Last Updated: 23 November 2022

Gut-Directed Hypnotherapy for IBS – Does It Help?

Researched & Written By:
When we first read about gut-directed hypnotherapy (GDH) being a possible treatment for IBS, there was a bit of skepticism and a lot of questions. What exactly is hypnotherapy? How is it different from gut-directed hypnotherapy? Does it actually work? How can hypnotherapy correct gut function? In this article, we will discuss all that and more. And if you’re a little skeptical too, you’re not alone; more than 50% of patients who received hypnotherapy had negative perceptions about it beforehand. This changed drastically once they completed their therapy. (S) And after sifting through the research, we are true believers in the potential GDH has in treating IBS.
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Table of Contents

    Medical Hypnotherapy

    What is 'medical' hypnotherapy?

    Medical hypnotherapy is a type of psychological therapy administered by a trained professional called a hypnotherapist. Clinical hypnotherapists are generally trained psychologists or have a background in the medical field.1S

    It may be surprising to hear that hypnotherapy is a real and seemingly effective therapy used to help treat problems like pain management2, improving mental health3, addiction management4, and gut disorders like IBS5.

    Medical hypnotherapy
    Medical hypnotherapy puts you into a deep state of relaxation, but you still have control of your surroundings & decisions

    What happens when you are 'hypnotized'?

    If it sounds a little out there to you, hypnotherapy may not be what you’re envisioning. We’re not talking about what you’ve maybe seen on TV or a magic show where you seem to lose a sense of consciousness and are forced to do things outside of your control as a means to entertain an audience.

    You still have full control of your surroundings and your decisions during hypnotherapy. The goal is simply to enter into a state of deep relaxation while being open to suggestions. (S

    Once in that state of relaxation, the person being hypnotized will have various experiences, either at the suggestion of the hypnotist or just from being hypnotized. (S) These different experiences include:

    • Alterations in consciousness and memory
    • Increased openness to suggestion
    • Experiencing new ideas or responses
    • Muscle rigidity or relaxation
    • Reduced pain sensation (S)

    Quick Summary

    Gut-Directed Hypnotherapy

    What is gut-directed hypnotherapy?

    Gut-directed hypnotherapy (GDH) is a type of medical hypnotherapy aimed specifically at gut dysfunction, provided by a specially trained clinician. Like with traditional hypnosis, patients are placed into a heightened state of focus and awareness that increases openness to suggestions and peaceful imagery.

    However, in GDH, suggestions and imagery are customized to the patient’s symptoms like constipation, pain, or diarrhea and focus on themes that involve gut-brain dysregulation.57

    GDH aims to normalize physiological dysfunction rather than focusing on different psychological factors.

    What is the experience like?

    Patients are given general statements about improving health and well-being and direction for controlling intestinal muscles and symptoms. Reinforcement by visualization is usually used as well. And while psychological wellness isn’t the main focus of GDH, patients are still taught skills for relaxation, ego strengthening, and coping.(S)8

    Here is a sample excerpt of something one may hear when going through GDH:

    ​​”Now, I’d like you to turn that power of your mind towards your tummy. On the count of 3, put your hand on your tummy and feel a lovely warm feeling in your tummy, feel a surge of control coming over your tummy – 1,2,3. Feel a lovely soothing feeling in your tummy as your mind takes control of your gut. Feel every part of your gut being put under the control of your mind, no part of your gut can resist the power. Feel the energy of your mind as it gets stronger and stronger and stronger.”9

    Gut directed hypnotherapy
    It might seem unusual, but there is a reason behind the structure of gut hypnotherapy sessions

    As you may have noticed, suggestions for symptom improvement are made repetitively. Researchers have found that, for reasons that are unknown, it’s helpful if ideas or words are repeated three times. For example, ‘no pain, no bloating, and a normal bowel habit’ or ‘your IBS will become better and better and better.’ (S)

    GDH also includes suggestions for digestive calm, reduced sensitivity, increased comfort, and establishing a healthy digestive rhythm. This is helped by the hypnotherapist giving those calming imageries or metaphors. For example, several articles referenced the ‘warm hand visualization.’ This involves a patient being told to imagine their hand is warm and then placing it on their stomach to aid in pain relief. Patients learn to transfer this perceived warmth into their gut, mimicking the act of resting a hot water bottle on their stomach.10

    Other metaphors that are often used are either a ‘turbulent’ or ‘blocked’ river (turbulent if you have diarrhea, blocked if you have constipation). You’d then imagine that river either calming down or getting unblocked.10

    This may sound like some sort of super-placebo, but brain imaging studies on IBS patients who received GDH show that GDH can induce changes in the brain—but more on mechanisms in the next section.9

    Quick Summary

    Does Gut-Directed Hypnotherapy Help IBS?

    Decades of use & recommended by leading organizations

    So now that we’ve learned all about what gut-directed hypnotherapy (GDH) is, we can ask: Is it worth doing? The research tells us, yes.

    GDH has been studied in IBS since the 1980s and continues to show powerful results in its ability to treat IBS by lessening symptoms, decreasing anxiety and depression, and increasing quality of life112112.

    In fact, several organizations recommend GDH for treating IBS, including:

    • The American College of Gastroenterology (ACG)24
    • The British Society of Gastroenterology14
    • The Rome Foundation5

    3 supportive studies

    The results for GDH’s effect on decreasing IBS symptoms are rather impressive.

    1. An audit on 1000 people with IBS found that GDH was able to decrease symptoms significantly in 76% of study participants. This treatment response rate falls in line with other studies on GDH6
    2. Another study found that GDH is not only effective but that its’ benefits last anywhere between 1-5 years and decrease medication use and doctor visits.15(S)
    3. And interestingly, a study showed that GDH is as effective as the low FODMAP diet in treating IBS patients16

    Useful for all IBS sub-types - IBS-D, IBS-C, IBS-M & IBS-U

    What’s exciting about GDH is that it seems to be a form of treatment that anyone with IBS can benefit from. The ACG suggests that ‘gut-directed psychotherapies,’ like GDH, are a good adjunct treatment option for all IBS subtypes–even IBS-U13.

    And although most of the studies on GDH have been done in either ‘severe’ or ‘refractory’ cases, GDH has been shown to be effective as an early intervention in children7.

    Glutamine IBS in vivo
    GDH seems to be a form of treatment that anyone with IBS can benefit from

    How does it help IBS?

    Exactly how GDH works is still being researched. There is some evidence that hypnosis may improve symptoms by correcting visceral sensitivity, GI motility, or maladaptive cognition.5

    A brain imaging study showed that changes in the brain lead to favorable neuroplastic changes that occur during and in between hypnotherapy sessions. Neuroplasticity is the brain’s ability to change and adapt, both structurally and functionally17. These changes may explain how pain sensation is reduced with hypnotherapy, so ‘normal’ processing of pain is restored.189

    The takeaway from these studies

    Based on the available literature, GDH has been shown to help treat IBS by lessening symptoms, decreasing anxiety and depression, and increasing quality of life.

    Quick Summary

    How To Use Gut Hypnotherapy For IBS

    Who should try it?

    If you’re considering gut-directed hypnotherapy (GDH) for treating IBS, you should have a formal diagnosis from a doctor first.

    The Rome Foundation suggests that patients who seek GDH should have moderate to severe GI symptoms that have not responded to conventional medication for at least 3-6 months. 19And as we said earlier, GDH can be an effective form of treatment for all IBS subtypes24.

    GDH may also be a good option for people who don’t want to try medications, people who have side effects from medications, those whose GI symptoms are exacerbated by stress, or those with food-related anxiety or overly restrictive diets.19

    Who should avoid it?

    People with IBS who should not seek GDH include patients with:

    • Untreated/unstable psychiatric issues
    • Cognitive limitations
    • Language barriers
    • Untreated eating disorders or with a BMI of <1719

    How are sessions conducted?

    Traditionally, GDH is one-on-one and in person with a hypnotherapist. However, now group sessions, video calls, and even apps are available to make GDH more widely accessible.5

    • The first session generally gives an introduction to the ins and outs of the GI system. The purpose of this is so that you’re able to visualize what’s happening in your body and any dysfunction that needs correcting. (S
    • After your first appointment, your hypnotherapist may give you ‘homework’ to do before your next appointment. This may look like listening to a recording several times between sessions.
    • Your next appointments will focus on correcting GI dysfunction through the methods we spoke about earlier: relaxation techniques, suggestions, calming imagery, etc. 
    How gut hypnotherapy is conducted
    GDH is one-on-one and in person with a hypnotherapist. However, now group sessions, video calls, and even apps are available

    How many sessions are needed to see results?

    It’s important to know that for GDH to be effective and worth your time, you have to be dedicated and willing to commit to weekly (sometimes bi-weekly) sessions for 3-4 months, as well as any additional ‘homework’ that needs to be completed in between sessions.19

    One meta-analysis found that it was imperative to complete at least 8 sessions or 6 hours of GDH in order for it to be effective10.  Although up to 12 sessions may be recommended.

    Gut-directed hypnotherapy (GDH) is usually scheduled for 6-12 sessions from 30 minutes to 1 hour.

    Side effects

    Overall, GDH seems to be a very safe method of treatment for IBS. Adverse events generally have not occurred during studies. Although one study did mention a patient dropping out of the study due to panic attacks during the GDH sessions18.

    Quick Summary

    How To Find A Hypnotherapist

    In-person hypnotherapist

    Finding a hypnotherapist trained in gut-directed hypnotherapy (GDH) may be a bit difficult. Your doctor would be a good starting point in trying to find a reliable hypnotherapist.

    If your doctor doesn’t have a hypnotherapist that they refer to, there are two websites below where you may be able to find a hypnotherapist in your area:

    Remote hypnotherapist

    If there are no hypnotherapists trained in GDH in your area, remote hypnotherapy may be a good option for you.

    A small study looked at how remote GDH (via Skype) compared to in-person treatment. In this study, the participants had 1 face-to-face introductory session, followed by 11 remote sessions of hypnotherapy. The results showed that patients had a comparable response rate to those who received GDH in person.

    With that said, in-person hypnotherapy seems to be superior when it comes to symptom reduction.20

    Group hypnotherapy

    Group hypnotherapy is another option if accessibility is low, as a couple of studies have shown that group hypnotherapy is comparable to individual therapy when it comes to treating IBS symptoms.2110
    Apps for gut hypnotherapy
    The 2 leading apps we found are Nerva and Regulora, which you can use to do GDH at home

    Apps for gut-directed hypnotherapy

    Lastly, there are 2 apps currently on the market for GDH.

    Nerva is an app that you can subscribe to for 3 months at a time.

    • It involves daily reading that takes 3-5 minutes, along with a hypnotherapy session that is roughly 15-20 minutes long.
    • A study conducted by Nerva’s creator showed that 64% of the study participants who completed the entire program had some symptom relief.
    • However, only 9% of the study participants actually completed the program.22
    • From using the app ourselves, we saw compliance as one of the biggest roadblocks with the app. The daily readings were informative and easy to understand and the hypnotherapy sessions were relaxing–almost like a meditative practice. However, finding about 30 minutes a day to do this regularly was challenging.

    Regulora is an app that claims that it is the ‘first and only FDA-cleared app specifically for abdominal pain caused by IBS.’

    • Accessing this app requires a prescription from a doctor.
    • Once you’re able to access it, the website indicates that you will have 7 sessions of GDH for 30 minutes every other week for 12 weeks.
    • Their website also says that ‘Regulora provides a digital version of gut-directed hypnotherapy to help you find pain relief in the comfort of your home.23
    • We’ll also remind you of the meta-analysis we referred to earlier in the article that found you needed to complete at least 8 sessions or 6 hours of GDH to see significant symptom decreases10.

    Alternative psychotherapy

    Another option if you’re unable to find a hypnotherapist with experience in GDH would be to try a different type of psychotherapy, like cognitive behavioral therapy (CBT). These therapists are a little more widely available and CBT has also been shown to have great efficacy in treating IBS13.

    Quick Summary

    Summary & Verdict

    IBS ebook

    Which Foods Really Trigger Your IBS?

    Discover exactly which foods you should and shouldn’t eat using our IBS Food Journal.

    1. About ASCH

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    3. Sharma, Vikas. Hypnotherapy in cancer care: Clinical benefits and prospective implications. Review Article, 2017, Journal of Health Research and Reviews, 10.4103/jhrr.jhrr_45_17, 96-103, 4, 3, https://www.jhrr.org/article.asp?

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    10. Matthew Krouwel, Amanda Farley, Sheila Greenfield, Tariq Ismail, Kate Jolly, Systematic review, meta-analysis with subgroup analysis of hypnotherapy for irritable bowel syndrome, effect of intervention characteristics, Complementary Therapies in Medicine, Volume 57, 2021, 102672, ISSN 0965-2299, https://doi.org/10.1016/j.ctim.2021.102672.

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    16. Peters SL, Yao CK, Philpott H, Yelland GW, Muir JG, Gibson PR. 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 Sep;44(5):447-59. doi: 10.1111/apt.13706. Epub 2016 Jul 11. PMID: 27397586.

    17. Patrice Voss, Maryse E. Thomas, J. Miguel Cisneros-Franco, Étienne de Villers-Sidani. Dynamic Brains and the Changing Rules of Neuroplasticity: Implications for Learning and Recovery. Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, Montreal, QC, Canada.

    18. Lowén, M.B.O., Mayer, E.A., Sjöberg, M., Tillisch, K., Naliboff, B., Labus, J., Lundberg, P., Ström, M., Engström, M. and Walter, S.A. (2013), Effect of hypnotherapy and educational intervention on brain response to visceral stimulus in the irritable bowel syndrome. Aliment Pharmacol Ther, 37: 1184-1197. https://doi.org/10.1111/apt.12319

    19. Improving the lives of people with disorders of gut-brain interactions.

    20. Shariq S. Hasan, James S. Pearson, Julie morris & Peter J. Whorwell (2019) SKYPE HYPNOTHERAPY FOR IRRITABLE BOWEL SYNDROME: Effectiveness and Comparison with Face-to-Face Treatment, International Journal of Clinical and Experimental Hypnosis, 67:1, 69-80, DOI: 10.1080/00207144.2019.1553766

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    23. Regulora

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    About the Authors