What is IBS?
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.
Diarrhoea 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 -- diarrhoea, 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
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 Diverticulitis, a disorder in which
balloon-like pockets push out from the bowel wall because of
excessive, prolonged contractions.
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
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
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.
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
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.
The treatment of IBS is directed to both the gut
and the psyche.
Hypnotherapy and Cognitive
Behavioural Therapy (CBT)
and CBT can produce long term positive results in a high % of the
people who use it.
therapies are often thought to be therapies that only affects the
mind, but as mind and body are inseparably joined, they can also help
Irritable Bowel Syndrome, one of hypnotherapy's greatest benefits is
its well-established ability to reduce the effects of stress. Your
state of mind can have a direct impact on your physical well-being,
even when you're in the best of health. If you're struggling with IBS,
the tension, anxiety, and depression that comes from living with an
incurable illness can actually undermine your immune system and
further compromise your health.
and CBT can reduce this stress and its resultant negative impact by
placing you in a deeply relaxed state, promoting positive thoughts and
coping strategies, that clear your mind of negative attitudes.
Bowel Syndrome in fact is almost uniquely suited to treatment by
hypnosis, self-hypnosis and CBT for several reasons. First, as just
noted, stress-related attacks can be significantly reduced. Secondly,
hypnotherapy, has a well-documented ability to relieve virtually all
types and degrees of pain. Finally, because IBS is not a disease at
all but a syndrome, if you can relieve and prevent the symptoms, you
have effectively cured yourself of the disorder, and you will be
living an IBS-free life. This outcome is a definite possibility from
hypnotherapy and CBT treatments.
The diet requires review,
with those foods that aggravate symptoms being avoided.
Current medical thinking about diet has changed a great deal in recent
years. There is good evidence to suggest that, where tolerated, a high
roughage and bran diet is helpful. This diet can result in larger,
softer stools which seem to reduce the pressures generated in the
Large amounts of beneficial fibre can be obtained by taking
over-the-counter bulking agents such as psyllium mucilloid (Metamucil,
Konsyl) or methylcellulose (Citrucel).
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.
We are members of the UK Register of IBS Therapists
and IBS responds very well to the methods we use. If you live in
or around the Nottinghamshire area please give us a ring to arrange an
appointment where we can discuss your situation in complete
confidence. From that consultation a treatment programme will be
designed specifically for you.
us today for more information: 01623 556234.