Gut-brain - psychogastroenterology
Gut-Brain
There is a very strong link between the gut and the brain. When the link becomes disturbed, digestive issues and mental health issues can arise. Since your doctor cannot see the irregularities in your gut, it can be difficult to diagnose these conditions. Consequently, patients may become highly distressed in their isolation & hopelessness.
The good news is, that even if you've faced persistent and embarrassing gastrointestinal discomfort with high anxiety and had limited success from medicine, one of our psychologists could help. The majority of our patients leave the clinic after treatment feeling like they have regained control over their gut, body, and life.
Treatment
Medical research emphasises the complicated brain/bowel interaction. Many nerve to muscle messages in the bowel are similar to those in the brain and reactions can be triggered by emotion. This is why people may get diarrhoea when nervous. Given this relationship, gut-brain disorders are treated by specialised psychologists via psychogastroenterology, which combines gut-directed hypnotherapy and cognitive-behavioral therapy (CBT). Research shows these methods lead to improved gut physiology, reduced visceral hypersensitivity, so you can be symptom free. Even though IBS appears unlikely to be directly related to a particular food, some people may be food sensitive. Hence, reviewing your diet is also likely going to be part of the treatment.
Gut-Directed Hypnosis
Often therapeutic hypnotherapy is linked to “stage hypnosis”, but it is very different. It involves engaging the mind (rather than not remembering), so that you can see the digestive system issue from a healthier and functional perspective. This helps your brain and gut remember how to work together in harmony again so that you can forget about your gut and get on with living life.
It is important to emphasise that optimal results rely on the therapists skill in case formulation and treatment, and strong patient-psychologist trust. A genuine trusting relationship is paramount.
Origin of Symptoms
Symptoms may arise from bacterial infection, genetic mutations, over use of antibiotics, steroids, chronically high levels of cortisol, hormone changes, overseas travel, parasitic infection, and microbiome imbalances.
Pharmaceuticals may be of use, however efficacy fluctuates and side effects exist. For instance, a constipation remedy may trigger gassiness or pain and ant-acids can slow the digestive process further impeding gut recovery.
Medicine
Colofac is an anti-spasmodic used in relieving pain and urgency, but it only works if taken long-term.
Antidepressants such as tricyclic compounds (eg Endep) have a soothing effect on the nerves and muscles in the bowel and can assist with pain relief.
Zelmac may assist females with IBS-C
Anti-diarrhoeal agents such as Imodium or Lomotil are often useful for loose stools.
Laxatives are rarely useful for Irritable Bowel Syndrome.
Inflammatory Gut Conditions – are conditions where inflammation causes gut disease with symptoms such as structural damage and loss of function. At the Engel Clinic we provide psychological counselling and hypnosis to support our clients along this journey, which have been shown to improve abdominal pain and psychosocial quality of life.
CONDITIONS TREATED
Functional Reflux
Functional heartburn, as defined by Rome IV criteria, is the presence of typical heartburn symptoms in patients with normal upper endoscopy findings, normal esophageal pH testing, and a negative correlation between symptoms and reflux events. CBT and Gut-Brain hypnosis is highly effective in treating symptoms.
Irritable Bowel Syndrome
Irritable bowel syndrome (IBS) is the most common FGBD and it affects the stomach and intestines.
Symptoms come and go with attacks lasting hours, days or weeks, and include cramping, pain, bloating, gas, diarrhea, constipation, or both. Clinical psychology and Gut-Brain Hypnotherapy is highly effective in treating symptoms.
ARFID
Avoidant/restrictive food intake disorder (ARFID) is a fairly new eating disorder. Children with ARFID are extremely selective eaters and sometimes have little interest in eating food. They may eat a limited variety of preferred foods, which can lead to poor growth and poor nutrition. Clinical psychology and Gut-Brain Hypnotherapy is highly effective in treating associated symptoms.
Functional Abdominal Pain
Functional abdominal pain, also known as intractable abdominal pain, is persistent stomach pain that does not resolve with usual therapeutic treatment. The pain may be constant or may come and go. Approximately 10 to 15 percent of school-age children have functional abdominal pain at some point. Clinical psychology and Gut-Brain Hypnotherapy is highly effective in treating associated symptoms.
Functional Nausea
Functional nausea is a condition that severely impairs the quality of life of affected individuals. Only recently, it has been added to the pediatric list of disorders of gut-brain interaction. In most cases, only minimal testing is needed to diagnose functional nausea. Gut directed hypnotherapy has been shown to be a very effective treatment. There are several other non-medical interventions which have the potential to benefit sub-groups of patients with chronic nausea.
Functional Vomiting
Functional vomiting is defined as recurrent unexplained vomiting at least once per week that is not cyclical. Careful history taking will rule out rumination syndrome or an eating disorder. GI - Hypnotherapy has been shown to be a very effective treatment and there are several other medical and non-medical interventions which have the potential to benefit sub-groups of patients with chronic nausea.
Emitophobia
Emetophobia is a mental health condition in which you experience an intense fear of vomiting. Vomiting isn't something that people enjoy doing. But after an illness, most people don't think about it again, unless Emitophobia develops.
Rumination
A condition where a person vomits up food from the stomach, rechews it and either swallows it again or spits it out. It tends to occur within 30 minutes of every meal. The cause can have a psychological origin and be treated by a qualified psychologist who uses gut-brain hypnotherapy.
Motility Issues
In essence, the cause of these motility disorders is a dysfunction of either the nerves or muscles that leads to the intestinal muscles contracting or relaxing improperly. Some motility disorders (like gastroesophageal reflux disease) are very common, while others, like gastroparesis, are more rare. Gut-brain hypnotherapy can be highly effective in relieving these symptoms
Functional Bloating
Visible, measurable, abdominal uncomfortable distention. May be due to aerophagia, hypomotility of the GI tract, a symptom of psychiatric conditions such as anorexia nervosa, bulimia, or somatisation disorder. If an organic or psychiatric cause cannot be found, then bloating is usually considered to be “functional" and managed via psychogastroenterology and gut-directed hypnotherapy.
Dysphagia
Dysphagia is a medical term for difficulty swallowing. Dysphagia can be a painful condition. In some cases, swallowing is impossible. Please do review symptoms with your GP or GI specialist prior to psychological intervention or gut-brain hypnotherapy. If there is no improvement we often find excellent treatment outcomes with the treatment at the Engel Clinic.
Functional Burping
Excessive and bothersome belching is a common symptom, which is often seen in patients with functional dyspepsia and gastroesophageal reflux disease. Often other symptoms are predominant, and these should be treated by a gastroenterologist prior to gut-directed hypnotherapy, both of which are effective in reducing symptoms.