Evidence based trauma Informed IBS treatment: Reading and web clinics across the UK by arrangement

Abdominal Migraine

What is it?

Abdominal migraine — sometimes called stomach migraine — is a disorder of gut–brain interaction characterised by recurrent, episodic attacks of intense stomach pain, typically around the navel or centre of the abdomen, lasting from one to 72 hours, with complete freedom from symptoms between episodes. Attacks are accompanied by nausea, vomiting, pallor, and loss of appetite, and can be severe enough to be completely disabling during the episode itself.

Although historically described in children, stomach migraine is increasingly recognised in adults, where it is frequently missed or misdiagnosed because the episodes occur without headache — leaving many people with years of unexplained, recurring stomach pain and no clear diagnosis.

Abdominal migraine has been formally added to the Rome V classification of centrally mediated disorders of gastrointestinal pain, reflecting growing clinical recognition of its distinct gut–brain axis pathophysiology. (1, 2, 3)

Effect

Abdominal migraine can significantly disrupt daily life. The unpredictability of severe episodic stomach pain — arriving without warning, lasting hours, and then clearing completely — makes it extremely difficult to plan work, social events, travel, or relationships with any confidence.

Many adults with stomach migraine have undergone repeated investigations, A&E visits, and unnecessary procedures before receiving an accurate diagnosis, and the absence of a clear visible cause can itself become a source of anxiety, self-doubt, and exhaustion.

The Rome V biopsychosocial model identifies how psychosocial stressors, early life experiences, and gut–brain axis dysregulation interact to shape both the frequency and severity of episodic centrally mediated pain disorders of this kind — including the visceral hypersensitivity and serotonergic dysregulation ( an imbalance in serotonin levels, either too high or too low ) that drive attacks.

Living with unpredictable, severe stomach pain that others cannot see or understand is isolating, and the psychological burden compounds the physical one. (1, 4, 5)

Management Support Provided

The Mind-Gut Connection practice provides evidence supported trauma-informed therapy and coaching for abdominal migraine and stomach migraine in adults.

Your programme will focus primarily on what is most important for you, and frequently includes: reducing episode frequency and severity, improving function between attacks, and addressing the gut–brain axis dysregulation that sustains the condition.

Because abdominal migraine involves disturbance of the central nervous system–gut communication pathway, treatment aligns with the brain–gut behaviour therapy framework recommended in Rome V — including gut-directed hypnotherapy, which works directly on the gut–brain connection, cognitive behavioural approaches to pain and anxiety, trauma-informed somatic and psychotherapeutic methods that regulate the nervous system, and mindfulness-based techniques that reduce the anticipatory anxiety that can itself trigger or worsen episodes.

Improving nervous system regulation, reducing visceral hypersensitivity, and building resilience between episodes supports greater stability, reduced attack frequency, and improved quality of life. (1, 6, 7)

Gastrointestinal Pain Disorders

What is it?

Centrally mediated abdominal pain syndrome — CAPS — is a disorder of gut–brain interaction characterised by chronic, constant, or near-constant stomach pain that has been present for at least six months and significantly limits daily functioning.

Unlike IBS or other gut disorders where pain is linked to eating, bowel movements, or other gut events, the pain in CAPS is largely independent of these triggers — it is there most of the time, often severe, and driven primarily by central sensitisation within the nervous system rather than by the gut itself.

Many people with CAPS have spent years searching for answers.

Chronic stomach pain with no physical cause found on any test is one of the most distressing and poorly understood presentations in gastroenterology, and one of the most common reasons people seek specialist help from me, outside the NHS system. (1, 2, 8)

Effect

Constant abdominal pain that investigations cannot explain is not only physically exhausting — it is psychologically devastating.

The Rome V biopsychosocial model identifies how central sensitisation, in which the nervous system becomes progressively more amplified in its pain response, interacts with psychological factors including anxiety, depression, trauma history, and chronic stress to create and sustain the experience of unrelenting gut pain.

Many individuals with CAPS develop feelings of helplessness, catastrophising about their symptoms, begin to lose hope and have a deep loss of confidence in their body and in the healthcare system.

Chronic stomach pain affects work attendance and productivity, relationships, social life, sport, exercise, and the ability to engage in basic daily activities.

Repeated normal test results, rather than being reassuring, can compound feelings of not being believed — a pattern clearly recognised in the Rome V framework and one that requires a fundamentally different kind of therapeutic engagement. (1, 9, 10)

Management Support Provided

The Mind-Gut Connection practice provides evidence supported therapy, and coaching. Effective management of chronic centrally mediated gut pain is built on a comprehensive biopsychosocial approach in which the patient–provider relationship (sometimes called the Therapeutic Alliance) is itself considered therapeutic.

Rome V is explicit that these disorders require treatment addressing psychosocial, physiological, and central nervous system components together — not gastrointestinal symptoms in isolation.

Brain–gut behaviour therapies are a core recommended component, targeting the central sensitisation, visceral hypersensitivity, and psychological distress that sustain the pain cycle.

Trauma-informed somatic psychotherapy addresses the nervous system dysregulation and early life factors that the Rome V model identifies as foundational to centrally mediated pain — working with the body and the story it holds, not just the symptom.

The aim of support is improved central pain modulation, greater psychological stability, and the gradual return of daily function and quality of life. (1, 6, 11)

Irritable Bowel Syndrome (IBS)

What is it?

Irritable bowel syndrome is one of the most common disorders of gut–brain interaction, affecting an estimated one in twenty people globally and accounting for a substantial proportion of gastroenterology consultations in the UK.

IBS is characterised by recurrent stomach pain or abdominal discomfort associated with changes in bowel habit — IBS with diarrhoea, IBS with constipation, or a mixed pattern in which both occur.

Symptoms commonly include stomach cramps, bloating, urgent diarrhoea, difficulty going to the toilet, and a bowel pattern that is unpredictable and hard to control.

The Rome V diagnostic criteria, updated in 2026, have refined the definition to better reflect the real clinical picture — including reintroducing abdominal discomfort alongside pain, recognising that IBS presents differently across individuals and cultures.

The pathophysiology of IBS is multifactorial, involving gut–brain axis dysregulation, visceral hypersensitivity, altered gut motility, changes in the gut microbiome, immune activation, food triggers, and psychosocial factors that mutually amplify one another. (1, 2, 12)

Effect

IBS often becomes self-reinforcing in ways that are hard to break without the right help.

Unpredictable bowel symptoms — urgent diarrhoea, painful constipation, or both — generate anxiety about when the next IBS flare up will strike, which in turn heightens gut sensitivity through the brain–gut axis, making symptoms more frequent and more severe.

Up to 50% of people with IBS experience clinically significant anxiety or depression, and stress makes IBS worse in ways that are now clearly understood — the gut and the brain are in constant two-way communication, and a stressed nervous system produces a stressed gut.

IBS affects work — through absenteeism, presenteeism, and the constant mental load of managing symptoms around professional life.

It affects relationships and social life — the fear of urgent diarrhoea in public, the embarrassment of bloating, the exhaustion of explaining a condition that others cannot see.

Rome V global epidemiological data from more than 54,000 participants confirms that people with gut–brain interaction disorders and concurrent psychological distress have substantially worse quality of life, higher healthcare use, and greater functional impairment. (1, 13, 14)

Management Support Provided

The Mind-Gut Connection practice provides evidence supported IBS treatment and coaching. IBS treatment is most effective when it addresses the full biopsychosocial picture — the gut, the nervous system, the psychological history, and the life context — rather than targeting gut symptoms in isolation.

Gut-directed hypnotherapy for IBS has one of the strongest evidence bases of any psychological treatment, with research showing sustained improvement in IBS symptoms, reduced bloating and pain, and improved quality of life maintained over the long term.

CBT for IBS — cognitive behavioural therapy specifically adapted for gut problems — is recommended by both NICE and the Rome Foundation as a core treatment option, targeting the thoughts, behaviours, and nervous system responses that maintain the IBS cycle.

Additional IBS treatment methods include mindfulness and trauma informed somatic psychotherapeutic approaches to address the deeper nervous system dysregulation that underlies IBS for many people, particularly those with a history of stress, adverse life events, or trauma.

In my practice I draw on all of these approaches, integrated into a bespoke programme built around you and your specific pattern of symptoms, history, and life. (1, 6, 15)