Doctors like to know what is wrong with their patients. They want to understand what is causing the symptoms of disease and they want an effective treatment.
A diagnosis of Irritable Bowel Syndrome, IBS, is a classic heart-sink for a doctor because IBS, although affecting 15% of the population has no known cause or explanation. Both patient and doctor are stumped and proceed along a long and unhappy winding road of tests and head scratching.
However, if you consult the NICE directory, the NHS bible of how disease is treated in this country you will find they recommend a treatment that shows clinical effectiveness in over 70% of patients and which continues to help over a 5 year period following treatment. This treatment advice has not filtered down to your local GP, in fact it's a bit of a taboo.
So why, if there is an effective treatment, sanctioned by the NHS, is it not available to the sufferers of a complaint that effects so many people?
I think IBS is 'overlooked' by the health system for two reasons.
Firstly, because IBS is a disease that cannot be measured ( blood tests, scans etc show nothing) but only experienced (patients simply suffer from symptoms) then the medical profession finds it more annoying than interesting. With no cause to treat the profession feels powerless and frustrated, it does not compute. If it does not compute it therefore, in their logic, cannot be treated.
Secondly because the effective treatment is Hypnotherapy, a treatment that is easily misunderstood.
Professor Whorwell at Manshester University has been studying the effect of hypnotherapy on patients with IBS for 30 years and is similarly perplexed why the NHS, by its own standards does not embrace such a well studied and effective treatment. Commenting on studies showing effectiveness he writes here in the BMJ
Despite all this evidence, it is noteworthy that there has been an apparent reluctance by the medical profession to embrace this form of treatment and its availability within healthcare systems remains sparse in the UK, despite endorsement by National Institute for Health and Clinical Excellence (NICE),
In this video Professor Whorwell stresses the importance of really listening to the patient and giving the patient time to explain and tell their story, a vital part of the healing process.
The non 'clinical' nature of IBS combined with skepticism about Hypnotherapy has led to a situation that a treatable disease goes untreated. A perfect storm of confusion and mistrust has resulted in a well meaning health system failing to treat a problem that affects significant proportion of the public. And all those sufferers dont just go away. They continue to harass the health system seeking answers and treatment.
To understand hypnotherapy simply think of the power of the imagination and emotion to effect the physical body. Use that same imagination to positively effect your body and you have hypnotherapy. No mind control, no sub conscious messages, no swinging watches.
The Royal College Of Nursing thorough report on treatment guidelines of IBS;
"decided to include hypnotherapy in one of its top five research recommendations, with the potential for this intervention to be considered as a first line therapy option".
The question is how does the NHS listen and act on advice that is coming from its own recommendations?
The answer must be to talk more, to collaborate, to hold meetings where service users and providers are in the same room together, talking about what is needed. To build trust in new but tested treatments, to bring patients and doctors together in a way that supports and listens. To demand interventions that are effective in clinical studies but also to be open to new ways of doing things.