I was probably around 9 when I first experienced excruciating abdominal pain that didn't have an obvious trigger. The pain wasn't related to the food I ate, or anything that I drank. It would come and settle in at any time, even while I was playing with my friends, or watching a film. It wasn't a sneaky kind of pain that starts small and develops gradually. Instead, it was a mind-boggling sharp spasm that wouldn't go away. Like someone turned the light on. And then off. While in pain I couldn't do or focus on anything else, so quite naturally the fear of pain and expectation of it settled in quite early on.
Now, although the triggers were unknown, the root of the pain was pretty obvious. I lost my father to a car crash only a year before the pain started. He kissed me ‘goodbye' and never came back. As an 8-year-old I didn't have my defence or coping mechanisms developed, so the pain of traumatic loss had to find a way out. And it did, in my gut. The pattern was born and my response to life's difficulties was established.
As soon as I reached early puberty my pain was distracted with other life's offerings. It was this turbulent period filled with self-discovery, experience and learning that made me temporarily forget my abdominal pain. However, it was back once I reached my mid-twenties and it started after a few episodes of severe and prolonged stress. At about that time, I got married and moved to the UK and had my first child. I will never forget breastfeeding her with a kitchen cloth in my mouth and hours spent on a bathroom floor, bending over in debilitating pain while clutching onto a heating pad. This time it would be triggered by food or drink that didn't agree with me and the psychological and physical stresses of having a child. The fear of the unknown and uncertainty was the fertile soil for all my future anxieties, depression and anger. Ever since then, I've had these pains that doctors have done every test in the book for and have come up with nothing, so they've called it IBS (irritable bowel syndrome).
A person is considered to have IBS if, in the absence of other pathology, she experiences abdominal pains along with disturbances of bowel function, such as diarrhoea or constipation. Medical terminology calls IBS a functional disorder. Functional refers to a condition in which the symptoms are not explainable by any anatomical, pathological or biochemical abnormality or by infection. Doctors are accustomed to rolling their eyes when faced with a patient who has functional symptoms since functional is medical code for ‘all in the head'. Although, there is some truth in that. The patient's experience is, in part, in their brain, but not in the disparaging and dismissive sense that the phrase ‘all in the head' implies.
When not seen as the patient's neurotic imagining, the pain of IBS, and of undiagnosed abdominal pain in general, has been, until recently, thought to be caused purely by uncoordinated contractions of the intestines. Now it has been confirmed that dysfunction in these disorders does not lie solely in the gut itself. A key issue is the way that the nervous system senses, evaluates and interprets pain. It appears that in functional abdominal pain, physiological messages from the gut are transmitted by the nervous system and received by the brain in an altered fashion. So, what accounts for these altered nervous-system responses? The answer often emerges when we look not only at human organs but at human lives. There is a high incidence of some sort of psychological trauma in the histories of patients with IBS and other functional disorders. But how does psychological trauma exert its effect on the perception of pain?
The nervous system of the gut contains about one hundred million nerve cells. These nerves do more than coordinate the digestion and absorption of food and the elimination of waste. They also form part of our sensory apparatus. The gut responds to emotional stimuli by way of muscle contractions, blood flow changes and the secretion of large numbers of biologically active substances. Such brain-gut integration is essential for survival. In turn, the gut is abundantly supplied with sensory nerves that carry information to the brain. Quite frankly, life would not be liveable if we felt every micro-event in our bodies. There has to be a threshold below which the brain does not register sensation, but above which the brain will be alerted to potential danger from within or without.
When there are too many ‘gut-wrenching' experiences, the neurological apparatus can become over-sensitised. In the spinal cord, the conduction of pain from the gut to the brain is adjusted as a result of psychological trauma. The nerves involved are triggered by weaker stimuli. The greater the trauma, the lower becomes the sensory threshold. In other words, a normal amount of gas in the intestinal lumen and normal tension in the intestinal wall will trigger pain in the overly sensitive person. At the same time, the prefrontal areas of the cortex will be in a heightened state of vigilance, responding with stress to normal physiological processes.
Heightened perception of pain can be generalised, which means that patients exhibiting IBS symptoms are more likely than others to have symptoms elsewhere in the body and suffer from other conditions like oesophageal reflux, migraine or fibromyalgia.
Hypnotherapy has been scientifically proven to be effective in IBS and can lead to a long-term improvement of symptoms and quality of life. Solution-focused approach not only relieves symptoms but also appears to restore many of the recognised psychological and physiological abnormalities associated with these conditions toward normal. Solution-focused hypnotherapy is an extremely powerful form of talking therapy which takes the best from psychotherapy, NLP, cognitive behavioural therapy and coaching and combines it with hypnosis. The result is a considerable reduction in anxiety levels, restoring patients' sense of control while improving overall health and well-being.