IRRITABLE BOWEL SYNDROME
1. BY JACK ARTIE MCMURTREY
2. BY MELISSA ROTH
IRRITABLE BOWEL SYNDROME
by Jack Artie McMurtrey
IBS is a disturbance of the colon where patients present with long-standing symptoms of crampy abdominal pain, bloating, excessive flatulence, diarrhea, constipation, or alternating diarrhea and constipation. It accounts for about half of all the visits to gastroenterologists and affects approximately 10% of the population. Stress is involved and the symptoms of IBS also cause stress because they are very uncomfortable and inconvenient. Stress probably makes it worse and the symptoms of the disease make the stress worse making it a never ending cycle.
Summary of Presentation:
Hypnotherapy for the treatment of IBS therapy is very nonspecific as it manifests differently in different people. This presentation is only intended as a guide because the therapist must develop individualized treatment.
CASE HISTORY: It is absolutely essential to take a detailed case history even though the referring specialist has made the diagnosis of IBS.
The following should be determined:
1. When symptoms first appeared,
2. What makes the situation better or worse,
3. How severe is the pain (on a scale of 1-10,1 no pain, 10 most severe pain).
4. What does it stop the patient from doing
5. What steps have been taken in he past to solve the problem.
7. Establish the patient's recreational interests (do they still experience IBS in recreational situations?).
8. Does the patient suffer from lack of confidence
9. Are there any other complicating symptoms
10. Family history
ESTABLISH A TREATMENT PLAN:
For doing this the therapist should consider what techniques might be applicable for the patients own personal needs.
1. Is the pain a problem? (Utilize glove anesthesia protocol)
2. Is the patient afraid to go out? (Has the patient lost bowel control in public?)
3. Is the patient sleeping well? (good indication of anxiety level)
4. Is there any warning (prodrome) to attacks? (find what triggers attack and intercept it) Multimodel approach to treatment
1. Patient's "homework", Self-hypnosis, green count
2. Analysis I Dissociation
3. Re-framing the anxiety and the behavior problem
4. Direct suggestion
5. EGO strengthening
6. Consider ways of making the patient feel good about themselves
7. Consider the need for "healing white light" script
When improvement has been noted it is always useful to use pseudo orientation in time to prepare the patient for discharge. Ego strengthening should be "client driven" especially following improvement and a fractionation technique should be employed to make best possible use of the improvement already gained
Use of a sample script for treatment
1) Induce trance and deepen.
2) Set up IMR for "yes"
3) Establish glove anesthesia
A script for helping those with IBS: White Warm Comforting Ball: A white warm glowing ball full of purifying light begins to form over your head. A beautiful, healthy, cleansing white mist. You see it as good, positive, healthy, full of comfort and security. It slowly descends around your head and now, completely surrounds the top of your head. As you take your next breath, you begin to breathe this wonderful white mist into your body. As it slowly enters your nostrils you now immediately begin to breathe easier. This wonderful healthy, beautiful, cleansing white mist begins to heal all the tissues in your body; as it slowly begins to coat your throat, moving through your body. Moving now, into your stomach and completely coating the lining, beginning the healing process immediately. Now slowly the mist flows down into your intestines coating the inside with this white wonderful, protective mist. A coating that protects your intestines from all forms of irritation. Now moving slowly into the colon and thoroughly coating and protecting it from further irritants. As the mist begins to leave the colon, your breath pulls it back up into the colon and intestines, to re-coat everything again, doubling the wonderful new line of protection for your colon in the future. It will not allow any foods or irritation to bother your intestines and colon again. Now leaving the colon well protected, the mist flows back into the intestines thoroughly coating to prevent any further irritation in the future. The mist gives you protection that lasts and lasts. Now the white mist begins to move back into the stomach, once again recoating the entire surface, doubling that wonderful protection that will last and last. The mist now travels back through your nostrils, growing back into that warm ball of protective mist. Back surrounding your entire head, slowly raising from your head, slowly dissolving away, leaving your entire digestive system, completely coated and safe from further irritation.
CONCLUSION: Through the case histories, it appeared that the primary origin to IBS was due to continual self-perceived stress, tension and anxiety. Once this vicious cycle was broken through the use of hypnotherapy, the subject's became better. The extent of improvement depended upon their motivational use of hypnosis and whether or not their self-belief's had changed. Continued referrals from the MD have lead to a fine-tuning of this protocol. Continued use of these chosen outcome measures, easily demonstrate to the subjects, their improvement through the use of hypnotherapy. firstname.lastname@example.org
Irritable Bowel Syndrome And Hypnosis
By Melissa J. Roth, Cht, DCH
Irritable Bowel Syndrome, also known as spastic colon, colitis, or nervous stomach, is a baffling and complex set of gastrointestinal symptoms that affects 15% to 20% of the population (approximately 20 million people). It is characterized by intermittent abdominal cramping, constipation, diarrhea, a combination of both constipation and diarrhea, pain and bloating. are women. It is the second most cited reason for missed work days. It accounts for approx Some IBS patients report having both constipation and diarrhea in the same day. .
The causes of IBS are unknown. A diagnosis of IBS is actually a diagnosis of exclusion--you rule out everything else. Since IBS symptoms overlap a number of other, potentially life-threatening conditions, it is imperative that the person see his/her physician or a gastroenterologist, to receive a proper diagnosis. While it is not clear what causes it, we know that people with IBS have changes in the way sensations are perceived in the colon. There are some anatomical changes in the lining of the colon and to the nervous system of the colon. What causes these changes is unknown. Symptoms range in severity from an occasional mild episode to a debilitating, life-altering illness which prevents the individual from working or from functioning normally. The symptoms are exacerbated by stress, changes in diet and changes in daily routine, among many other things. Some people are so sensitive they must eat virtually the same foods, in the same proportions, at the same times each day or suffer the consequences. Until recently, IBS was thought to be simply a Anervous disorder and was not taken as seriously as it deserved. While IBS will not kill you, it is far more than just a nuisance.
Traditional treatment consists of fiber therapy, antispasmodic medications and antidepressants. Fiber is added to the diet both through the use of bulking type laxatives and a high fiber diet. These are just as important for those people whose chief complaint is diarrhea as it is for constipation. Antispasmodic medications, such as Bentyl, reduce the spasms in the gut. Antidepressants, in this case, actually function on the nervous system of the gut to reduce its sensitivity to pain and other sensations rather than acting as emotional antidepressants. However, anyone who has suffered from the symptoms of IBS for any length of time justifiably presents with some degree of depressions. It is important to note that only 25% of the people who suffer with IBS symptoms respond to traditional treatments. That means that 75% do not seem to improve with traditional treatments or do not improve enough to actually feel better.
However, the evidence is overwhelming that IBS symptoms do respond to hypnosis. Not only do they respond, but they respond dramatically! The research evidence to support this is so dramatic and so overwhelming that Adriane Fugh-Berman, MD, chair of the National Women's Health Network in Washington, D.C., says that hypnosis should be the treatment of choice for severe cases of IBS. In my practice, so far, 100% of the clients I have treated with hypnosis have shown marked improvement in their symptoms. Seven of the first eight clients (the number in the first phase of a three-stage research project) became symptom free during the six sessions. While the eighth subject did not become symptom free in the standard six session regimen, his symptoms did improve significantly in the number of symptoms, duration and severity. He has continued his sessions to gain even greater relief. All of these clients had refractory (meaning that had not responded to drug and diet therapy) IBS symptoms for greater than four years. Most reported that the symptoms had started in childhood. Clients ranged in age from 35 to 50 years old. Although all of them were on multiple medications, including steroids, bulking laxatives and on special diets, none of them had gained relief from their symptoms.
For instance, Melinda is a 35 year old special education teacher. When Melinda first came to my office, she had recently been released from the hospital for a particularly severe episode of uncontrolled diarrhea. She was on high dosages of multiple medications. She reported that the medications had too many side effects, and that in spite of them, she had not seen much improvement in her symptoms. While she was no longer experiencing fecal incontinence, she still had watery stools several times a day. When asked to rank her symptoms on a scale of zero to ten, with ten being the worst and zero indicating the absence of symptoms, she ranked them as follows: diarrhea 5; abdominal pain 7; bloating 8; fatigue 8. At the beginning of the sixth and final sessions she ranked the same symptoms as follows: diarrhea 0; abdominal pain 0; bloating maybe 2"; fatigue 0. She reported these results in symptom improvement in spite of higher levels of stress caused by the unexpected deaths of two close friends. Working in conjunction with her physician, Melinda is now off medications for her IBS symptoms.
Jackie characterized her symptoms as a panic attack of the bowels. After only two sessions, she reported that her symptoms had improved so much that she actually got out with (her) family and went a few places for the first time in over four years. She cannot remember when she did not have IBS symptoms. Now, she reports that she feels better upon awakening than I have in years. She no longer has abdominal pain upon awakening. Even though she had one period of diarrhea in a time of unduly high stress, she still had no pain associated with it. Working in conjunction with her physician, Jackie has come off all the drugs she was on prior to starting the program and has not had a return of her symptoms even though her stress levels remain high.
Susan, a financial specialist, during her first visit characterized her symptoms as: pain 10; gas 7; bloating 10; constipation 10; and diarrhea 2. By the middle of the program, she reported her symptoms as follows: pain 0; gas 1; bloating 0; constipation 0-1; diarrhea 0. By the end of the program, she reported zeros in all categories.
` The common thread among these people is that they had unabated IBS symptoms which interfered with their daily living. None of them actually believed hypnosis would work to alleviate their symptoms. However, they were so desperate for relief they were willing to try anything. They were desperate for hope, for an alternative to learning to live with debilitating symptoms. Now, due to hypnotherapy treatment for their symptoms, they have been able to return to a much more normal lifestyle.
The hypnotherapy program I used with this people was modified from the research done by gastroenterologist P. J. Whorwell, MD, in Manchester, England, and Dr. Olafur Palsson's research done at Eastern Virginia Medical Center. The clients came for six to eight sessions spaced two weeks apart. The hypnosis portion of their session was tape recorded and they were instructed to play the tape for themselves daily until the next session. All suggestions and imagery was gut specific and incorporated information on how a normal gastrointestinal system functions. Suggestions were made about the intestines being coated with a special protective coating to insulate it from irritants, etc. At the last session, subjects were taught self hypnosis techniques and given instructions on how to formulate their own self hypnotic suggestions.
There is no doubt in the world literature that hypnosis is a highly effective treatment for IBS symptoms. In today's climate of managed care, hypnosis represents a brief therapy which is benign, inexpensive and non-invasive. Since IBS symptoms fluctuate, you have to evaluate the results over a long period of time. What Dr. Whorwell, Dr. Palsson and I all found to be true is that the greater number of sessions, the longer lasting relief the client gets. While many clients will report symptom relief after one to two sessions, unless they come for multiple sessions spaced over a period of three to four months, they will notice a gradual creeping back of their symptoms. Clients following the multi-session approach have maintained their symptom improvements for up to three years after the sessions ended - so far.
Melissa J. Roth Alabama Hypnotherapy Center email@example.com (205)933-5705
Melissa J. Roth is a Certified Hypnotherapist and a Doctor of Clinical Hypnotherapy candidate through the American Institute of Hypnotherapy. Ms. Roth is the President of the Alabama Hypnotherapy Center located in Birmingham, Alabama. For more information on hypnotherapy and Ms. Roth's services, please contact her at 1-205-933-5705 or via e-mail at firstname.lastname@example.org