Harnessing the Mind to Manage Irritable Bowel Syndrome
Cognitive behavioral therapy and hypnosis may help ease symptoms, research shows
By Karen Pallarito
FRIDAY, Feb. 15 (HealthDay News) -- When drugs and dietary changes don’t provide relief from the pain, bloating and other unpleasant gastrointestinal symptoms of irritable bowel syndrome, patients may want to try a different approach.
Recent studies show that using one’s own thoughts in a process called cognitive behavioral therapy may help ease symptoms. Likewise, using hypnosis to visualize the pain and imagine it seeping away can be a powerful treatment strategy, too.
"Research indicates that the probability of achieving benefits is excellent with either approach, even for patients who haven’t improved from standard medical care," said Olafur S. Palsson, a clinical psychologist and associate professor of medicine at the University of North Carolina at Chapel Hill’s Center for Functional GI & Motility Disorders.
As many as 45 million Americans may have irritable bowel syndrome, or IBS, the International Foundation for Functional Gastrointestinal Disorders reports. Sixty percent to 65 percent of IBS sufferers are women.
In addition to pain and discomfort, people with IBS experience chronic or recurrent constipation or diarrhea -- or bouts of both. While the exact cause of the condition isn’t known, symptoms seem to result from a disturbance in the interaction of the gut, brain and nervous system, according to the foundation.
Doctors generally advise patients to avoid certain foods that may exacerbate symptoms. Several different medications may be recommended for relieving abdominal pain, diarrhea and constipation. But these approaches don’t always provide adequate relief.
"For some people, medications and dietary changes are the perfect match, but most of our patients -- the great, great majority of patients -- have not responded to medications and dietary changes," said Jeffrey M. Lackner, assistant professor of medicine at the University of Buffalo, State University of New York, and a behavioral medicine specialist whose research focuses on gastrointestinal disorders, particularly IBS.
For many patients, cognitive behavioral therapy, which uses the power of the mind to replace unhealthy beliefs and behaviors with healthy, positive ones, may be the answer. But, Lackner observed, very few facilities around the country specialize in this type of treatment.
Recognizing this, he and his colleagues set out to devise and test a treatment program that IBS patients could administer themselves.
Seventy-five women and men were divided into three groups. One group was placed on a "wait list" for 10 weeks while they monitored their symptoms. Another group received the standard treatment of 10 cognitive behavioral therapy sessions over 10 weeks. The third group had once-a-month therapy sessions over four months and practiced relaxation and problem-solving exercises at home.
Not surprisingly, people on the wait list did not do well at all, while those in the 10- and four-week sessions showed significant improvement. "They said at the end of treatment they had achieved adequate relief from pain and adequate relief from bowel problems, and a significant proportion of patients said they improved their symptoms," Lackner explained.
While more studies are needed, the findings suggest that traditional and self-administered cognitive behavioral therapy both provide adequate relief and improve symptoms, said Lackner, who first reported the findings at large meeting of GI professionals.
Hypnosis may be another option. A pair of Swedish studies presented at that same meeting found that patients who received "gut-directed hypnotherapy" had significant improvement in symptoms compared with those who did not receive this intervention.
Hypnosis treatment has been reported to improve symptoms of the majority of treated IBS patients in all published studies, noted UNCs Palsson.
For patients who’ve tried the diet-and-drug regimen to no avail, Palsson said he would recommend either of these two psychological treatments.
"If a patient’s main goal is substantial relief of bowel symptoms, hypnosis is probably the better choice," he said, for the research literature strongly suggests that it improves the gastrointestinal symptoms far more reliably.
On the other hand, he added, if a patient wants to cope better with the illness or improve mental well-being, then cognitive behavioral therapy is equally good or perhaps even the better treatment option.
SOURCES: Jeffrey M. Lackner, Psy.D., assistant professor, medicine, University at Buffalo School of Medicine, Buffalo, N.Y.; Olafur S. Palsson, Psy.D., associate professor, medicine, Center for Functional GI & Motility Disorders, University of North Carolina at Chapel Hill; International Foundation for Functional Gastrointestinal Disorders, Milwaukee 
Book Review
Harvest for Hope: A Guide to Mindful Eating
By Jane Goodall with Gary McAvoy and Gail Hudson
In Harvest for Hope, Goodall uses a plethora of anecdotes and facts to show the reader the huge impact one’s food choices have, not only on the individual body, but also on our planet. With interesting and varying stories sprinkled between the facts, Goodall connects the reader to his or her food choices. Her language is easy to understand making it feel as if she is speaking directly to the reader. It is a hard book to put down as each new topic pulls you deeper and deeper into your true relationship with the food you eat.
She uses the first chapters of the book to introduce the reader to how the world’s current food consumption patterns developed. Then Goodall truly delves into the distinct problems concerning our current food consumption patterns. She begins with explaining the state of current farming practices. Leaving behind commonsense farming practices, she informs the reader that much of today’s farming products are covered in chemicals and genetically engineered. I was certainly convinced of the harmful effects of genetically modified products in Goodall’s section titled Animals and GMOS. She stated that
The Well Being Journal ran a story in September of 2003 about a farmer named Bill Lashmet who performed a feeding experiment with his cows. He filled one trough with fifty pounds of genetically modified Bt corn and the other with natural shelled corn. He watched as every single one of his cows sniffed the Bt corn, withdrew, and then moved to the natural corn, which they devoured.
Like all of the topics she tackles, she finishes addressing farming practices in her What You Can Do section by telling the reader to demand labeling, to focus on grocers, and to avoid eating GMOs. In the same amount of detail and depth, Goodall goes on to enlighten readers about animal factories and how farming animals can negatively impact our health. Then she devotes an entire chapter to how we can help farm animals live better lives by supporting the right farmers, buying grass-fed animal products, and reading labels carefully among other actions.
Beginning with Becoming a Vegetarian Goodall shifts her focus from people’s meat consumption to produce and processed food consumption. Her chapter on Global Supermarkets was of particular interest to me because it never seemed odd to have "fresh" grapes in Chicago during the freezing months. To demonstrate her point of how much ordinary supermarket produce travel in comparison to a farmers market produce, Goodall states the averages of a Chicago Terminal Market and a San Francisco Ferry Plaza Farmers Market.
| Chicago Terminal Market |
San Francisco Ferry Plaza Farmers Market |
| Apples: 1,555 miles |
Apples: 105 miles |
| Tomatoes: 1,369 miles |
Tomatoes: 117 miles |
| Grapes: 2,143 miles |
Grapes: 151 miles |
Any grapes I consumed this winter were definitely not fresh and had lost much of their nutritional value. To remedy this situation of eating foods picked thousands of miles away, Goodall gives the reader step-by-step directions on how to eat local, seasonally grown foods. She spends much of the rest of her book demonstrating with concrete examples that we can no longer afford to eat the non-organic, nutritionally inferior foods.
Eating is a very personal act that can affect many aspects of a person’s life. As part of Goodall’s title, A Guide to Mindful Eating, suggests, the majority of people are no longer connected to the food they eat. Harvest for Hope is an excellent resource to help one become more mindful and connected to the food he or she eats.
Reviewed by Kathryn Marcinak, HHP, BA, C-PT, Editor
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Jane Goodall is the world’s foremost authority on chimpanzees. An internationally renowned conservationist, she is the founder of the Jane Goodall Institute and has received many distinguished awards in science. Dr. Goodall is also the author of many acclaimed books, including the bestseller Reason for Hope.
Gary McAvoy established the volunteer Seattle Base Camp for the Jane Goodall Institute. A technology consultant, he is also at work on a novel.
Gail Hudson has written about holistic living for numerous publications including Utne and Self. Her books include I Wanna Be Sedated: 30 Writers on Parenting Teenagers.
Motivational Tips
Five Keys to Setting Attractive, Sustainable Goals
By Anne Walsh
We’ve all been there. How many of you have set up new year’s resolutions only to discover that you have slipped after the first week or been to a workshop and sworn that this time you are really going to achieve those dreams you have had at the back of your mind? The following article gives you five keys on setting goals that will keep you motivated.
Key One: Make them realistic, make them yours.
Key Two: Write them down.
Key Three: See them every day.
Key Four: Make it easy, set up strong support structures.
Key Five: Acknowledge and review regularly.
Key One -- Make Them Realistic, Make Them Yours
Jung described a parent’s unrealized dreams as the most powerful influence in a child’s life. When you choose your goals, make sure they are your goals not anyone else’s. Also, make sure that the goals are realistic. For example, you may not be able to make the Olympics gymnastic team, but you could walk a marathon next year or work towards a high standard in yoga. Be honest with yourself about it and when the "yeah, but" tape starts playing remind yourself that you are not given a dream without the capacity to make it true. This is particularly true if you find that you have a recurring desire about something.
Key Two -– Write Them Down
There’s something about the human brain that doesn’t seem to see things as real until they are visible or written down. Pick 3 – 5 goals that you want to achieve for the coming year and write them down. Make sure that they are measurable. Writing down "I will save money" is a goal, but writing down "I will have saved €4000 in the next 12 months" is more powerful.
Key Three -– See Them Every Day
Write your goals on ten small 3" X 5" index cards and have them visible everywhere to you. Another powerful exercise is to take time to visualize what your life would be like with those goals. If you can make the experience as vivid as possible, it gets the brain going on ways to achieve them; in ways you could never imagine at the beginning!
Key Four -– Make It Easy, Set Up Strong Support Structures
Don’t rely on your own willpower to carry you through because it probably won’t. (But you know that already, don’t you?) In Ireland, there is a proverb, "ar scáth a chéile a mhaireann na daoine" which means that we live in each other’s shadows, we are interdependent. Put systems and supports in place that will sustain you when your energy is low. For example, if you plan to save money, set up an automated direct debit to do it. If you want to exercise more, find something you enjoy and buddy up with someone. Build in a practice of daily silence/meditation/prayer to help you keep in touch with your deeper, truer self. Get a coach to help create structures that keep you accountable. Remind yourself on a daily basis of the benefits of achieving this goal.
Key Five – Acknowledge and Review Regularly
Set aside time every week to quickly review your goals, acknowledge progress, and simply note where you have slipped. Slippage is inevitable. Don’t beat yourself up, note what caused it and begin again! Adopt a gentle curiosity with yourself as to what caused you to slip and then begin again.
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About the author:
Anne Walsh is a life coach based in Co. Galway, Ireland. Bring your best self to light at http://www.annewalshcoach.com.
GCNM Faculty Profile
Heather Johnstone PhD RN BC APN AMP-C RYT
Director GCNM/Director GIFAM
Dr. Heather Johnstone has been working in the healing arts for over thirty years and maintains an active Holistic Wellness Consultancy practice. She is a Nursing Master’s level prepared Advanced Practice Nurse (APRN) with a Family Nurse Practitioner specialty. Heather is an active member of many professional organizations including the American Holistic Nurses’ Association. Her holistic health education includes a Doctorate in Metaphysics and a Diploma in Acupuncture. Additionally, Heather is a Yoga Instructor at the 500 hour level with the Yoga Alliance and has a specialization in Pranic Healing. Professionally, Heather finds the perfect balance in providing direct service to clients and facilitating the development of healing arts students.
She has been kind enough to further detail her experiences and journey towards providing holistic health care.
I started in health care very early. At age 8, I gave massages to my aunt and cousin who had severe arthritis. Being the daughter of a Christian Scientist and granddaughter of a nurse, I found myself in nursing school after working as a nurse’s aide in college. In nursing school, I was drawn to alternative medicine. I did many of my reports on alternative medical modalities. My first job as a nurse was as a staff nurse on an Indian reservation. Fortunately, I was privileged to view the work of the Navajo healers. One example of their work particularly impressed me. The Western medical care for an infant with uncontrolled seizures included paraldehyde enemas. Of course, the seizures were no better and the nurses all had horrendous headaches. The healer came in and was able to control the seizures. Over time as I worked as a nurse and later as a nurse practitioner, I became more and more frustrated with the ineffectiveness of Western medicine and began to study holistic health. I started with reflexology and acupuncture and moved on through to metaphysics. I presently teach nursing and holistic health while maintaining a private practice with a focus on those impacted with cancer.
Learn more about the Global College of Natural Medicine by logging on at http://www.GCNM.com, where you will find details on the school, its programs, tuition, and contact information.
Search online for values in the USDA National Nutrient Database for Standard Reference.
