Hypnosis for Irritable Bowel

Medically Reviewed by Jacqueline Brooks, MBBCH, MRCPsych
From the WebMD Archives

Aug. 23, 2001 -- Relax, you're getting sleepy ... very sleepy.

That may sound like a Hollywood cliché -- the glassy-eyed subject lulled by a swinging watch -- but some researchers believe the peaceful state achieved in hypnosis can help people suffering from irritable bowel syndrome.

At a meeting this week of the World Congress of Psychosomatic Medicine, gastroenterologist Peter Whorwell, MD, will discuss more than 20 years of research showing that hypnosis can not only improve symptoms of irritable bowel syndrome, or IBS, but can even alter the underlying physical problems that cause the symptoms.

The movie version of hypnosis is not much like the real thing. Instead, says Whorwell, in his practice it is more like meditation, yoga, or guided imagery. For treating IBS, a hypnotherapist guides a patient in relaxation exercises and helps him focus on the muscles of the stomach that are so critical in IBS.

"It's a concentrated form of relaxation where the therapist is teaching the patient to control systems of their body they can't normally control," Whorwell tells WebMD.

IBS is a common disorder of the digestive system that leads to cramps and pain, gassiness, bloating, and changes in bowel habits. Some people with IBS have constipation, others have diarrhea, and some have both.

And many doctors believe there is a psychological component to IBS, in which stress, depression, or other mental states can lead to physical symptoms in the gut. Such symptoms are called "psychosomatic," and Whorwell says they are not confined to IBS. "Every disease has a psychological component," he says.

With IBS it's important for patients to have better control of the contractions of their stomach muscles and the sensitivity of their stomach to stress and other influences. That's where hypnosis can help, Whorwell says.

But it doesn't happen overnight.

"It's a skill the patient has to take the time to learn," he says. "Just as it took time to learn to control bowels as an infant, it takes time to train your body to control your gut."

At the Hypnosis Unit of University Hospitals of South Manchester, in England, where Whorwell practices, patients typically receive twelve half-hour sessions of hypnotherapy, he says.

Hypnotherapy can be used in combination with drugs that ease the pain of stomach contractions, or with changes in diet. But Whorwell believes that for some patients hypnosis can be superior.

"The beauty of hypnotherapy is that once patients are better, they stay better," he says. "Once a person stops using drugs, the symptoms can come back."

Whorwell acknowledges that finding a hypnotherapist who knows what he is doing and -- more important -- knows about IBS, can be difficult. And hypnotherapy remains somewhat outside the mainstream, he believes.

Still, a 1996 statement by the American Gastroenterological Association suggests that hypnotherapy is generally accepted as a treatment for IBS.

"Several psychological treatments have been studied in patients with IBS, including psychotherapy, ... hypnosis, relaxation, and biofeedback," according to the statement. "These seem to be effective at reducing abdominal pain and diarrhea but not constipation, and they also reduce anxiety and other psychological symptoms."

"I'm a believer," says gastroenterologist Cynthia M. Yoshida, MD, director of the Women's GI Clinic at the Digestive Health Center of Excellence at the University of Virginia, Charlottesville. "Most people in the field will tell you it's not just medicine that does it [for IBS]."

At the Women's Clinic, people with IBS may receive a range of "alternative" treatments similar to hypnosis, including guided imagery and relaxation techniques, possibly in addition to drugs and dietary changes.

"It's very individualized depending on what is going on in the patient's life and whether stress is a big part of their symptoms," she tells WebMD. "There is no cookbook for treating IBS."