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The IBS Audio Program 100®
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IBS Information |
Important: Additional information on IBS and IBS and Hypnotherapy in other sections of this website.
Irritable
Bowel Syndrome
What is an Irritable Bowel?
Medically, irritable bowel syndrome (IBS) is known by a variety of other
terms: spastic colon, spastic colitis, mucous colitis and nervous or functional
bowel. Usually, it is a disorder of the large intestine (colon), although
other parts of the intestinal tract -- even up to the stomach -- can be affected.
The colon, the last five feet of the intestine, serves two functions
in the body. First, it dehydrates and stores the stool so that, normally,
a well-formed soft stool occurs. Second, it quietly propels the stool from
the right side over to the rectum, storing it there until it can be evacuated.
This movement occurs by rhythmic contractions of the colon.
When IBS occurs, the colon does not contract normally. instead, it seems
to contract in a disorganized, at times violent, manner. The contractions
may be terribly exaggerated and sustained, lasting for prolonged periods of
time. One area of the colon may contract with no regard to another. At other
times, there may be little bowel activity at all. These abnormal contractions
result in changing bowel patterns with constipation being most common.
A second major feature of IBS is abdominal discomfort or pain. This
may move around the abdomen rather than remain localized in one area. These
dis-organized, exaggerated and painful contractions lead to certain problems.
The pattern of bowel movements is often altered. Diarrhea may occur, especially
after meals, as the entire colon contracts and moves liquid stool quickly
into the rectum. Or, localized areas of the colon may remain contracted for
a prolonged time. When this occurs, which often happens in the section of
colon just above the rectum, the stool may be retained for a prolonged period
and be squeezed into small pellets. Excessive water is removed from the stool
and it becomes hard.
Also, air may accumulate behind these localized contractions, causing
the bowel to swell. So bloating and abdominal distress may occur. Some
patients see gobs of mucous in the stool and become concerned. Mucous is a
normal secretion of the bowel, although most of the time it cannot be seen.
IBS patients sometimes produce large amounts of mucous, but this is not a
serious problem.
The cause of most IBS symptoms -- diarrhea, constipation, bloating,
and abdominal pain -- are due to this abnormal physiology.
IBS is not a disease. Although the symptoms of IBS may be severe, the
disorder itself is not a serious one. There is no actual disease present in
the colon. In fact, an operation performed on the abdomen would reveal a perfectly
normal appearing bowel.
Rather, it is a problem of abnormal function. The condition usually
begins in young people, usually below 40 and often in the teens. The symptoms
may wax and wane, being particularly severe at some times and absent at others.
Over the years, the symptoms tend to become less intense.
IBS is extremely common and is present in perhaps half the patients
that see a specialist in gastroenterology. It tends to run in families. The
disorder does not lead to cancer. Prolonged contractions of the colon, however,
may lead to diverticulosis, a disorder in which balloon-like pockets push
out from the bowel wall because of excessive, prolonged contractions.
Causes
While our knowledge is still incomplete about the function and malfunction
of the large bowel, some facts are well-known. Certain foods, such as coffee,
alcohol, spices, raw fruits, vegetables, and even milk, can cause the colon
to malfunction. In these instances avoidance of these substances is the simplest
treatment.
Infections, illnesses and even changes in the weather somehow can be
associated with a flare-up in symptoms. So can the premenstrual cycle in the
female.
By far, the most common factor associated with
the symptoms of IBS are the interactions between the brain and the gut.
The bowel has a rich supply of nerves that are in communication with the brain.
Virtually everyone has had, at one time or another, some alteration in bowel
function when under intense stress, such as before an important athletic event,
school examination, or a family conflict.
People with IBS seem to have an overly sensitive bowel, and perhaps
a super abundance of nerve impulses flowing to the gut, so that the ordinary
stresses and strains of living somehow result in colon malfunction.
These exaggerated contractions can be demonstrated experimentally by
placing pressure- sensing devices in the colon. Even
at rest, with no obvious stress, the pressures tend to be higher than normal.
With the routine interactions of daily living, these pressures tend to rise
dramatically. When an emotionally charged situation is discussed, they can
reach extreme levels not attained in people without IBS. These symptoms are due to real physiologic changes in the
gut -- a gut that tends to be inherently overly sensitive, and one that overreacts
to the stresses and strains of ordinary living.
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Diagnosis
The diagnosis of IBS often can be suspected just by a review of the
patient's medical history. In the end it is a diagnosis of exclusion; that
is, other conditions of the bowel need to be ruled out before a firm diagnosis
of IBS can be made.
A number of diseases of the gut, such as inflammation, cancer, and infection,
can mimic some or all of the IBS symptoms. Certain medical tests are helpful
in making this diagnosis, including blood, urine and stool exams, x-rays of
the intestinal tract and a lighted tube exam of the lower intestine. This
exam is called endoscopy, sigmoidoscopy or colonoscopy.
Additional tests often are required depending on the specific circumstances
in each case. If the proper medical history is obtained and if other diseases
are ruled out, a firm diagnosis of IBS then can usually be made.
Treatment
The treatment of IBS is directed to both the gut and the psyche.
As many people have already discovered, the simple act of eating may,
at times, activate the colon. This action is a normal reflex, although in
IBS patients it tends to be exaggerated. It is sometimes helpful to eat smaller,
more frequent meals to block this reflex.
There are certain medications that help the colon by relaxing the muscles
in the wall of the colon, thereby reducing the bowel pressure. These drugs
are called antispasmodics. Since stress and anxiety may play a role in these
symptoms, it can at times be helpful to use a mild sedative, often in combination
with an antispasmodic.
Physical exercise, too, is helpful. During exercise, the bowel typically
quiets down. If exercise is used regularly and if physical fitness or conditioning
develops, the bowel may tend to relax even during non-exercise periods. The
invigorating effects of conditioning, of course, extend far beyond the intestine
and can be recommended for general health maintenance.
As important as anything else in controlling
IBS is learning stress reduction, or at least how to control the body's response
to stress. It certainly is well-known that the brain can exert controlling
effects over many organs in the body, including the intestine.
Summary
Patients with IBS can be assured that nothing serious is wrong with
the bowel. Prevention and treatment may involve a simple change in certain
daily habits, reduction of stressful situations, eating better and exercising
regularly.
Perhaps the most important aspect of treatment is reassurance. For most
patients, just knowing that there is nothing seriously wrong is the best treatment
of all, especially if they can learn to deal with their symptoms on their
own.
reprinted with the kind permission of Jackson
Gastroenterology
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Irritable Bowel Syndrome & Hypnotherapy
www.healingwell.com/library/ibs/mahoney1.asp
by Michael Mahoney, UK Register of IBS Therapists
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 these management issues as facilitator addressing the
human response to this disorder, whereas physicians address the treatment of the disorder.
Etiology
IBS is an extremely common digestive disorder accounting for up to 50% of
all cases seen by gastroenterologists (Harvey 1983). Of those that present
in western society women outnumber men 4:1.
Pathogenesis
IBS is defined as a “functional bowel disorder in which abdominal pain is
associated with defecation or change in bowel habit, and with features of
disordered defecation and with distention (Thompson et al 1992). However
there is multiple symptomology that is associated with this complex disorder
which is not always mentioned in standard textbooks. Upper gastroenterology
symptoms including nausea, vomiting, early satiety are common (Farthing 1995).
Extra bowel manifestations include urological symptoms (Jones 1992), fatigue
backache, headache and gynecological symptoms (Longstreth 1995) often precipitating
multiple specialist referrals to exclude organic cause. Many women undergo
diagnostic laproscopy or even hysterectomy (Langstreth 1995). Inappropriate
surgery in the form of cholecystectomy and appendectomy has also
been reported.
Many suggestions are made as to onsetting causes of IBS such as stress factors,
enteric infection or surgical intervention all of which have been found to
increase visceral hypersensitivity. Even antibiotics, or trauma
have been suggested as triggers.
The Uses of Hypnotherapy
The medical profession cannot be sure of the causes, nor have they suitable
treatment for the condition, new drugs which may be effective in some individuals
are mainly prohibitively expensive for sufferers. Hypnotherapy in the
UK and elsewhere has been shown to help in the vast majority of cases of IBS
sufferers. The writer is aware of at least one hospital gastroenterology
department with its own hypnotherapy team alongside.
Hypnotherapy is non intrusive, safe, comfortable and
a cost effective and complementary to use along side mainstream medicine,
some in the profession would in this case argue ‘alternative’ since the medical
profession are generally at a loss with this condition. Having conducted
a private medical research project at the invitation of a medical center,
and subsequently private patient trails in specifically designed hypnotherapy
processes, the IBS Audio Program 100® is now used by sufferers in over 26
countries.
As a specialist in this area, the 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 benefits of hypnotherapy from a specialist in the field. As a medical
centre 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 ‘topup’, 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 taken or are taking at this moment, with positive changes.
© 2000 Michael Mahoney
Michael Mahoney is a clinical Hypnotherapist with over 13 years experience in his profession. He is principle trainer of the UK Register of IBS Therapists, and an associate member of the Primary Care Society for Gastroenterology.
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