Irritable Bowel Syndrome

## Clinical Evidence for Gut-Directed Hypnotherapy

Professor Peter Whorwell is a consultant gastroenterologist and Emeritus Professor of Medicine and Gastroenterology at the University of Manchester. He has spent several decades treating and researching gastrointestinal disorders and is particularly known for developing gut-directed hypnotherapy as an additional treatment option for patients with IBS and related gut–brain disorders, especially where conventional treatments have not provided sufficient relief.

Professor Whorwell and his team at the University of Manchester have been researching the use of hypnotherapy for IBS since the 1980s. Their work has consistently reported significant improvements in IBS symptoms, with response rates of around 70% in specialist clinical populations. In one large Manchester clinical audit involving 1,000 patients with difficult-to-treat IBS, 76% achieved a clinically significant improvement following gut-directed hypnotherapy.

Importantly, the benefits can also be long-lasting. In a long-term follow-up study, 71% of patients initially responded to treatment and, of those responders, 81% maintained their improvement. Benefits were still evident in patients followed for five years or longer.

Research from Professor Whorwell’s team also suggests that hypnosis can influence measurable physiological processes within the digestive system. These include gut sensitivity, the strength of muscular contractions within the gastrointestinal tract and gastric-acid secretion.

In experimental studies, different hypnotic suggestions were even shown to increase or decrease gastric acid production. This is important because it demonstrates that hypnosis is not simply a relaxation technique: it can influence physiological processes that are partly regulated through communication between the brain and the digestive system — often referred to as the gut–brain axis.

This does not mean that gut-directed hypnotherapy should be regarded as a proven treatment for every condition involving stomach acid, such as gastro-oesophageal reflux disease. However, the findings provide evidence that hypnotic interventions can influence gastric function as well as the perception of gastrointestinal symptoms.

### Can gut-directed hypnotherapy be delivered online?

Yes. Professor Whorwell’s Manchester team has also studied gut-directed hypnotherapy delivered remotely by video consultation.

In their Skype study, patients received an initial face-to-face appointment followed by treatment remotely. Clinically significant improvements in IBS symptoms were observed, with 65% meeting the study’s response criteria compared with 76% in the Manchester team’s face-to-face clinical cohort.

This research suggests that remote gut-directed hypnotherapy can be an effective option for people who cannot easily attend treatment in person.

In the video below, Professor Whorwell explains the rationale behind the use of hypnotherapy for IBS and other disorders of gut–brain interaction.

Professor Peter Whorwell, gastroenterologist and pioneer of gut-directed hypnotherapy, explains the rationale behind its use in IBS and other disorders of gut–brain interaction.

Gut-directed hypnotherapy does not replace appropriate medical assessment or treatment. IBS symptoms should first be discussed with a doctor so that an appropriate diagnosis can be made and other causes of gastrointestinal symptoms can be excluded.

Research suggests that the benefits of gut-directed hypnotherapy can be long-lasting, with improvements maintained for several years in many people who respond to treatment. Read the BBC article.

For anyone that wants to read the clinical research itself you can look at the following articles:

https://onlinelibrary.wiley.com/doi/10.1111/nmo.13573?fbclid=IwAR1Dib1ra9g20cLR_HnVDAwVFAikc3AUZtNI3pkX4NItZRGh31Gye0IjHFM

https://pubmed.ncbi.nlm.nih.gov/30702396/

• Abdominal pain and discomfort
• Abdominal contractions, cramps or spasms
• Bloating
• Constipation
• Diarrhoea
• Excessive wind
• Indigestion
• Nausea

In many cases the cause is unknown, however much research points to stress, with infection being another contributing factor. A common denominator however is that those with a sensitive gut are caught up in a vicious circle with initial tummy upset resulting in pain, which leads to psychological stress or distress. Consequently, this results in greater pain and so the cycle continues. After some duration in this cycle, the gut has become hypersensitive, which means that the pain feels greater. Did you also know that your gut is like a second brain with as many neurons as a dog’s brain (approx 200,000!)