The best treatment for IBS? It’s in your brain!

Are you one of the many people who is bothered by chronic or intermittent abdominal pain with changes in your bowel habits?  Do certain foods get revenge on your GI system after being chewed and swallowed?  Does stress or anxiety show up first in your tummy?  If yes to any of those, you may be part of a very large club that no one wants to join.  Irritable bowel syndrome (IBS) affects an estimated one out of every 10 to 20 people in the US, so if it’s not you, you know someone who suffers from this condition. 


 

Why does this happen?  It’s common in kids, and common in adults, and though there are differences between kids and adults, some common reasons exist.  IBS is thought to be a disorder of gut-brain interaction. Through nerve pathways and chemicals in the blood, the brain and gut are “talking” to each other constantly, in both directions. Things like anxiety, poor sleep and depression make IBS more likely, and changes in gut barrier function, immune cells in the gut walls, and changes in gut nerves that make them more likely to send pain signals to the brain are all part of the disorder. It’s also very likely that the gut microbiome (the trillions of bacteria that are living in our guts) is altered in IBS, and those microbiome alterations also make mental disorders like anxiety and depression more likely. 

With a disorder this complex, touching many systems simultaneously, it’s not hard to see why “we have a pill for that” just doesn't work very well in IBS. And this recognition of the limitations of the biomedical model drove a recent landmark change in official guidance from the American and European gastroenterology professional societies. The 2025 guidelines for IBS in kids (up to age 18) gave the strongest recommendation to hypnosis as a treatment, even stronger than the recommendation for cognitive behavioral therapy (CBT) which also has evidence that it helps to resolve IBS symptoms in kids. CBT and gut-directed hypnotherapy are now also considered “standard of care” for adults with IBS, highlighting the evolution of our understanding of this disorder of gut brain interaction.

In my own practice, my approach is “both and,” not “either or.”  Having practiced clinical hypnosis for nearly 25 years, I have seen this approach work well for kids and adults, and I also pay close attention to dietary factors and addressing gut permeability and microbiome issues as well. I’ve also found that it’s important for me to explain why a mind-body medicine approach is the gold standard of care for my patients, who sometimes are skeptical about my thinking, as if I were implying that it’s “all in their head,” or that using hypnosis means I think the pain is not real.  The suffering with IBS is very real, and the good news is that the good clinical outcomes from gut-directed hypnotherapy are also very real.  I may ask you to employ your imagination as part of your hypnosis experience, but the healing that occurs is anything but imaginary.

I hope that this short summary provides some clarity on current best practices for a very common malady that causes a huge amount of suffering for people around the world.  If you know someone who is suffering in this way, please forward this post to them.  If you are in my area, I’d be happy to consult with you directly in the office and get you on the path to feeling better soon! 

Once again, all of us at Aiken-Augusta Holistic Health are committed to your health and well-being.  Let us know how we can be of service.

 

To your health and healing,

 

Robert Pendergrast, MD

csraholistichealth.com

803-426-1421 

 

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