Hypnosis can relieve syptoms of IBS
>> Sunday, September 19, 2010
Don’t Be Irritable
By James N. Dillard, M.D.
(August 26, 2010) It’s hard to believe that the actress who once drove Kevin Kline crazy in the 1988 British-American crime comedy “A Fish Called Wanda” is now the colon health lady. Jamie Lee Curtis’s performance helped drive Kevin up to the stage to pick up an Oscar for his work in that film. Now she wants you to pick up Activia.
In a time of salmonella-laced eggs, and with an economy looking to double dip like George Costanza at the hors d’oeuvre table, it’s no wonder we have achy bellies. One in five Americans has a condition called irritable bowel syndrome (I.B.S.), and many have trouble getting any relief for it.
Young women don’t usually have many health problems, but this is one condition that commonly plagues them. It usually starts in the late teens to 20s, and affects women twice as often as men. It is characterized by abdominal pain, bloating, cramping, constipation, and diarrhea. People with I.B.S. feel better when they go to the bathroom, but their bowel habits are irregular.
Seventy percent of those suffering with I.B.S. are not receiving care for their condition, and many have tried conventional medications without relief or with intolerable side effects. About half of I.B.S. sufferers have tried alternative therapies for their condition, again with mixed results.
If you have typical persistent symptoms, your doctor has to make sure you don’t have an inflammatory bowel disease, such as ulcerative colitis or Crohn’s disease, or lactose intolerance, parasites, cancer, celiac disease, bacterial overgrowth, or thyroid trouble. Ten percent of I.B.S. sufferers develop chronic symptoms after a bout of bacterial gastroenteritis.
There is no definitive cause or cure for irritable bowel syndrome. The nerves and muscles surrounding the intestines may be especially sensitive in I.B.S. patients. Shortly after a meal, they will contract excessively, causing cramping and pain. Another theory implicates an imbalance in the neurotransmitter serotonin, 95 percent of which is in the gut and 5 percent is in the brain.
Common treatments that help some people are increased fiber and specific dietary restrictions, though the research on dietary interventions is equivocal. Soluble fiber like psyllium — not bran — has been shown in several studies to ease I.B.S. symptoms. Every patient will respond differently to these interventions, although fatty foods and caffeine are generally poorly tolerated.
There is a certain amount of gluten hysteria around, with folks deciding they can’t eat it without actually doing a well-controlled test. Gluten is a grain protein in wheat, barley, and rye, and can also be found in medicines, supplements, and cosmetics. Two weeks of strict gluten elimination, with subsequent reintroduction, can certainly tell you if you are sensitive to this food. The blood tests for celiac disease or gluten sensitivity are also fairly reliable.
Medications can help some I.B.S. patients, but none are curative. A 2005 review paper showed that about 18 percent of I.B.S. patients will benefit from antispasmodics (intestine-relaxing drugs) like hyoscyamine (Donnatal, Levbid, Anaspaz, NuLev) or dicyclomine (Bentyl). Mild sedatives, like Donnapine and Librax, don’t help much and can be habit-forming.
Tegaserod (Zelnorm) was pulled from the market back in 2007 for possible association with heart problems, but it is now available on a limited basis for women only. Studies show that tegaserod only benefits a small percentage of patients. The old tricyclic antidepressants (amitriptyline, nortriptyline) in low dose seem to make a difference, and lubiprostone (Amitiza) can help with constipation in the short-term.
“When I repress my emotions, my stomach keeps score,” wrote John J. Powell, S.J., a Jesuit priest. Most of us intuitively understand that the belly is the seat of the emotions, and the brain-gut connection has received much interesting research attention.
More than 50 percent of those who seek care with irritable bowel symptoms have underlying anxiety, depression, or somatization (medically unexplained physical symptoms related to psychological distress). This does not mean that these folks are crazy or mentally ill. However, understanding this gives doctors an opportunity to help.
Some people just have a sensitive nervous system. Over 50 percent of those with noncardiac chest pain and more than one-third of those with nondiagnostic stomach pain will also have symptoms consistent with I.B.S.
Relaxation routines, cognitive behavioral therapy, and especially clinical hypnosis has been shown in multiple research studies to help I.B.S. patients. A comprehensive review article by Peter Whorwell published in the “Journal of Psychosomatic Research” in June 2008 substantiated the usefulness of hypnotherapy for I.B.S.
To try hypnosis for I.B.S., consult with a hypnotherapist who has experience with gut-directed hypnotherapy — this is a specialized form. The American Society of Clinical Hypnosis is a good resource for finding a practitioner (asch.net). Mindfulness-based stress reduction and meditation can help as well.
On the natural medicine side of the fence, enteric-coated peppermint oil capsules have some positive studies to support their use. Don’t use antacids with this — you don’t want peppermint oil released in the stomach. It can cause gastric reflux and heartburn.
Acupuncture can certainly relax you, but research results are mixed for I.B.S. patients. A European multiple-herb extract called Iberogast was shown to improve I.B.S. symptoms in a 2004 double-blind placebo study.
Finally, Jamie Lee Curtis may be a bit right. Several studies have shown that the Bifidobacterium in the yogurt product she is selling on TV may be helpful. As for Activia itself, who knows? It contains fructose syrup, which is a tough sugar for I.B.S. folks to digest, and milk products don’t work for many.
The probiotics theory suggests that if you get healthy bacteria to flourish in your large intestine, which is the natural state of things, by consuming large amounts of the good bacteria (a probiotic product), you will have a colon that works better. Sales in the United States of nondairy probiotics were $220 million in 2005, with an annual growth rate of 14 percent.
A review article in September 2005 by Picard et al., confirmed that the Bifidobacterium probiotic was helpful for bloating and constipation, but a 2010 systematic review by Anna Chmielewska and Hania Szajewska on the National Institutes of Health Web site concluded that probiotics were not confirmed to help. I hate when that happens.
Milk-free probiotics or yogurt products are pretty benign therapies, so feel free to partake if you wish, but they may not have a big effect on your irritable gut symptoms. The documented improvements in the studies were not large, and other therapies may help more.
I.B.S. does not lead to more serious disease, so you don’t need lots of tests. Try some simple interventions and see how you do. The mind-gut connection will be key for many. As the great fastball pitcher Satchel Paige once said, “If your stomach disputes you, lie down and pacify it with cool thoughts.”
—
In a time of salmonella-laced eggs, and with an economy looking to double dip like George Costanza at the hors d’oeuvre table, it’s no wonder we have achy bellies. One in five Americans has a condition called irritable bowel syndrome (I.B.S.), and many have trouble getting any relief for it.
Young women don’t usually have many health problems, but this is one condition that commonly plagues them. It usually starts in the late teens to 20s, and affects women twice as often as men. It is characterized by abdominal pain, bloating, cramping, constipation, and diarrhea. People with I.B.S. feel better when they go to the bathroom, but their bowel habits are irregular.
Seventy percent of those suffering with I.B.S. are not receiving care for their condition, and many have tried conventional medications without relief or with intolerable side effects. About half of I.B.S. sufferers have tried alternative therapies for their condition, again with mixed results.
If you have typical persistent symptoms, your doctor has to make sure you don’t have an inflammatory bowel disease, such as ulcerative colitis or Crohn’s disease, or lactose intolerance, parasites, cancer, celiac disease, bacterial overgrowth, or thyroid trouble. Ten percent of I.B.S. sufferers develop chronic symptoms after a bout of bacterial gastroenteritis.
There is no definitive cause or cure for irritable bowel syndrome. The nerves and muscles surrounding the intestines may be especially sensitive in I.B.S. patients. Shortly after a meal, they will contract excessively, causing cramping and pain. Another theory implicates an imbalance in the neurotransmitter serotonin, 95 percent of which is in the gut and 5 percent is in the brain.
Common treatments that help some people are increased fiber and specific dietary restrictions, though the research on dietary interventions is equivocal. Soluble fiber like psyllium — not bran — has been shown in several studies to ease I.B.S. symptoms. Every patient will respond differently to these interventions, although fatty foods and caffeine are generally poorly tolerated.
There is a certain amount of gluten hysteria around, with folks deciding they can’t eat it without actually doing a well-controlled test. Gluten is a grain protein in wheat, barley, and rye, and can also be found in medicines, supplements, and cosmetics. Two weeks of strict gluten elimination, with subsequent reintroduction, can certainly tell you if you are sensitive to this food. The blood tests for celiac disease or gluten sensitivity are also fairly reliable.
Medications can help some I.B.S. patients, but none are curative. A 2005 review paper showed that about 18 percent of I.B.S. patients will benefit from antispasmodics (intestine-relaxing drugs) like hyoscyamine (Donnatal, Levbid, Anaspaz, NuLev) or dicyclomine (Bentyl). Mild sedatives, like Donnapine and Librax, don’t help much and can be habit-forming.
Tegaserod (Zelnorm) was pulled from the market back in 2007 for possible association with heart problems, but it is now available on a limited basis for women only. Studies show that tegaserod only benefits a small percentage of patients. The old tricyclic antidepressants (amitriptyline, nortriptyline) in low dose seem to make a difference, and lubiprostone (Amitiza) can help with constipation in the short-term.
“When I repress my emotions, my stomach keeps score,” wrote John J. Powell, S.J., a Jesuit priest. Most of us intuitively understand that the belly is the seat of the emotions, and the brain-gut connection has received much interesting research attention.
More than 50 percent of those who seek care with irritable bowel symptoms have underlying anxiety, depression, or somatization (medically unexplained physical symptoms related to psychological distress). This does not mean that these folks are crazy or mentally ill. However, understanding this gives doctors an opportunity to help.
Some people just have a sensitive nervous system. Over 50 percent of those with noncardiac chest pain and more than one-third of those with nondiagnostic stomach pain will also have symptoms consistent with I.B.S.
Relaxation routines, cognitive behavioral therapy, and especially clinical hypnosis has been shown in multiple research studies to help I.B.S. patients. A comprehensive review article by Peter Whorwell published in the “Journal of Psychosomatic Research” in June 2008 substantiated the usefulness of hypnotherapy for I.B.S.
To try hypnosis for I.B.S., consult with a hypnotherapist who has experience with gut-directed hypnotherapy — this is a specialized form. The American Society of Clinical Hypnosis is a good resource for finding a practitioner (asch.net). Mindfulness-based stress reduction and meditation can help as well.
On the natural medicine side of the fence, enteric-coated peppermint oil capsules have some positive studies to support their use. Don’t use antacids with this — you don’t want peppermint oil released in the stomach. It can cause gastric reflux and heartburn.
Acupuncture can certainly relax you, but research results are mixed for I.B.S. patients. A European multiple-herb extract called Iberogast was shown to improve I.B.S. symptoms in a 2004 double-blind placebo study.
Finally, Jamie Lee Curtis may be a bit right. Several studies have shown that the Bifidobacterium in the yogurt product she is selling on TV may be helpful. As for Activia itself, who knows? It contains fructose syrup, which is a tough sugar for I.B.S. folks to digest, and milk products don’t work for many.
The probiotics theory suggests that if you get healthy bacteria to flourish in your large intestine, which is the natural state of things, by consuming large amounts of the good bacteria (a probiotic product), you will have a colon that works better. Sales in the United States of nondairy probiotics were $220 million in 2005, with an annual growth rate of 14 percent.
A review article in September 2005 by Picard et al., confirmed that the Bifidobacterium probiotic was helpful for bloating and constipation, but a 2010 systematic review by Anna Chmielewska and Hania Szajewska on the National Institutes of Health Web site concluded that probiotics were not confirmed to help. I hate when that happens.
Milk-free probiotics or yogurt products are pretty benign therapies, so feel free to partake if you wish, but they may not have a big effect on your irritable gut symptoms. The documented improvements in the studies were not large, and other therapies may help more.
I.B.S. does not lead to more serious disease, so you don’t need lots of tests. Try some simple interventions and see how you do. The mind-gut connection will be key for many. As the great fastball pitcher Satchel Paige once said, “If your stomach disputes you, lie down and pacify it with cool thoughts.”
—
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