What is gut directed hypnotherapy?
Irritable Bowel Syndrome (IBS) is a common condition which can cause a range of symptoms including abdominal pain, nausea, diarrhoea, bloating, excess wind and constipation which can significantly affect quality of life (1). It is classified as being a ‘disorder of brain gut interaction (DGBI)’ because research has identified that IBS involves miscommunication between the gut, the gut microbiome and the brain (2). This results in changes in gut motility, visceral hypersensitivity and immune function and can also impact mood (3).
Gut directed hypnotherapy involves using imagery and metaphors to calm the gut, reduce pain and gut reactivity and normalise bowel function once a deep state of relaxation has been induced. Metaphors that might be used include picturing the gut as a river and modifying the flow of the river depending on whether the individual has constipation or diarrhoea (4). Abdominal pain may be soothed by feeling warmth coming from a hand placed on the abdomen (4) or picturing a wave of soothing medication passing through the gut (5).
Professor Peter Whorwell first developed gut directed hypnotherapy and published work on this in 1984 (6) so it is not a new therapy! Since then, many researchers have shown how gut directed hypnotherapy can be beneficial when given individually (4), in group settings (7) and online (8).
A key benefit of hypnotherapy is that there are no side effects unlike with medical management. It has also been noted to improve psychological symptoms such as anxiety and depression (4), improve quality of life (7) and was found to be as effective as the low FODMAP diet in a study comparing both (9). Unfortunately, gut directed hypnotherapy is not widely available in NHS settings and private courses can be expensive so we set up The Contented Gut online group courses to provide access to more people struggling with their IBS symptoms.
What does The Contented Gut course involve?
The Contented Gut courses are run in small groups of up to 6 people online. Each course consists of 8 sessions and is open to adults with a diagnosis of IBS or functional symptoms that can occur when someone has coeliac disease or inflammatory bowel disease. The first five sessions are weekly and the last three are fortnightly. Although the course is run as a group session, there is no requirement to converse with others or discuss symptoms. Participants can simply join a few minutes before it starts and enjoy listening to the session.
The introductory session lasts an hour and covers the brain-gut interaction as well as how and why hypnotherapy can help, along with a short hypnotic relaxation at the end. Sessions 2-8 then focus on the GDH and each session lasts for around 40 minutes. All that is needed is to be somewhere quiet and comfortable with a good internet signal. Participants receive a recording to practice with between sessions. Regular practice with the recording between sessions is encouraged to gain the most benefit.
For more information please visit The Contented Gut
References
1.National Institute for Health and Care Excellence. Addendum to NICE guideline CG61, irritable bowel syndrome in adults: diagnosis and management of irritable bowel syndrome in primary care. NICE guideline CG61, 2015 29 March 2021. Available from: http://www.ncbi.nlm.nih.gov/books/NBK550725/.
2.Drossman DA, Hasler WL. Rome IV-Functional GI Disorders: Disorders of Gut-Brain Interaction. Gastroenterology. 2016;150(6):1257-61. Available from: https://doi.org/10.1053/j.gastro.2016.03.035.
3. Mayer EA, Nance K, Chen, S. The Gut-Brain Axis. Annu Rev Med 2022. 73: 439-53. Available from: https://doi.org/10.1146/annurev-med-042320-014032.
4. Vasant DH, Whorwell PJ. Gut-focused hypnotherapy for Functional Gastrointestinal Disorders: Evidence-base, practical aspects, and the Manchester Protocol. Neurogastroenterol Motil. 2019; 31(8). Available from: https://doi.org/10.1111/nmo.13573.
5.Palsson OS, van Tilburg M. Hypnosis and Guided Imagery Treatment for Gastrointestinal Disorders: Experience With Scripted Protocols Developed at the University of North Carolina. Am J Clin Hypn. 2015;58(1):5-21. Available from: https://doi.org/10.1080/00029157.2015.1012705.
6. Whorwell PJ, Prior A, Faragher EB. Controlled trial of hypnotherapy in the treatment of severe refractory irritable-bowel syndrome. Lancet. 1984;2(8414):1232-4. Available from: https://doi.org/10.1016/S0140-6736(84)92793-4.
7.Lövdahl J, Törnblom H, Ringström G, Palsson OS, Simrén M. Randomised clinical trial: individual versus group hypnotherapy for irritable bowel syndrome. Aliment Pharm Ther. 2022;55(12):1501-11. Available from: https://doi.org/10.1111/apt.16934.
8. Hasan SS, Vasant D. The Emerging New Reality of Hypnosis Teletherapy: A Major New Mode of Delivery of Hypnotherapy and Clinical Hypnosis Training. Int J Clin Exp Hypn. 2023;71(2):153-64. https://doi.org/10.1080/00207144.2023.2185527.
9. 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 Pharm Ther 2016; 44 (5): 447-449.
Available from: https://doi.org/10.1111/apt.13706.
Written by Liane Reeves – Registered Dietitian at Reeves Diets