brain affects the gut, the gut’s brain can talk back to the head. Most of the gut sensations that enter conscious awareness are negative things like pain and bloatedness.
The question has been raised: Why does the human gut contain receptors for benzodiazepine, a drug that relieves anxiety? This suggests that the body produces its own internal source of the drug. According to Dr. Anthony Basile, a neurochemist in the Neuroscience Laboratory at the national Institutes of Health in Bethesda, MD, an Italian scientist made a startling discovery. Patients with liver failure fall into a deep coma. The coma can be reversed, in minutes, by giving the patient a rug that blocks benzodiazepine. When the liver fails, substances usually broken down by the liver get to the brain. Some are bad, like ammonia and mercaptan, which are “smelly compounds that skunks spray on you,” says Dr. Basile. But a series of compounds are also identical to benzodiazepine. “We don’t know if they come from the gut itself, from bacteria in the gut or from food, but when the liver fails, the gut’s benzodiazepine goes straight to the brain, knocking the patient unconscious”, says Dr Basile.
The payoff for exploring gut and head brain interactions is enormous, according to Dr. Wood. Many people are allergic to certain foods like shellfish. This is because mast cells in the gut mysteriously become sensitized to antigens in the food. The next time the antigen shows up in the gut, the mast cells call up a program, releasing chemical modulators that try to eliminate the threat. The allergic person gets diarrhea and cramps.
Many autoimmunie diseases like Crohn’s disease and ulcerative colitis may involve the gut’s brain, according to Dr. Wood. The consequences can be horrible, as in “Chagas disease,” which is caused by a parasite found in South America. Those infected develop an autoimmune response to neurons in their gut. Their immune systems slowly destroy their own gut neurons. When enough neurons dies, the intestines literally explode.
A big question remains. Can the gut’s brain learn? Does it “think” for itself? Dr. Gershon tells a story about an old army sergeant, a male nurse in charge of a group of paraplegics. With their lower spinal chords destroyed, the patients would get impacted. “At 10am every morning, the patients got enemas. Then the sergeant was rotated off the word. His replacement decided to give enemas only after compactions occurred. But at 10 the next morning everyone on the ward had a bowel movement at the same time, without enemas.” Had the sergeant trained those colons?
The human gut has long been seen as a repository of good and bad feelings. Perhaps emotional states from the head’s brain are mirrored in the gut’s brain, where they are felt by those who pay attention to them.
We use a combination of hypno-cognitive therapy and hypnoanalysis to find the cause and thereby eliminate the emotional effects.