Irritable bowel syndrome is the most common gastrointestinal diagnosis. Doctors in California noticed that the symptoms of IBS are similar to those where the small intestine gets an overgrowth of gut flora. Their study looked at whether or not gut flora overgrowth is associated with IBS. If that were so, there might be a chance that dealing with the overgrowth would reduce the symptoms of IBS.

The results showed that of 202 IBS patients, 157 (78%) had overgrowth. This showed a very strong association. They then treated the overgrowth which eliminated IBS suymptoms in just under half.

This is very helpful. If you have IBS, ask your doctor to check for gut flora overgrowth in the small intestine. If he finds it, antibiotics could take away your symptoms. For the rest of us, hypnotherapy has an 85% success rate in eliminating IBS symptoms.

Most of us are likely to think that bran will help with some of the symptoms of IBS. Bran absorbs water and this helps digestive transit. Drs Francis and Whorwell at South Manchester University Hospital who work in the IBS clinic, decided to check whether this widely held view is true. It isn't. These doctors got the impression that wholemeal wheat and bran products make the condition worse. They questioned 100 patients to resolve this issue.

55% of patients were made worse by bran. 10% found it helpful. All symptoms of irritable bowel syndrome were exacerbated by bran, with bowel disturbance most often adversely affected, followed by abdominal distension and pain. They are also concerned that encouraging bran consumption might be creating new cases of irritable bowel. So that seems clear enough. Wholemeal wheat and bran should be eaten in moderation and should not be used by people who already have symptoms of IBS.

But what does work then?

Dr Whorwell and his colleague Dr Prior ran a controlled trial of ispaghula husk in 80 patients with IBS. Ispaghula is also known as psyllium husk. This was found to work for 82% of patients taking ispaghula and 53% of the placebo group who took something with no active ingredient, so this means it really does make a difference. Bowel habit was unchanged in the placebo group, while constipation significantly improved in patients taking ispaghula.

Transit time decreased significantly in those taking ispaghula, especially in patients with initially slow transit time. Abdominal pain and bloating improved in both groups, with no significant differences between ispaghula and placebo.

Ispaghula significantly improves overall well being in patients with irritable bowel syndrome, and in those with constipation favourably affects bowel habit and transit time. So that is clear too. IBS sufferers should try psyllium husk.

For many sufferers, IBS symptoms are worse after dinner. This is due to an exaggerated movement and sensation response by the gut nerves. The gut has a huge nervous system, and is often referred to as the "second brain" because it is so large and developed.

So after a meal, these nerves trigger responses blown out of proportion - bigger movement of the gut, maybe including spasms, and heightened sensitivity, including pain.

Magnus Simren and colleagues at Sahlgrenska University Hospital, researched whether hypnosiss, which works so well for IBS generally, would help with these particular after-meal symptoms.

Half of the patients were given supportive therapy. Half were given hypnotherapy. Both groups were seen for one hour a week for 12 weeks.

The results showed that hypnotherapy reduces significantly these after dinner symptoms, the pain in particular.

Many people find it extraordinary that hypnosis can deal so effectively with these gut symptoms. We don't really know how hypnosis works, but there is plenty of evidence to show how it does. The gut-brain link is very well-developed, due to the huge quantity of neurons in the gut linking up with the brain. So that is probably a key to the success of gut-directed hypnotherapy.

Research conducted by Edward Blanchard of the Center for Stress and Anxiety Disorders, State University of New York at Albany, found significantly more anxiety disorders among  people seeking treatment for irritable bowel syndrome than among comparable age and sex samples of treatment seeking patients with Inflammatory Bowel Disease. So he has developed a programme to deal with these emotional and psychological factors as a way to treat the IBS.

His programe, the Albany Multicomponent Behavioral Therapy Program for IBS, employs techniques drawn from a cognitive behavioural therapy, so that you deal with any unhelpful thinking patterns and responses to situations.

In Britain, Professor Peter Whorwell, at South Manchester University Hospital, has also found this and has developed a psychological programme using hypnotherapy. He has found that the gut is very responsive to suggestions of relaxation and coolness, such that the gut rhythms change for the better. His team enjoy considerable success.

As a cognitive behavioural hypnotherapist, I draw from both these protocols. And they work well. Fast, effective and safe.

This research paper shows how extensively our thoughts and emotions affect our intestines, and as a result, are actively involved in irritable bowel syndrome.

Their conclusion is that helping people to be aware of their emotional state, and to learn how to modulate feelings and thoughts, will assist people to manage the symptoms of IBS.

And we already know that our emotions affect our insides. We say "I had a gut feeling about it", and we feel sick when we are anxious.

Hypnosis is successful in the treatment of refractory IBS - that is, where the symptoms have not been resolved with other treatments. Hypnosis is an attractive option for many IBS sufferers with chronic and severe symptoms for a number of reasons.

First, it has a track record of success. Published scientific studies show success rates of over 80%.

Second, it is non-invasive. No surgery, no physical poking about. No drugs.

Third, it uses the power of your own mind, and after the treatment, you retain the skills you learned.

A fourth and very interesting result is that other problems, like migraine, end up treated - a beneficial side effect. improvement in IBS symptoms.

And fifth, the improvements last. According to research, individuals who improve from hypnosis treatment for IBS can generally look forward to years of reduced bowel symptoms.