New ways of thinking

Personal relationships can have a major impact. Symptoms are worse if there is conflict in the family, better if relationships are supportive, the Gersons have found. When a person is in a bad marriage, divorce can become a cure. The brain has the ability to inhibit sensations from the gut. But, as Gerson put it, “IBS patients tend to be hypervigilant -- too aware of what is going on in their gut.”

Through techniques like hypnotherapy and cognitive-behavioural therapy, it is possible to change how the brain perceives what is happening in the body.

In hypnotherapy, patients learn to visualise their colon as functioning more normally. In cognitive-behavioural therapy or short-term psychotherapy, patients can learn to change symptom-provoking beliefs, like thinking that their colon will always be abnormal or that a given circumstance will provoke symptoms.

In a British study of 204 patients in which more than two-thirds were initially helped by hypnotherapy, 81 per cent of those maintained the improvement up to six years after the treatment. Learning to practice stress-reduction and relaxation techniques can be as helpful as learning which foods to avoid.

Questions, not tests

The medical profession tends to emphasise the physical aspects of the condition rather than patient insight, putting patients through a series of tests that focus on the colon, like colonoscopies.

But an international panel of experts concluded that in the vast majority of case — the exceptions are patients who warrant a full physical work-up — questioning patients about their condition is enough to arrive at an accurate diagnosis.

... contd.