Gut-directed hypnotherapy for IBS: what is it and what are the options?

Hypnotherapy Blog

Ellen Anderson - PhD Candidate, 18 October 2024

What is gut-directed hypnotherapy?

Gut-directed hypnotherapy is a type of hypnotherapy, wherein suggestions are made to the subconscious mind for the control and normalisation of gut function. This includes metaphors like swallowing down medicine and imagining that this medicine provides healing and protection to the gastrointestinal tract. Gut-directed hypnotherapy is a well-recognised psychological therapy for the management of symptoms of IBS. It is currently recommended as a third-line treatment(1), after dietary therapies (such as the low FODMAP diet) and medications. This is despite similar levels of symptom improvement to the low FODMAP diet of around 70%(2). The main reason for this relates to accessibility with a limited number of adequately trained practitioners and the cost of frequent appointments needed in quick succession. This brought about the idea of App-delivered gut-directed hypnotherapy. Mindset Health, a Melbourne-based company, worked in conjunction with Dr Simone Peters, an experienced gut-directed hypnotherapist, and co-founded the App Nerva, which many of you may have already come across. The Nerva program is comprised of daily 15-minute recordings for 6 weeks. It also includes daily education readings that teach you about the gut-brain axis, how the body functions, how IBS symptoms occur and how they can be managed.

So does GDH still work when delivered through an App?

Despite the therapy being similar, it is very important that the digital form of gut-directed hypnotherapy is assessed to ensure it does reduce symptoms. A retrospective analysis of the Nerva App users was published in 2023, showing significant improvement in abdominal pain and overall IBS symptoms(3). These exciting results prompted a randomised control trial comparing the Nerva gut-directed hypnotherapy program including the educational readings to the educational readings alone. The results showed 81% of the gut-directed hypnotherapy group had a clinically significant reduction in overall IBS symptoms and 71% had a clinically significant reduction in abdominal pain(4). The improvement in symptoms found are comparable to face-to-face trials (in clinic with a gut-directed hypnotherapist) while providing a cheaper and more flexible option for people with IBS.

Gut-directed hypnotherapy is a safe and effective IBS symptom management option, with both face-to-face and App-delivered options showing similar rates of improvement.

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References:

  1. Lacy BE, Pimentel M, Brenner DM et al. ACG Clinical Guideline: Management of Irritable Bowel Syndrome. Am J Gastroenterol. 2021;116(1):17-44.
  2. Peters SL, Yao CK, Philpott H et al. Randomised clinical trial: the efficacy of gut-directed hypnotherapy is similar to that of the low FODMAP diet for the treatment of irritable bowel syndrome. Aliment Pharmacol Ther. 2016;44(5):447-59.
  3. Peters SL, Gibson PR, Halmos EP. Smartphone app-delivered gut-directed hypnotherapy improves symptoms of self-reported irritable bowel syndrome: A retrospective evaluation. Neurogastroenterol Motil. 2023;35(4):e14533.
  4. Anderson EJ, Peters SL, Gibson PR et al. Comparison of digitally-delivered gut-directed hypnotherapy program to an active control for irritable bowel syndrome. Am J Gastroenterol. 2024.
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