IT MAY NOT BE life-threatening, but the gnawing pain, nausea, burning and bloating of indigestion often deeply disrupt daily life. More than one in ten of us suffers from indigestion (or dyspepsia) for which there is no obvious cause — and little in the way of effective relief.

For such a common complaint, it is one of the least successfully treated. Up to half of dyspepsia sufferers are dissatisfied with standard treatments — usually anti-acid medications or diet changes. But now a surprising alternative has been shown to be more effective than mainstream approaches — hypnosis.

For 20 years researchers at the Wythenshawe Hospital in Manchester have been studying hypnosis and have shown that it can relieve irritable bowel syndrome (IBS); and the team has recently found that it works on indigestion too.

A recent editorial in the respected international journal Gastroenterology says that “it is becoming increasingly hard to ignore the notion that the skills of the hypnotherapists should be made routinely available to patients with functional gastrointestinal disorders”.

As Dr Martin Sarner, the secretary of the Digestive Disorders Foundation, explains: “Hypnotherapy is a perfectly reasonable way to proceed. It seems to work very well. We know that the mind influences the gut in a big way.”

The Manchester research took 126 patients with functional dyspepsia — dyspepsia not caused by a hernia or other obvious causes — and offered them either hypnotherapy, acid-suppressant drugs or counselling. In the hypnotherapy group, 73 per cent said that their symptoms improved, compared with 34 per cent for counselling and 43 per cent for drug therapy.

One of the most encouraging aspects of the study is that the benefits appear to last. During a 40-week follow-up, the hypnosis group didn’t need to take any drugs for their condition, while 80 to 90 per cent of those in the other groups did. Time off work and the number of medical consultations were also reduced.

Dr Peter Whorwell, a gastroenterology consultant who led the research, says that he has been battling for 20 years to get wider acknowledgement of hypnotherapy as a mainstream treatment. “The trouble is that hypnotherapy has a lot of baggage — it’s associated with Paul McKenna.

“I have no problems with my colleagues, who are all happy to refer patients to me. The real problem these days is persuading the Government and NHS purchasers to invest in anything that isn’t subject to a government target. Indigestion may not be as serious as heart disease or cancer, but it causes mass absenteeism and suffering.”

There is nothing mysterious or illusionist about the way that Dr Whorwell treats his patients. His “gut-focused” hypnotherapy course, carried out weekly for up to 12 weeks, provides patients first of all with medical information about their condition. Then they are told that, with the aid of hypnosis, they will be taught to change the way their gut functions — influencing, for example, sensitivity, spasm or secretions. Trained hypnotherapists induce a “trance” by concentrating the attention of patients on ideas of calm, comfort and relaxation. Then they ask the patient to place their hand on their stomach, feel warmth, and relate this sensation to control and relief of symptoms. Visual imagery is also used — patients imagine their gut as a river, whose flow they must adjust.

Those surprised that such a seemingly touchy-feely approach should have an effect need look only at some of the latest research on gut disorders to see that it makes sense. “People with functional dyspepsia and IBS tend to have a hypersensitive gut,” says Whorwell. “After hypnotherapy, sensitivity returns to normal.”

Research by scientists around the world, among them Dr Whorwell’s colleagues at Manchester University’s gastrointestinal sciences unit, is charting the close relationship between the brain and gut function. Brain scanning experiments have revealed that IBS patients show increased activation of an area of the brain called the anterior cingulate cortex when the bowel is stimulated. Separate studies have shown that hypnosis results in changed activity patterns in this area of the brain.

For all the apparent benefits, however, hypnosis is not easily available to indigestion sufferers on the NHS. Dr Whorwell’s centre in Manchester is the only NHS hypnotherapy unit in the country. And he is pessimistic that provision will improve, because treatment is timeconsuming, labour-intensive and therefore costly. “The best thing you can do is go to your GP and ask for a good hypnotherapist,” he says.

What is indigestion?

IF YOU have persistent indigestion (symptoms for three weeks running), you should consult your GP. Although in around 60 per cent of cases there is no obvious disease or infection causing the complaint, it is important that you are checked to ensure that indigestion is not a symptom of an underlying problem.

Indigestion can be caused by:

An ulcer — an open sore on the lining of the stomach. These are invariably caused either by anti-inflammatory drugs commonly used for arthritic conditions (NSAIDs) or an infection with the bacteria Helicobacter pylori. These drugs or bacteria can inflame the stomach lining, and sometimes cause indigestion without causing an ulcer.

Acid reflux — digestive acid splashing out of the stomach into the tube leading to the throat (oesophagus).

Stomach cancer — rarely. This condition is largely limited to people over the age of 60. If blood tests or lifestyle changes provide no clue to the cause of the indigestion, the doctor may arrange an endoscopy — examination of the stomach lining by means of a tiny camera on the end of a tube, inserted down the throat.

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