Two seperate studies indicate that the pain of Irritable Bowel Syndrome is due to increased sensitivity in the brain and that hypnosis can provide the tools for patients to control symptoms.
Irritable Bowel Syndrome (IBS) is the most commonly diagnosed gastrointestinal disease in developed countries yet it remains poorly understood. In recent years much research has focused on how the body perceives pain through the brain and nervous system.
A study published recently found that womens' brains process sensations slightly differently than mens' which results in them having a higher sensitivity and greater likelihood of experiencing various stimuli as pain. This may explain why women are more likely to suffer from IBS and other chronic pain conditions such as fibromyalgia.
Now a new study has investigated the response of the brain to the expectation and actual sensation of pain in women with IBS. The research was carried out at the the University of California - Los Angeles (UCLA) and was led by gastroenterologist Dr. Emeran Mayer.
Dr. Mayer and his team recruited women with IBS that had no co-existing psychiatric disease or psychological symptoms along with a group of healthy controls.
The brain activity of the women was measured at two points during a procedure which distends the colon; a mildly uncomfortable sensation for healthy people. A light on the scanning machine would light up a few seconds before the actual distention began giving the women prior warning of the uncomfortable sensation to come. Brain activity was measured at this point and during the actual distention. This procedure allowed the researchers to determine the impact of both the anticipation of physical discomfort with the discomfort itself in terms of the effects on the brain and the pain experienced.
It was found that when someone is anticipating a painful event (e.g. when the light came on) which cannot be avoided the brain prepares itself and the body for what it thinks is going to happen. This means that In a healthy person the brain turns down the volume on the sensory systems so that pain sensations are felt less strongly. Emotions such as anxiety also amplify pain so the brain dampens the activity in the areas that control emotion as well.
The main finding of the research was that the brains of the IBS patients did not react in this way. Instead of the expected suppression of sensory and emotional responses these were actually heightened, making IBS patients more sensitive to pain.
In an interview with News 8 Austin Dr. Mayer said: "The brain fundamentally did not show the normal, what we call adaptive response to the situation. At first glance, this seems trivial, but it confirms -- actually relates to -- a much larger body of the literature about symptom-related fears or symptom-related anxiety which seem to be play a big role in many chronic pain disorders."
Dr. Mayer further explains that although many people (including those in the medical profession) like to seperate diseases into biological and psychological the distinction doesn't really exist. Brain imaging studies such as this are showing that every brain function, emotions, cognitions or pain response, has a biological basis. Furthermore, Dr. Mayer says that the pain experience in humans is a very complex experience with sensory, emotional, cognitive, and memory components all involved.
In terms of how this research fits into the treatment of IBS it helps to explain why cognitive behavioural type therapies seem to be most effective. While medications that suppress the arousal centres of the brain sometimes help it is therapies that actually retrain the brain how to respond to pain and the anticipation of pain that are most effective.
To confirm this further another recent and unrelated study has provided more evidence that hypnotherapy is a highly effective therapy for IBS.
Specialists at Wythenshawe Hospital in Manchester, England, conducted a trial of 60 patients using 'gut-directed hypnotherapy'. The therapy aims to address the sensation of pain and also trains patients to gain control over their bowels. This in turn leads to less anxiety and further reduces symptoms as the brain doesn't become so hypersensitive.
Patients are given 12 sessions of the hypnotherapy treatment at the hospital and the success rate is reported to be 70%; very impressive for a single therapy in a condition such as IBS.
There is now said to be an 18-month waiting list for patients wanting the hypnotherapy sessions at the hospital.