Treatment of irritable bowel syndrome: Using dietary carbohydrate restriction and hypnotherapy as complementary therapies

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Irritable bowel syndrome (IBS) is a chronic functional gastrointestinal disorder. Current treatment strategies of IBS are unsatisfactory. Currently there are three common modes of treatment for IBS including: drugs, diet and psychological therapies. Pharmacologic interventions are generally not effective in treating IBS and no drug has been shown to relieve the full spectrum of gastrointestinal symptoms that make up IBS. Two common modes of treatment, however, that have been scientifically proven to relieve the symptoms of IBS include hypnotherapy and the low FODMAP diet. Gut-focused hypnotherapy uses hypnosis to induce a deep state of relaxation allowing the subconscious mind to become highly receptive to suggestions directed towards the control and normalisation of gut function. Recently published scientific research has shown that gut-focused hypnotherapy can have a 70+% success rate in the reduction of abdominal symptoms including abdominal pain, bloating, constipation and diarrhoea. Additionally, gut-focused hypnotherapy has been shown to improve overall well-being and quality of life, reduce anxiety and depression and reduce medication needs. Furthermore, these improvements have been shown to be maintained for 2-5 years. FODMAPs (Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols) are a group of dietary sugars that can be poorly absorbed in people with IBS. When these sugars are poorly absorbed in the small intestine they continue along the gastrointestinal tract and arrive at the large intestine where they act as a food source to the bacteria that normally live there. The bacteria of the large intestine then ferment these FODMAPs and can cause symptoms of IBS. Recently published scientific research has shown that dietary restriction of these poorly absorbed FODMAP sugars (the low FODMAP diet) can have a 75% success rate in the reduction of abdominal symptoms including abdominal pain, bloating, constipation and diarrhoea. Additionally, the low FODMAP diet has been shown to improve levels of fatigue amongst this population. While both the low FODMAP diet and hypnotherapy significantly reduce symptoms in the majority of IBS patients, the benefit of combining these therapies has not yet been investigated. It is anticipated that this study will shed light on the benefit of applying these therapies both individually and in combination with one another, allowing GPs and gastroenterologists to direct IBS patients to the best available treatment which may be tailored to each individual patient. Aims To assess the effectiveness of using dietary carbohydrate restriction (the low FODMAP diet) and hypnotherapy as complimentary therapies for the effective management of IBS To compare the combined treatment of the low FODMAP diet and hypnotherapy to each of the standalone therapies To assess the long term effectiveness of each of the treatment conditions Hypotheses Hypnotherapy will improve IBS symptom severity and psychological status amongst the IBS population The low FODMAP diet will improve IBS symptom severity and psychological status amongst the IBS population Hypnosis and the low FODMAP diet as complimentary therapies will improve IBS symptom severity and psychological status to a greater extent than if these two therapeutic modalities were administered independently Improvements in IBS symptom severity and psychological status will be maintained at 3 and 6 months following each of the treatment conditions

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