Gut-directed hypnotherapy made its name treating irritable bowel syndrome. Having seen it work there, researchers asked an obvious question: would it help with other problems along the digestive tract? Three trials stand out.
Functional dyspepsia
What it is. Persistent upper-abdominal discomfort, fullness, bloating or nausea, with no ulcer or other cause found on tests. It is very common and often frustrating to treat.
The trial. In a 2002 study from Manchester, 126 people with functional dyspepsia were randomly assigned to one of three groups for 16 weeks: hypnotherapy, supportive therapy with a placebo medication, or standard medical treatment. They were assessed at the end of treatment and again at 56 weeks.
The result. Hypnotherapy was found to be highly effective in the long-term management of functional dyspepsia. A striking detail came from the follow-up period: 90 per cent of the medical treatment group and 82 per cent of the supportive therapy group started taking medication. Nobody in the hypnotherapy group did.
Non-cardiac chest pain
What it is. Chest pain that feels like angina, but where the heart has been thoroughly investigated and found to be healthy. It is frightening, often recurring, and can come from an oversensitive oesophagus.
The trial. In a 2006 study, 28 patients whose heart tests were normal received either 12 sessions of hypnotherapy or supportive therapy with a placebo medication over 17 weeks.
The result. Twelve of 15 people in the hypnotherapy group (80 per cent) reported an overall improvement in pain, compared with three of 13 (23 per cent) in the control group. A later follow-up found the benefit had lasted at least two years, with patients continuing to improve after treatment ended.
A vital caution. This applies only after cardiac causes have been ruled out by a doctor. Never assume chest pain is harmless.
Ulcerative colitis
What it is. An inflammatory bowel disease, with visible inflammation and ulcers in the colon. Unlike IBS, it involves physical damage and needs medical treatment. It runs in flares and remissions.
The trial. In a 2013 American study, 54 people whose colitis was in remission received either seven sessions of gut-directed hypnotherapy or an attention control, and were followed for a year. All continued their usual medication.
The result. After one year, 68 per cent of the hypnotherapy group were still in remission, compared with 40 per cent of the control group. The authors described it as the first prospective study to show a psychological treatment significantly prolonging remission in quiescent ulcerative colitis.
Important limits. This was one modest trial. It tested hypnotherapy for keeping remission going, alongside medication, not for treating an active flare. Hypnosis is not a treatment for inflammatory bowel disease in place of medical care.
Why would it work across the gut?
The digestive tract has its own extensive nervous system, in constant two-way communication with the brain. In “functional” conditions such as IBS, dyspepsia and non-cardiac chest pain, that communication is oversensitive: normal sensations are amplified into pain.
Gut-directed hypnotherapy appears to turn that sensitivity down. With colitis the mechanism is less clear. Stress is known to be linked to flares, and effects on inflammation have been suggested, but this is not established.
What treatment involves
The approach is adapted from the IBS protocol:
- A standard induction and relaxation
- Imagery aimed at the affected area: a calm, comfortable stomach; a smooth, relaxed oesophagus; a healthy, settled bowel lining
- Suggestions for reduced sensitivity and normal function
- A hand on the abdomen or chest with suggestions of warmth and comfort
- Typically seven to twelve sessions, with daily home practice using a recording
How strong is the evidence?
Less strong than for IBS, where there are many trials and guideline backing. Each of these three conditions rests mainly on one trial, from specialist centres with experienced therapists. The results are encouraging and deserve repeating.
Before you try it
- Get a proper diagnosis. Indigestion, chest pain and bowel symptoms all need medical assessment.
- Know the red flags: difficulty swallowing, unintended weight loss, vomiting blood, black stools, blood in the stool, or chest pain on exertion. These need urgent attention.
- Keep taking prescribed treatment. This matters especially for colitis.
- Tell your specialist you are trying hypnotherapy.
- Look for a therapist trained in gut-directed hypnotherapy.
The bottom line
The gut and brain talk to each other constantly, and hypnotherapy seems able to influence that conversation along the whole digestive tract. The evidence beyond IBS is promising and still limited. Use it with medical care, never instead of it.
Next in the series: Hypnosis for Burn Pain: Help Where It Hurts Most
This article is for general information and is not medical advice.