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Opinion

Finally, relief from irritable bowel syndrome

YOUR DOSE OF MEDICINE - Charles C. Chante MD -
For some hypnotherapy or an elimination diet can offer successful treatment without the need for medication. Nearly 5 million people in the United States suffering from irritable bowel syndrome (IBS) may be surprised to hear that relief from their symptoms is not a lost cause. Two non-medicines, not so frontline approaches to combating the symptoms include hypnotherapy and an elimination diet – and their success rates are encouraging. For those who suffer from IBS, symptoms such as gas, bloating, cramps, constipation and diarrhea can be disabling, inhibiting social activities, work and travel. IBS is a functional disorder because there is no sign of disease when the intestinal tract is examined. The abnormality may be undetectable to medical diagnostic equipment, but there’s no refuting the symptoms. Sufferers of IBS, a disorder with no known cause and no cure, go about their daily lives in unrelenting dread of their next bout of symptoms. After trying countless medications that work either inconsistently or not at all, long-time sufferers of IBS can become desperate, seeking healing in herbal or homeopathic medicine or even colon cleansing, expensive therapies that, in some cases, may be harmful.

In recent years, some IBS sufferers have found relief through hypnotherapy or an elimination diet, two treatments that work better than traditionally prescribed medicine from some sufferers.
Hypnosis: Beyond The Swaying Pocket Watch
Health professionals began using hypnosis more than 200 years ago to treat "hysterical" conditions or to induce anesthesia in surgery, according to an article, of the University Hospital of South Manchester, England. If you were to have a leg amputated in the early 19th century, before anesthesia was available, you would have prayed to find yourself under the hands of a Scottish physician working in India at the time, who performed over 340 major operations using hypnosis as the only anesthetic. Not until 1958 did the Council on Mental Health of the American Medical Association recommends that instruction in hypnosis be included in medical school curricula. Now, nearly 50 years later, people still raise a skeptical eyebrow at the notion of hypnosis, wary that a hypnotist may make them cluck like a chicken, bark like a dog or fall into a deep sleep, never to awake again. Hypnosis still carries an aura of mystery and magic in the minds of many people, said by a research associate for the Department of Medicine at the University of North Carolina, Chapel Hill. They think that it comes mostly from misrepresentations in stage shows and movies. The most common misconceptions are that a hypnotist has power over the person who is hypnotized and that hypnosis is mystical and unusual. It is a powerful mental state, but the ability to enter the special state is a perfectly normal mental ability that most people have, although few make use of it. One doctor standardized a hypnosis treatment protocol in use by more than 80 clinicians nationwide.

Psychological stress, though probably not a direct cause of IBS, often increases the symptoms. Therefore, according to a doctor, if the mind can have such a powerful negative effect on the intestinal tract, it may follow that the mind could be used to achieve a positive, calming effect on the intestines. Clinical hypnosis does just with a success rate of 70 to 95 percent in IBS patients. Clinicians use hypnosis treatment to induce a mental state where the mind is "unusually narrowly and intensely focused and receptive. While the patient is under hypnosis, the clinician uses verbal suggestions and imagery to affect the person’s physical and mental functioning. Since the first controlled trial of hypnotherapy in IBS by group nearly 20 years ago, study after study has shown its effectiveness for easing the symptoms of IBS sufferers. In the largest study to date, involving 250 IBS patients, researchers at the University Hospital of South Manchester concluded that hypnotherapy improves symptoms of IBS (eg. diarrhea, constipation and abdominal pain), quality of life and other symptoms, such as nausea, lethargy, backache and urinary problems. Even better, the effects of hypnosis treatment are long-lasting. After a period of between one and five years, 83 percent of responders remained well, and 59 percent required no further medication.

Hypnosis treatment (which typically consists of seven to 12 one-hour sessions) costs an average of $100 a session. However, according to a doctor, the sustained benefit after treatment is calculated to be cost-effective within two years, as patient take less time off from work and consult less often with medical professionals. Furthermore, some major insurance companies will cover the cost of hypnosis treatment, often under the mental-health portion of the plan. A consultant for the American Society of Clinical Hypnotherapy (ASCH) for 10 years occasionally uses hypnotherapy on his adolescent patients. He is a clinical professor of pediatrics and adolescent medicine at the University of Hawaii School of Medicine. Between the ages of 15 and 35, at least half the things people come to doctors for are not necessarily physical ailments. They can often be treated by changing their points of view or altering the way they handle situations. A doctor who has taught 7-year-olds to use imagery and hypnosis to manage, headaches and stomachaches, says that hypnosis helps sufferers of IBS overcome their symptoms through imagery and suggestion by modifying their perceptions and their ways of dealing with the associated problems.

He is not convinced any medication does a great job. But some physical symptoms of IBS can be alleviated such as gas or constipation. He recommends a shotgun approach to treating IBS, implementing dietary changes and medication at the same time the patient undergoes hypnosis. Hypnosis should not be considered an alternative to medication, but rather a complementary or adjunctive treatment.

He says there is every reason to expect that medicine and hypnosis combined given IBS sufferers greater therapeutic benefits than either treatment alone. Keeping in line with shotgun approach to IBS, even when patients do improve, conventional approaches to treatment should not necessarily be ignored. It is still important that lifestyle factors such as diet are aso taken into account. For some people, an elimination diet may prove most effective.
Elimination Diet: When Food Hurts
An elimination diet may sound like a crude, medieval punishment in which you will never again enjoy pizza, French fries, chocolate mousse, cream soufflé or beloved cheesecake, but it is simply a diet used to discover foods additives that are causing symptoms in those who have sensitiveness. Is it possible? A miracle healing diet? It sounds nearly as incredible as healing through hypnotherapy, but the scientific data supporting this approach are not as available as they are for hypnotherapy. However, brings the mystique of the diet down to earth. When people avoid certain foods for one to two weeks, we can see changes they may feel in many of the prevalent symptoms. After the first couple of weeks, patients should start to add foods in every two to three days, watching for a recurrence of symptoms. Problem foods tend to be broken into two groups, the first includes sugar, alcohol, caffeine, wheat and dairy; and the second group contains the most allergenic foods – corn, citrus, peanuts, eggs and gluten grains, (rye, barley). In addition to following an elimination diet, nutritionists often recommend that people take strains of healthy bacteria (probiotics), along with occasional supplements and complementary medication.

The diet sounds simple enough, but cautions that patients should be realistic in their expectations. The diet takes significant effort. There’s a therapeutic phase and a maintenance phase. In the therapeutic phase, the IBS patient will begin the diet and spend a couple of weeks avoiding foods that may cause symptoms. In the maintenance phase, patients start to determine how much of the offending foods they can tolerate by adding foods back into their diet. There will even be times when a person can go off the diet. They don’t expect people to never have sugar or coffee again, but if it causes symptoms, it reinforces that IBS is responsive to the elimination diet and that the effort is worthwhile. Success while on elimination diet is a huge milestone for many people who suffer from IBS. Before beginning a trial diet, you discuss it with your family to gain their support, you will need help staying on your diet and keeping foods that you shouldn’t be eating of the house for a while. Furthermore, don’t begin the diet during a holiday season – be more realistic and wait until a time when pies and stuffing aren’t accosting you at every corner. Finally, keep a diary or symptom inventory for at least three days before beginning the diet. You can use the diary while you follow the diet. You can use the diary to document what you eat and record whether symptoms arise afterward.

When patient first started the elimination diet, he had the most difficulty eliminating wheat. Instead of bringing a sandwich for lunch, he brought just the chicken. He made other sacrifices as well. He found a coffee substitute and used a soy creamer. His typical morning bowl of high fiber cereal with milk became Cheerios with soymilk. For patient, the elimination diet has made a huge difference in his quality of life; now he rarely experiences the pain in his side that used to last from a week to 10 days.
Why It All Works
With an unknown cause and no real cure, it’s difficult to determine exactly why an elimination diet or hypnotherapy treatment can work to relieve the symptoms of IBS. If you cut the bowel out, is there really anything wrong with it? AGA member says they don’t know. Some people can identify food triggers through an elimination diet, but for more people, the problem may be more complex. One day something seems to precipitate symptoms, and another day it doesn’t. Even patient, never nailed down specific food that caused his symptoms. Instead he has continued to stick to the original diet for the most part. He estimates, he follows the diet about 75 percent of the time and tries to observe his reactions when he goes off the diet. For many, including those people whose IBS symptoms don’t seem to be triggered by food, hypnosis treatment may be the answer because it appears to "reach in and help correct perception errors between the brain and gut in response to signals form the bowel. Hypnosis may be able to blunt suffering from stimuli from the bowel, thus preventing reaction.

Since the cause of IBS remains unclear, it’s a mystery exactly how hypnosis has such a positive influence over the disorder, and even with four studies completed on the issue; researchers continue to come up empty-handed form the standpoint of a precise explanation. Two of the four studies were conducted by group. The first study sought to understand how hypnosis treatment affected the intestinal tract. Seventeen of the 18 patients experienced marked improvement of IBS symptoms following the hypnosis treatment; however, researchers were unable to detect any significant changes in pain sensitivity or muscle tone in the gut. The second study examined changes in the central nervous system during the hypnotherapy that might explain the success of the treatment for IBS. In this study, 21 of the 24 patients experienced significant improvement in their IBS symptoms, but no related changes in the central nervous system could be detected with the testing methods used.
Mysterious Treatments For A Mysterious Disorder
For now, much about IBS remains a mystery. What causes the disease; who is predisposed to it; what triggers the symptoms – it may be years before we know. We may never understand how hypnosis affects the body to curb symptoms of IBS or how an elimination diet can effect immediate relief as it did. But research shows that both approaches have significant success, and that may be all an IBS sufferer really cares to know.

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AMERICAN SOCIETY OF CLINICAL HYPNOTHERAPY

BEYOND THE SWAYING POCKET WATCH

DIET

ELIMINATION

HYPNOSIS

IBS

PEOPLE

SYMPTOMS

TREATMENT

UNIVERSITY HOSPITAL OF SOUTH MANCHESTER

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