Physiological and psychological aspects of irritable bowel syndrome and the role of hypnosis

Over the years, irritable bowel syndrome has largely been considered as either a psychological or motility disorder. More recently, the concept that visceral sensitivity may be abnormal has become fashionable although there is still much debate over whether this is manifested at the gut level or located more centrally in the nervous system. Obviously, until the pathogenesis of irritable bowel syndrome is better understood, the rational development of appropriate pharmacological approaches to treatment is going to be hampered. Approximately 15 years ago, we formulated the hypothesis that as long as irritable bowel syndrome results from a potentially reversible rather than irreversible dysfunction of physiological control mechanisms, then it may respond favorably to an approach aimed at encouraging the body to restore itself to normal. Hypnotherapy is such an approach and has the advantage of not being necessarily dependent on a complete understanding of the pathophysiological mechanisms involved. This paper reviews some of our work in this field and how we have tried to also examine the effect of hypnosis on various pathogenetic mechanisms as they have become topical.