Hypnotherapy for IBS: the gut-brain axis

Hypnotherapy for IBS

If you have irritable bowel syndrome (IBS), you have an oversensitive gut that's more prone to digestive issues, like a swollen tummy or irregular bowel movements. What you feed your gut has a big influence, and for this reason the role of diet in the management of IBS is well-established.

There are also other factors and triggers involved in IBS flare ups - and these span the biological, psychological, and social. Experts believe that anything from early life experiences and trauma to infections and lifestyle can influence IBS. What's more, IBS tends to be more common and severe among people who experience more stress and anxiety¹.

Ro Huntriss is a leading dietitian and founder of Fertility Dietitian UK. She explains that, while the relationship between IBS and psychological therapies are discussed less than IBS and diet, the evidence of its effect is growing.

Types of IBS psychotherapies include:

• IBS hypnotherapy.

• Cognitive behavioural therapy (CBT).

• Dynamic psychotherapy.

• Relaxation therapy.

• Mindfulness-based therapy.

• Psychoeducation.

What happens during IBS hypnotherapy?

IBS hypnotherapy, also called gut-directed hypnotherapy, aims to reduce sensitivity in the gut by addressing any emotional triggers for your symptoms. For many people with IBS, their digestive symptom flare ups go hand-in-hand with stress and poor mental wellbeing. This can be a hard cycle to break - with stress being both a trigger for, and outcome of, digestive discomfort, inconvenience, and pain.

What is the gut-brain axis?

The gut-brain axis, also known as the gut-brain connection, is the name for the communication system that connects your gut and your central nervous system in the brain. Hypnosis for IBS is based on this intrinsic and complex relationship.

"The relationship between the gut microbiome and the brain is an area of active research in the field of neuroscience and gut health," says Huntriss. "The gut microbiome refers to the microorganisms living in your digestive system. These microorganisms play a crucial role in various physiological functions, including digestion, nutrient absorption, and the immune system."

Through nerve pathways and signals, information is sent between your brain and gut. It's this gut-brain axis that enables your gut to influence brain function and behaviour.

"For example," says Huntriss, "the microbiome can affect neural signalling and impact mood and brain function. It also interacts with the immune system, affecting inflammation levels that can impact brain health, and influences the production of brain chemicals, such as dopamine and serotonin - which help us feel pleasure and happiness."

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Research into this gut-brain axis is growing in popularity, and it's increasingly helping scientists better understand the relationship between IBS and mental wellbeing, and why there's such a high overlap in cases of IBS and psychiatric diseases such as²:

• Depression – a condition in 7 out 10 people with IBS.

• Anxiety disorders – in up to 5 out of 10 people with IBS.

Does hypnotherapy work for IBS?

There's a growing body of evidence that hypnotherapy for IBS is a viable and effective treatment - both for the digestive symptoms of this condition and related anxiety and depression - because hypnosis allows access to unconscious brain processes involved in the gut-brain axis³.

Psychological interventions – including hypnotherapy and CBT - are recommended by the National Institiute for Health and Care Excellence (NICE) for people with IBS who don't respond to IBS drugs after 12 months.

Are there any limitations?

Everyone is different, and hypnotherapy for IBS isn't one size fits all. While there's no cure, for many people with IBS, making diet, activity, and lifestyle changes recommended by a healthcare professional can be enough to get flare ups under control.

According to experts, it may be that IBS hypnotherapy is most helpful for those living with psychiatric conditions, who have traumatic events in their past, or those lacking social support¹⁰.

These are suggestions, not set criteria, and trying hypnotherapy is completely your choice. No matter your decision, Huntriss suggests that psychotherapies for IBS are there to help alongside - and not in replacement of - IBS dietary advice.

"A diet rich in plant foods, prebiotics, and probiotics can help to promote a healthy gut microbiome which in turn can reduce gut sensitivity. IBS dietary strategies, like the low-FODMAP diet and NICE guidelines, are proven to be hugely effective for many people."

Further reading

1. Drossman: Abuse, trauma, and GI illness: is there a link?

2. Creed et al: Outcome in severe irritable bowel syndrome with and without accompanying depressive, panic and neurasthenic disorders.

3. Császár-Nagy: and Bókkon: Hypnotherapy and IBS: Implicit, long-term stress memory in the ENS?

4. Laird et al: Short-term and long-term efficacy of psychological therapies for irritable bowel syndrome.

5. Lowén et al: Effect of hypnotherapy and educational intervention on brain response to visceral stimulus in the irritable bowel syndrome.

6. Black et al: Efficacy of psychological therapies for irritable bowel syndrome.

7. Donnet et al: Hypnotherapy for irritable bowel syndrome: patient expectations and perceptions.

8. Noble et al: Patient satisfaction after remotely delivered gut-directed hypnotherapy for irritable bowel syndrome during the COVID-19 era: implications for future practice.

9. Peters et al: Smartphone app-delivered gut-directed hypnotherapy improves symptoms of self-reported irritable bowel syndrome.

10. Hetterich and Stengel: Psychotherapeutic interventions in irritable bowel syndrome.