[eric]

FYIHypnotherapy Benefits Patients With Irritable Bowel SyndromeNEW YORK (Reuters Health) Apr 27 - In patients with refractory irritable bowel syndrome, hypnotherapy reduces the hyperresponsiveness of the colon after eating, according to Swedish researchers."Postprandial symptoms in irritable bowel syndrome are common and related to an exaggerated motor and sensory component of the gastrocolonic response," Dr. Magnus Simren and colleagues from Sahlgrenska University Hospital, Goteborg, write in the March/April issue of Psychosomatic Medicine.Twenty-eight patients with irritable bowel syndrome that had not responded to other treatments were randomly assigned to receive gut-directed hypnotherapy 1 hr/week for 12 weeks (n = 14) or supportive therapy (controls; n = 14).Hypnotherapy patients were given suggestions in the hypnotic state directed at normalizing GI function, and included imagery of "a river flowing smoothly, or a blocked river flow that was cleared by the patient," the researchers elaborate. Patients were encouraged to practice their "hypnotic skills" at home between sessions.Patients in the supportive group attended sessions on diet emphasizing "good and bad food items," and on relaxation training.At baseline and 3 months, the patients underwent a colonic distension trial before and following a 1-hour duodenal lipid infusion. The team assessed colonic sensory thresholds and tonic and phasic motor activity."At baseline, both groups had similar fasting balloon volumes in the colon and demonstrated reduced balloon volumes, indicating increased tone during the lipid infusion, without significant group differences," Dr. Simren and colleagues explain.After the treatment period, the hypnotherapy patients but not the control patients "failed to demonstrate a colonic tone response during the lipid perfusion."Based on their findings in relation to specific sensations, the investigators conclude that hypnotherapy reduces the sensory and motor components of the gastrocolonic response in irritable bowel syndrome. "This could be one of perhaps several factors responsible for the good clinical efficacy of this treatment modality in these patients."Psychosom Med 2004;66:233-238.

 

[kel1059]

eric,i think that HT can help with some symptoms.by the way do you have any evidence that HT is not masking symptoms in some patients. what a nightmare that would be.hey, i am all for whatever can give people some relief. --but it better be safe. do you have any proof?

 

[ohnometo]

I have to kinda agree with Kel on this one...I believe it can help reduce symptoms..but I also believe that there can be a underlying cause that hypnotherapy cannot help....

 

[eric]

Kel, since you don't understand IBS to begin with in the slightest this does not surprize me your going this route.Please fully explain masking symptoms in IBS?What does that mean to you? Since you don't know the cause in the first place?Nor is anybody saying this is a cure or everyone should do it. Second HT has already been proven to be one of the most effective treatments for IBS, I know you both fight like crazy when any role of stress or the brain is linked to IBS, but sorry you two they already are, regarless of what causes IBS. Not that is how HT works on IBS, because stress and anxiety reduction is more a side effect, but you two really have not fully studied it have you? Because then you would know it works phycophysiologically on IBS. Yes, it does work on some root causes in IBS. I am glad you both have spent so much time studying and understanding IBS and HT to begin with, because if you did you would see how foolish the comments really are in IBS.But what are the real facts.""Hypnosis is only one of several approaches to treating irritable bowel syndrome and may not be the most suitable option for all patients (click here for discussion of treatment options for IBS). However, hypnosis treatment has some advantages which makes it an attractive option for many IBS sufferers with chronic and severe symptoms:- It is one of the most successful treatment approaches for chronic IBS. The response rate to treatment is 80% and better in most published studies to date. - The treatment often helps individuals who have failed to get improvements with other methods (see for example: Whorwell et al., 1984, 1987; Palsson et al., 1997, 2000).- It is a uniquely comfortable form of treatment; relaxing, easy and generally enjoyable. - It utilizes the healing power of the person's own mind, and is generally completely without negative side effects. - The treatment sometimes results in improvement in other symptoms or problems such as migraine or tension headaches, along with the improvement in IBS symptoms. - The beneficial effects of the treatment last long after the end of the course of treatment. According to research, individuals who improve from hypnosis treatment for IBS can generally look forward to years of reduced bowel symptoms. " http://www.ibshypnosis.com/whyhypnosis.html Please explain why people are better five years after stopping the treatment?So what you guys are actually saying is people should not try a very safe, easy, enjoyable and very effective treatment for IBS, after being diagnosed with IBS? Also isn't this up to individuals to decide after they have been diagnosed and read the research and decided to try it?It is not just helping IBS either but non gi complaints as well.""It is unknown to what degree standard medical treatment for IBS, when successful, also results inimprovement in non-GI symptoms. The problem is that most IBS treatment research has notexamined how non-IBS symptoms change. Non-IBS symptoms have also not been a focus ofstandard IBS treatment. An exception to this is psychological treatment trials for IBS, whichsometimes have included general physical symptom questionnaires among the measures oftreatment effects. We therefore know from our two studies of hypnosis treatment for IBS22 aswell as from research in England23 that hypnosis treatment for IBS regularly improves non-GIsymptoms substantially in addition to beneficial effects on bowel symptoms. " http://www.med.unc.edu/wrkunits/2depts/med...idc/sitemap.htm

 

[kel1059]

once again, i think it is great that HT can help people to manage their symptoms or even outright eliminate many symptoms.however, you are not showing me any proof that HT is safe in all cases. what if it is just masking some very serious root causes for some poor unfortunate sufferers?i certainly hope you are not using N. as the poster child for IBS/HT success.that poor girl needs to get to the heart of the matter and quit thinking that HT is going to SOLVE her nightmare.what if she has some type of infection that the MDs are not aware of? what if they are not even aware that the hypothetical organism can cause such agony?then what?are not some of these poor unfortunates similar to a girl with her arm in a pot of water on the stove. the heat is turned up but a hypnotist assures her that her arm is as cool as a cucumber.once again -- i am glad that you promote HT but what if some people are harmed by it?

 

[eric]

You do not know in the slightest what your talking about in regards to N, nor will I address her life here with you.You can leave that between her doctor, who diagnosed her with IBS and her doctor patient relationship and hopefully a trained mental health therapist, who can work through some issues she has concurrent with the IBS.Its not up to you to diagnose people here or scare them further into belieing they have something more then the doctors who have medical degrees and are diagnosing people and are treating people in real life. IBSers are already worried enough, with cancer scares and other reasons.If you care so much about accurate diagnoses why don't you explain more to people about using the rome criteria to more accurately diagnose people (which rules out infection/an acute chronic inflammation as a cause) and spend more time helping people get a more accurate diagnoses, instead of scarying people due to your own theories, worries and misunderstandings and sheer lack of respect for IBS researchers, the medical community and the roles of drug companies in IBS research or the many researchers in all fields actually trying to understand and treat the disorder. Why don't you help explain alarm symptoms in IBS, that would point to a misdiganoses."Alarm SignsAs previously stated, typical symptoms point toward IBS, but certain co-existing alarm signs should alert the physician to the possibility of another disorder. These alarm signs�which are not attributable to IBS�include weight loss, frequent awakening by symptoms, fever, rectal bleeding, and anemia. These features can be a clue that another disorder besides IBS is responsible for the gastrointestinal symptoms and may call for further testing. However, a separate, benign problem is often found that explains the problem. For example, rectal bleeding with features typical of an anal origin that is reported by patients with an unchanged, chronic pattern of IBS symptoms is usually found to be caused by hemorrhoids. " http://www.aboutibs.org/Publications/diagnosis.html "what if she has some type of infection that the MDs are not aware of?"This is WHY you see a doctor and work with a doctor, something you don't promote yourself here. It could happen, although rarely, regardless of whatever treatments the person is doing and HT is no less safe then meditation and a lot more safe then medications when done by a tranied professional. HT can help things also through stress reduction regardless of what they have, because almost all illnesses are connected to stressors. However, that is not what the tapes are designed for, they are designed for people who have been diagnosed with IBS, it clearly states that on them.How do you know your information on telling everyone IBS is leaky gut will not harm anyone, considering there is no proof what so ever that its IBS? And it may actually hurt people do kill some specific oragnisms. For example killing all bacteria indiscriminately may lead to other health issues. This is very well known. Your soulution is homeopathy, and the same could be said for you suggesting that to IBSers in regards to ?"what if she has some type of infection that the MDs are not aware of? " I am pretty sure most Homeopathic doctors are not experts on infectious diseases.There is proof HT works on IBS, there is no proof on how Homeopathy works on IBS or even leaky gut and there is no proof IBS is leaky gut or that there is an acute on going infection, that rules out IBS.So from know on I will look forward to your posts on what is an accurate diagnoses in IBS, what the symptoms are and information on that and working closely with your doctor and a good doctor patient relationship. I will look forward to you learning what blood work rules out or stool work rules out and what differential diagnoses need to be ruled out.likeFor Patients Understanding IBS (Irritable bowel Syndrome): A Primer for Patients Chapter 7: Some Common Conditions Where Diarrhea and Gas with Bloating Can Be Misinterpreted as Evidence of IBSJames Christensen, M.D. and Robert W. Summers, M.D.Peer Review Status: Internally Peer Reviewed-------------------------------------------------------------------------------- Organisms growing in the Gut that should not be there Intestinal Parasites, Especially Giardia Bacterial Overgrowth in the Small Intestine Abnormalities in the Lining of the Intestine Intolerance to Lactose Celiac Disease, or Sprue Inflammatory Bowel Disease Things You Eat and Drink When Your Gut is Normal Intolerance to Fructose Unconscious Intake of Laxative Substances Chapter 8: Some Common Conditions Where Abdominal Pain Can Be Misinterpreted as Evidence of IBSJames Christensen, M.D. and Robert W. Summers, M.D.Peer Review Status: Internally Peer Reviewed--------------------------------------------------------------------------------Abdominal Wall Pain Neuropathies and Trigger Points Abdominal Wall Hernias Intra-abdominal Diseases Understanding IBS (Irritable bowel Syndrome): A Primer for Patients Chapter 9: Some Common Conditions Where Nausea and Vomiting Can Be Misinterpreted as Evidence of IBSJames Christensen, M.D. and Robert W. Summers, M.D.Peer Review Status: Internally Peer Reviewed--------------------------------------------------------------------------------Disordered Emptying of the Stomach Incomplete Small Intestinal Obstruction and for anyone thinking about HT and IBS, get a diagnoses regardless if you are thinking about any treatment and ask your doctor about it, if they are up to date on current IBS research, I am sure they will totally understand.

 

[lizzie0606]

Hi. I agree with Eric regarding HT, that is if you have been diagnosed with IBS from a GI doc. I have been diagnosed with IBS, predominately pain (cramping=pain). My GI doc works at Johns Hopkins Hospital in Baltimore, Maryland; director of Gastroenterology Department. Other than eating healthy, exercise, watching my stress triggers....they recommend cognitve behavioral therapy, or HT, since there isn't anything they can do for me; hence no cure for IBS. I do take hyoscyamine and donnatal for the cramping/pain....which aren't always effective, nor do I like feeling drowsy all day...so, I often opt for yoga, deep breathing, meditating etc...anything to get my mind off the pain & cramping. Lizzie

 

[Talissa]

Er,Do you know why most MDs don't use the Rome criteria?Because they are worth the paper they're written on.It's also why everyone is anticipating the new Rome III._______________Lizzie--I do yoga too & when I was IBS sick, tried to do meditation alot. I liked the music therapy route. I should get back in the habit, but life tends to get in the way!

 

[BackFire44]

Did you start HT lizzie? If it is too much for you to pay for a professional, there is a set of audio tapes or CDs for $100, which might just do the trick for you (ibsaudioprogram.com). I'm glad to see prominent doctors are picking up on the positive effects of HT and Cognitive Behavioral Therapy. Best of luck in getting better!Regarding kel's comment that HT would mask symptoms, I think kel is referring to the idea that doing HT is teaching your mind not to feel pain or not to have diarrhea or constipation when really these things can be useful signs that something is going wrong in your body and it needs help. First, as the audio tapes say, and any good hypnotherapist would tell you, it is important to get properly diagnosed by a good doctor first. A colonoscopy, bacteria tests -- the whole kaboodle should be done. I think, though, that most people that try HT do so after working with a doctor for months or years to no avail. Most people see HT as a fringe remedy and I don't think we need to really be concerned about people turning to it before even seeing a doctor. Plus, there are ample warnings everywhere that say you should see a doctor first.Second, I'm fairly certain HT would not have the same effect if you had an underlying cause of your symptoms such as an infection. In fact, it is percisely those people who have other problems with whom HT is not as effective. Assuming you have been to a doctor and he or she has run the necessary tests, there is no basis for saying that HT is unsafe at all. BackFire44

 

[lizzie0606]

Hi Backfire44. I also agree with you regarding HT and cognitive behavioral therapy. As you mentioned....if you been to a good GI doc, had a colonoscopy, blood work, stool samples, and often an abdomen CT and/or sonnogram is helpful as well to rule out any other possible diagnoses...I see nothing wrong with HT. Also, if you feel you have a food allergy, then by all means see an allergist.Backfire, I am a registered nurse. A psych doc who comes to our facility now/then got to talking to me about HT, just like my GI doc suggested, since I told him about my pain/cramping. He also has a private practice at home and some of his patients who he was treating for depression and other disorders also have IBS.....hmmmm! Anyway, he gave me a tape from one of his colleagues that he went to school at Harvard with & I recently just started listening to it. I am hoping it is effective for me, because nothing else seems to work. However, this psych doc advised me not to listen to in the car..., since he has found it very effective in relaxing oneself that it often can put you to sleep!Backfire...how are the CD's working for you? Maybe I might want to try those someday. Thanks for the website. Are you pain/cramping primarily?Best of luck to you too!

 

[ohnometo]

No Eric I didnt say that at all......That is what you are trying to twist my words to say something that I didn'tQUOTE:So what you guys are actually saying is people should not try a very safe, easy, enjoyable and very effective treatment for IBS, after being diagnosed with IBS? Also isn't this up to individuals to decide after they have been diagnosed and read the research and decided to try it?

 

[BackFire44]

lizzie, I did have cramps and some pain, but those were never my predominant symptoms. Mostly for me it was diarrhea and urgency. However, I have read story after story on this site of people with your symptoms finding relief from HT. I'm doing great with the CDs. Right now I'm on Questran as well because I think I probably have two separate things going on: IBS and bile-salt diarrhea. The combination of the two has been a life saver. I look forward to listening to the CDs and am not quite half way through the program yet. They have unquestionably helped a lot, though. There is a form at the back of the booklet that comes with the CDs that asks you to rate your symptoms on a scale of 1 to 10. You then do this again after 30 days and after the 100 day program. After day 30, I rated my symptoms without looking back at my initial ratings, and I couldn't even believe the improvement. I knew I was feeling better, but all of my symptoms have drastically reduced. Its definitely worth a shot (although I realize shelling out $100 seems like a lot). If it helps, though, its really not much at all compared to all the drugs and doctor visits it might replace. I'm not sure if you will get 100% relief from your symptoms with the HT, but I believe that if you follow the treatment and give HT a chance, it will at least reduce the severeity of your symptoms. Best of luck with the tapes your friend gave you.BackFire44

 

[lizzie0606]

Backfire44, hi again. Thanks so much for the info regarding the booklet with the CD rating your symptoms. I read every post regarding the HT CD/cassette. I tried calling the phone# which is printed on the web site, but it continously gives me a busy signal, just wanted to talk to someone prior to ordering. Guess I will just order online. I believe I made my mind up after reading all those posts, since nothing else is helping my cramping/pain. *The tapes I got from my friend are okay, maybe they are not as good as the CD's that are helping you....but, I am still listening to them.Do you much about Ibsacol...I see the ad on this website.Oh, noticed you are from Philly, my husband & I were at the Tower Theater to see Sting in March (love the venue). Also, we got some Philly cheese-steaks and went sight-seeing!! Wonderful weekend we had!Take care.Lizzie

 

[kel1059]

backfire,you are providing a very credible testimony. please keep it up. i believe that HT or even my meditation CD (Holosync) can definitely help to manage the condition or even give an outright remission to a select minority of the suffering people.*******************eric,your claim that people should go to a doctor is foolish (edit: i agree that they should go to the doctor but only to cover all the bases, ex things like IBD need to be explored, etc). don't you get it by now? the doctors are for the most part worthless. i could pick a team of 12 people from this board who have far more practical information on IBS than any team of doctors.the stool tests that they give to their patients are an ABSOLUTE JOKE. there are only a few very good labs that can give decent results. the GSDLabs is very good but even they are limited in the information that they can give.the perfect example of the cluelessness of doctors is H Pylori bacteria. it took them forever to discover that this bacteria is responsible for the majority of ulcers. --and even then having this bacteria is no guarantee that a person will get ulcers.dysbiosis is an incredibly tricky problem and going to a conventional doctor for dysbiosis is worthless unless it is something like C. Diff or one of the more common pathogens.how many times must have calid been to the doctor for her problems. it took a maverick doctor --a pure pragmatist-- to discover the proteus and citrobacter pathogens in her.wake up eric. wake up.*********************lizzie,IBS is NOT incurable. what a pity if you got that from eric.

 

[cookies4marilyn]

Hi Lizzie,RE this: [[ I tried calling the phone# which is printed on the web site, but it continously gives me a busy signal, just wanted to talk to someone prior to ordering.]] The number listed on the site (toll free ordering and information line for US, 877, etc.) has been checked and it is working, if you would still like to try again, leave your number and we will be happy to get back to you. Backfire, your wonderful comments are very encouraging to others! Thank you.

 

[kel1059]

it is not that i am saying HT is unsafe rather i am saying that eric's advice and his thinking can be very unsafe for many people. eric is trying his hardest to prevent some people from discovering the true source of their problems. if eric had his way, dr dahlman would have been run out of here on a rail and poor gret would still be suffering. calid would have NEVER discovered the PATHOGENS (P-A-T-H-O-G-E-N-S) that she carried --- proteus mir. and the citrobacter freundii. --and i would be far worse off for not having had the encounter him. he saved me a lot of money, his probiotics had a highly beneficial effect on me, and i learned a lot.i think that the author (Mike) of the HT program should be commended for his fine job.however, i don't think they could have stumbled on to a worse rep than eric. sure, eric is a tireless machine and that is great (i think HT should be a PART of some multimodal standard therapy for all IBS sufferers). the problem is his complete lack of understanding (and blatant disregard) of other issues such as dysbiosis.all i have to say is ---- Citrobacter F. and Proteus M. as stated before, the majority of labs --OTHER THAN SPECIAL LABS LIKE gsdl-- don't test for these. it is beyond simplistic for eric to think that he is covering all the bases by saying --"go to your doctor".the doctors are clueless that is why there are over 25,000 members here. eric lives in some type of fantasy world where he thinks that doctors will automatically discover whatever microbe might be causing harm. that is ridiculous.(this is not to say that i think IBS is due to some organism -- it may play a very strong role for some people but i am uncertain.)

 

[kel1059]

P-A-T-H-O-G-E-N-SPATHOGENS

 

[eric]

Dr Dahlman is NOT a medical doctor, he is a chiropracter and nutritionist period!!!!!Unlike you kel, I leave the diagnose of IBS up to real doctors and medical professionals.We know you hate doctors, IBS research and have your own personal based theories which are 9 times out of ten wrong!For Patients Understanding IBS (Irritable bowel Syndrome): A Primer for Patients Chapter 7: Some Common Conditions Where Diarrhea and Gas with Bloating Can Be Misinterpreted as Evidence of IBSJames Christensen, M.D. and Robert W. Summers, M.D.Peer Review Status: Internally Peer Reviewed-------------------------------------------------------------------------------- Organisms growing in the Gut that should not be there Intestinal Parasites, Especially Giardia Bacterial Overgrowth in the Small Intestine Abnormalities in the Lining of the Intestine Intolerance to Lactose Celiac Disease, or Sprue Inflammatory Bowel Disease Things You Eat and Drink When Your Gut is Normal Intolerance to Fructose Unconscious Intake of Laxative Substances Chapter 8: Some Common Conditions Where Abdominal Pain Can Be Misinterpreted as Evidence of IBSJames Christensen, M.D. and Robert W. Summers, M.D.Peer Review Status: Internally Peer Reviewed--------------------------------------------------------------------------------Abdominal Wall Pain Neuropathies and Trigger Points Abdominal Wall Hernias Intra-abdominal Diseases Understanding IBS (Irritable bowel Syndrome): A Primer for Patients Chapter 9: Some Common Conditions Where Nausea and Vomiting Can Be Misinterpreted as Evidence of IBSJames Christensen, M.D. and Robert W. Summers, M.D.Peer Review Status: Internally Peer Reviewed--------------------------------------------------------------------------------Disordered Emptying of the Stomach Incomplete Small Intestinal Obstruction Irritable Bowel Syndrome (IBS)"WHAT IS IT?IBS is characterized by a combination of persistent and recurrent abdominal pain and abnormal bowel habit (diarrhea, constipation, or both). The pain often begins after eating and goes away after a bowel movement. Other symptoms are bloating, passage of mucus, and a feeling of incomplete emptying.""CAUSEIBS is not caused by structural, biochemical, or infectious abnormalities . Rather, IBS is considered a dysregulation, or abnormality of brain-bowel function. There is increased pain sensitivity and abnormal motility (increased or irregular muscular movement of the gut). In IBS, diarrhea comes from an increased rate of passage of stool through the colon. Constipation is the result of a decreased speed of stool passing through the colon. Spasms, which are very strong contractions, also occur in IBS. Increased pain sensitivity results from the increased sensitivity of the nerves. Sometimes, the nerves are so sensitive that normal contractions, even with digesting a normal meal, bring on pain or discomfort. " http://www.med.unc.edu/wrkunits/2depts/med...e/fgidc/ibs.htm This points to a more positive diagnoses of IBS and less to an organic disease"It is relieved with defecation"and for anyone thinking about HT and IBS, get a diagnoses regardless if you are thinking about any treatment and ask your doctor about it, if they are up to date on current IBS research, I am sure they will totally understand.--------------------Why Consider Hypnosis Treatment for IBS?by Olafur S. Palsson, Psy.D.Hypnosis is only one of several approaches to treating irritable bowel syndrome and may not be the most suitable option for all patients (click here for discussion of treatment options for IBS). However, hypnosis treatment has some advantages which makes it an attractive option for many IBS sufferers with chronic and severe symptoms:- It is one of the most successful treatment approaches for chronic IBS. The response rate to treatment is 80% and better in most published studies to date. - The treatment often helps individuals who have failed to get improvements with other methods (see for example: Whorwell et al., 1984, 1987; Palsson et al., 1997, 2000).- It is a uniquely comfortable form of treatment; relaxing, easy and generally enjoyable.- It utilizes the healing power of the person's own mind, and is generally completely without negative side effects. - The treatment sometimes results in improvement in other symptoms or problems such as migraine or tension headaches, along with the improvement in IBS symptoms.- The beneficial effects of the treatment last long after the end of the course of treatment. According to research, individuals who improve from hypnosis treatment for IBS can generally look forward to years of reduced bowel symptoms. http://www.ibshypnosis.com/whyhypnosis.html Hypnotherapy for Functional Gastrointestinal Disorders By: Peter J. Whorwell, M.D., University Hospital of South Manchester, England Unfortunately, the word "hypnosis" often conjures up a whole variety of frequently quite negative connotations even within the medical profession. Many equate the phenomenon with the mind being taken over by the hypnotist and with loss of control by the recipient, which needless to say, is completely erroneous. As a consequence of this, the whole subject is surrounded by a cloud of mystery, which regrettably is often encouraged by those who practice the technique. Although unlikely to ever happen, it would probably be best if a completely new word could be coined for that of hypnosis so that all the "baggage" that accompanies it could be left behind. It seems likely that a variety of techniques such as relaxation, yoga, transcendental meditation, reflexology, aromatherapy, and others are different methods of achieving a similar state to that witnessed in hypnosis. Hypnosis probably only differs in that it concentrates more on the "trance" element and is usually targeted at a specific problem, which in the past has most often been identified as psychological. However, we have applied the use of hypnosis in a more physical way without, of course, forgetting its psychological benefits. 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. We recently 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. We have also undertaken some research in an attempt to ascertain how hypnosis might lead to benefit. There is no doubt that it can improve anxiety and coping capacities as might be expected. However, of far more interest, was the observation that motility and visceral sensitivity could also be modified in the desired direction. Thus, this approach to treatment appears to offer symptomatic, psychological, and physiological benefit and this presumably explains why it appears to be so effective. However, hypnosis should not be regarded as a panacea as up to 25% 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. One concern over the use of hypnotherapy is the possibility that patients might relapse once a course of treatment has been completed. We have recently addressed this question with a study on the long-term follow up of patients attending the unit. This has shown that after a period of between one and five years, 83% of responders remained well with 59% requiring no further medication at all. Patients also took much less time off work and consulted the medical profession less often. Following the success in patients with IBS, we have recently looked at the use of hypnotherapy in functional dyspepsia, which is a closely related condition resulting in primarily upper gastrointestinal symptoms. Again, compared with controls, the hypnotherapy patients showed substantial improvements in both symptoms and quality of life. One of the most striking outcomes of this particular study was that, after a follow up of one year, not one patient in the hypnotherapy group required any further medication compared with 82% and 90% of subjects in the 2 control groups. Similar trends to those observed in the IBS studies were seen for a reduction in medical consultations and time off work. 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. http://www.aboutibs.org/Publications/hypnosis.html Hypnosis Treatment of Irritable Bowel Syndrome By: Olafur S. Palsson, Psy.D., Research Associate, Department of Medicine, University of North Carolina at Chapel Hill The Mind and IBS The standard medical methods currently used to treat irritable bowel syndrome (IBS) are of some help to the majority of people with the disorder. However, up to half(1) of IBS sufferers are dissatisfied with the results of standard medical management, and many continue to have frequent symptoms after seeing doctors about them. In recent years, other alternatives have been sought to help these individuals. There has been growing interest in the possibility of using the mind to soothe the symptoms of IBS. Mental states clearly affect the way the gut behaves in people with IBS, and in fact, also in people who have no gastrointestinal problems. Although IBS is probably not caused by stress directly, it is well established from research that psychological stress increases the symptoms of many people who have the disorder. If the mind can have such a powerful negative influence on the intestinal tract, it would seem to make sense that the mind could be used to have a positive or calming influence on the intestines. Several psychological methods to treat IBS symptoms have been tested in formal research studies, including biofeedback, cognitive therapy, psychodynamic (insight-oriented) therapy, and hypnosis treatment. It is unclear, to date, which of these psychological treatment methods is most effective, for they have generally not been tested side by side. However, cognitive therapy(2,3) and hypnosis treatment(4-7) have had the highest reported success rates in repeated formal research studies, with improvement seen in 80% or more of all treated patients in some studies. Hypnosis treatment will be discussed specifically in this article. Hypnotherapy Clinical hypnosis is a method of inducing and making use of a special mental state where the mind is unusually narrowly and intensely focused and receptive. In such a state, verbal suggestions and imagery can have a greater impact on a person's physical and mental functioning than otherwise is possible. Unlike the popular portrayal of hypnosis in movies, on television, or in stage entertainment, a clinical hypnotherapist does not use any power over the person who is hypnotized. The only power at work in clinical hypnosis is the power the patient has to enter and make use of this special mental state. The treatment is comfortable, and generally without any negative side effects for psychologically sound individuals. The person who is hypnotized is typically fully aware of everything that happens under hypnosis both during and after the hypnosis session. Research has demonstrated that hypnosis can be used to have various effects on gastrointestinal functioning. It can slow down the propulsive movement of material through the intestinal tract(8), can increase or decrease acid secretion in the stomach(9), can sometimes reduce or eliminate nausea and vomiting(10), and can reduce the relapse rate of duodenal ulcers(11) and improve long-term management of functional dyspepsia(12). Hypnosis for IBS The results of the first formal research study(4) on hypnosis treatment for IBS were published in the Lancet in 1984. The investigators, Dr. Peter Whorwell and his group in Manchester in England, reported remarkable success from a seven-session hypnosis treatment of 15 patients with severe IBS problems who had not responded to any other treatment. All 15 patients treated with seven sessions of hypnotherapy improved, with dramatic improvement seen in all the central symptoms of IBS. The researchers furthermore showed that this therapeutic impact was not merely due to belief or expectancy of improvement, because a comparison group of 15 IBS patients who were instead treated with the same number of psychotherapy sessions and also received placebo pills (pills with no medication) showed only slight improvement. This was a powerful demonstration of the impact hypnotherapy could have on IBS, and led to considerable subsequent interest in this approach to IBS treatment. Since this first report, more than a dozen other published research reports have confirmed that hypnosis treatment is effective in treating IBS. Generally, the treatment procedures reported in the literature consists of 4 to 12 sessions (shorter treatment than 7 sessions may be a bit less effective). Hypnosis sessions are typically conducted weekly or once every other week, last 30-40 minutes and consist of induction of hypnosis followed by deep relaxation and the use of gut-directed imagery and suggestions. Patients are commonly given short audiotape hypnosis home exercises to use during the course of treatment in addition to the sessions with the clinicians. The experience to date may be outlined as follows: Reported success rates range from approximately 70-95% in all studies with any significant number of patients [for example, in the work of the Manchester group in England(4,5,13) and our studies(6,7)]. The improvement enjoyed from this treatment often lasts at least two years after the end of treatment(5). All major IBS symptoms improve from this kind of treatment (abdominal pain, diarrhea/constipation, and bloating). There are some indications that individuals with certain characteristics are somewhat less likely to benefit from this kind of treatment(5,7,13): People with very little hypnotizability (perhaps 15-25 % of all people), persons with psychiatric disorders, and maybe (according to one report) males with diarrhea-predominant type of IBS. This treatment can be effective also when people are treated in groups(14). In addition to effects on physical symptoms, the treatment commonly improves psychological well-being and life functioning substantially(6,7,13,15) and can have long-term positive effects in reducing disability and health care costs and improving the quality of life of IBS patients(15). How hypnosis treatment improves IBS symptoms Although it is by now well established that hypnosis treatment often improves the symptoms of IBS, it remains a mystery exactly how hypnosis influences IBS in such a beneficial way. Our research team has conducted two studies to try to shed some light on this issue, using completely standardized seven-session protocol with written hypnosis scripts where all treated patients receive the same exact hypnosis treatment word for word. Our first study(6), which was the first hypnosis group trial for IBS in the U.S., was conducted in Dr. Whitehead's research laboratory at the University of North Carolina at Chapel Hill in 1995-1996. In this study, we sought to understand how the treatment influenced the intestinal tract, by measuring changes in rectal pain sensitivity and gut muscle tone with a computerized balloon inflation test. We found no significant changes in pain sensitivity or muscle tone in the gut after hypnosis treatment. However, 17 of the 18 treated patients, all of whom had unsuccessfully tried conventional treatment methods, rated their IBS symptoms significantly improved after treatment. It should be noted that the Manchester group has also conducted two studies to examine the changes in the gut after hypnosis treatment. They similarly found no overall changes in gut pain sensitivity (although in one study(16) a subgroup of the most pain-sensitive individuals showed reduced sensitivity) nor muscle tone changes after treatment, even though the clinical symptoms of their patients improved. We conducted our second study(7) at Eastern Virginia Medical School in Norfolk, Virginia, to examine whether the effects of the hypnotherapy on IBS could be explained by treatment changes in nervous system activity, and also to test further our standardized treatment protocol. Twenty-four people with severe IBS were treated with our standard protocol, and we measured the activity of the autonomic nervous system (the part of the nervous system that automatically controls the body's inner functions) in various ways before and after treatment. We measured sweat gland activity, heart rate, blood pressure, skeletal muscle tension, and skin temperature in the participants, both at rest and in response to a standard mental stress task (problem-solving under time pressure). Twenty-one of the 24 patients (87.5%) treated in the study improved substantially and maintained their improvement at 10-month follow-up. The only change we saw after hypnosis treatment in the nervous system data, however, was a small reduction in sweat gland activity, suggesting somewhat lessened physical stress. This seemed to be unrelated to the much larger improvement in clinical symptoms from the treatment, and could not account for the mechanism of improvement. In contrast, we did find that patients had greatly reduced experience of general (non-IBS) bodily symptoms after treatment, and this was statistically related to their improvement of IBS symptoms. This suggests that changes in the mind's interpretation of, or attention to, signals from the body play some role in the improvement. The overall conclusion from our work and the studies of the Manchester group is that we still know relatively little about exactly what makes the hypnosis treatment so effective for IBS, in spite of four studies examining that to date. We plan to continue doing research to address that question. Efforts to make hypnosis treatment for IBS more widely available As IBS sufferers in the U.S. have become increasingly aware of hypnosis as a treatment option, we have received numerous inquiries about how people can get such therapy in their home area. Unfortunately, the demand for such treatment is largely unmet in the U.S. For that reason, we are making two types of effort to help make this treatment more generally available: 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 We started a couple of years ago to give qualified clinicians, nationwide, permission (at no cost) to use the treatment protocol we have tested and found successful in our research studies. The protocol package contains verbatim scripts and full instructions sufficient for experienced hypnotherapists to successfully conduct such treatment. In this way, more than eighty clinicians throughout the country have been able to begin using this treatment. To further facilitate this, we have established a Web page where individuals with IBS can get information about clinicians using hypnotherapy for IBS in different states, and where clinicians can request our treatment protocol package. The web address is www.ibshypnosis.com. Secondly, we are now conducting a pilot study at UNC-Chapel Hill, under the direction of Dr. Whitehead, of a home treatment version of our standardized treatment protocol. In this study, IBS patients receive the same treatment, word-for-word, as in our studies, but instead of working with a clinician in person, they use a set of audio CDs at home. It must be emphasized that at the present time, we do not know whether this home treatment format will be effective. However, we hope that at least some of the therapeutic effects of hypnosis treatment can be achieved that way, so that the benefits of this type of treatment can be made more widely available. How to select a hypnotherapist It is important to use care when selecting a person to receive hypnosis treatment from, because many people practice hypnosis that are not qualified to treat medical problems. You can begin by looking in the phone book or asking around in medical settings for anybody who treats medical problems with hypnosis. Then you should obtain answers to the following three questions: Is this person a licensed health professional? In every community there are lay hypnotists with no health care training who advertise their services, and they will sometimes inappropriately take on the treatment of health problems. Be aware that hypnosis certificates and vanity letters after the person's name such as C. Ht. ("certified hypnotherapist") mean nothing in terms of clinical qualifications. Only state-licensed health professionals (psychologists, nurses, physicians, clinical social workers, etc.) should treat irritable bowel syndrome. Does this person have formal training and significant experience in clinical hypnosis? Using hypnosis with good success requires considerable skill and knowledge. Find out how many patients this person has treated with hypnosis, and how he/she received training. Most clinicians learn hypnosis through workshops held by national or regional organizations of health professionals. In general, fifty hours or more of certified workshop training in hypnosis would be good, although less is sometimes adequate. Does this person know the details of successful hypnosis treatment protocols for IBS? Unfortunately, the great majority of clinicians who practice hypnosis in the U.S. are not familiar with the specific approaches that have been found to be effective in IBS treatment. Hypnosis in itself is probably not sufficient to treat IBS effectively. Specific gut-directed suggestions and imagery need to be included. If the clinician you are considering is not knowledgeable in tested methods such as Dr. Whorwell's method or our standardized protocol, the easiest way to remedy this is to ask them to request our free protocol package.Many major health insurance plans in the U.S. reimburse for IBS treatment with hypnosis when it is billed as psychological treatment under the mental health portion of the plans. It should always be kept in mind that hypnosis is just one option of many in the treatment of IBS. Other psychological methods, cognitive therapy in particular, are also effective options. Hypnosis may be especially suitable when severe chronic symptoms continue after standard medical management approaches have been tried. It has become clear that in such cases, hypnosis treatment can often produce major improvement that can last for years. http://www.aboutibs.org/Publications/HypnosisPalsson.html Z Gastroenterol 2003 May;41 5:405-12Hauser W.Medizinische Klinik I, Klinikum Saarbrucken gGmbH, Saarbrucken. w.haeuser###klinikum-saarbruecken.deHypnosis is one of the oldest remedies against physical diseases and mental disorders of mankind. The term hypnosis is used for the description of a technique as well as for the description of an altered state of consciousness which is induced by this technique. Hypnosis is a scientific tool in psychophysiological studies of gastrointestinal functions secretion, motility, visceral sensitivity and their processing in the central nervous system. Hypnosis is an empirically validated treatment of the irritable bowel syndrome even refractory to medical treatment which is recommended by international expert groups Rome II and the British Society of Gastroenterology. In diagnostic upper gastrointestinal endoscopy the relevance of hypnosis as an alternative of intravenous sedation needs to be clarified. Hypnosis cannot be recommended as an alternative for intravenous analgosedation in painful endoscopic therapeutic procedures of the gastrointestinal tract.PMID: 12772053

 

[kel1059]

stop, STOP, STOP with the long cut and pastes!!!okay i need to think of kittens, warm fuzzy kittens.

 

[ohnometo]

In many years in dealing with IBS-D I have never had one Doctor to ever do anything for me...I have been to some of the best hospitals...It was always you have IBS so just learn to live with it....and give you alittle of this medicine and a little of that medicine and millions of dollars in test....The ONLY relief that worked for me was getting rid of the foods that was making me sick....When I began to feel better my anxiety went away...and I become alot more confident in myself and with my illness...I have tried many times to use hypnotherapy and not one time did that ever stop my pain and make my stomach settle down...I had to find out what the problem was and fix it and that took many many years....Hypnotherapy can help some people but I believe there are many that needs more then hypnotherapy