Gut-Directed Hypnotherapy for Irritable Bowel Syndrome: Should It Be the Treatment of Choice? (2026)

Dipesh H Vasant

Neurogastroenterology Unit, Wythenshawe Hospital, Manchester, UK

Jane Boissière

National Office UK British Society of Clinical & Academic Hypnosis, Hollybank House, Mossley, UK

Peter J. Whorwell

Neurogastroenterology Unit, Wythenshawe Hospital, Manchester, UK.

Correspondence: Peter J Whorwell, Neurogastroenterology Unit, Wythenshawe Hospital, Manchester M23 9LT, UK. Peter.Whorwell@manchester.ac.uk

Keywords: Hypnotherapy.  Irritable Bowel Syndrome

Irritable bowel syndrome (IBS) affects approximately one in ten of the population. Symptoms can be severe with women saying that the abdominal pain can be as bad as that of childbirth.  In addition, the bowel habit is affected by constipation, diarrhoea, or a combination of the two, and faecal incontinence is not uncommon. Furthermore, low backache, constant tiredness, nausea, bladder and gynaecological symptoms frequently occur and can lead to misdiagnosis or even inappropriate investigation and treatment (Whorwell, McCallum, Creed, & Roberts, 1986). Unfortunately, IBS can’t be cured, and medication only approaches are unsatisfactory as they only target individual symptoms rather than the whole problem.  Consequently, patients become frustrated about their lack of progress which results in deterioration in mental health and quality of life. IBS is associated with considerable direct and indirect healthcare and financial costs (Vasant & Whorwell, 2019).

In the early 1980’s Whorwell and colleagues explored the possible use of gut-directed hypnotherapy as a more holistic way of treating IBS, especially as it offered the opportunity to address the interaction between the gut and the brain.  They showed that compared to controls, patients with severe IBS who received hypnotherapy experienced a highly significant improvement in their symptoms (Whorwell, Prior, & Faragher, 1984) and in subsequent studies showed that non colonic features, psychological symptoms, and quality of life also improved (Miller et al., 2015). These results were initially met with scepticism but have been consistently reproduced by others (Lindfors et al., 2012; Palsson, 2015; Peters, Muir, & Gibson, 2015), and hypnotherapy is now recommended in national and international guidelines (Vasant & Whorwell, 2019). Furthermore, the benefits of hypnotherapy are long lasting with patients consulting less often, consuming less medication, and taking less time off work (Gonsalkorale, Miller, Afzal, & Whorwell, 2003; Lindfors, et al., 2012). Hypnotherapy is also effective in children with IBS (Vlieger, Rutten, Govers, Frankenhuis, & Benninga, 2012) and the benefits are not confined to Caucasians (Sasegbon, Hasan, Whorwell, & Vasant, 2022).

Despite good evidence of effectiveness, the uptake of hypnotherapy for IBS by healthcare providers has been disappointing possibly because of ignorance and prejudice about the subject. This has resulted in limited access to hypnotherapy leading those wanting to try it having to go to private providers who may not necessarily be trained in the gut-directed hypnotherapeutic approach. Concerns about the initial upfront costs of hypnosis compared to those of current treatments for IBS which are very cheap may also be a factor, although in the long term the cost benefits of adjunctive hypnotherapy have been shown to be considerable.

Gut-directed hypnotherapy should not be regarded as a ‘stand-alone’ treatment for IBS. Instead, it should be an option offered routinely as part of integrated care in a gastroenterology department in conjunction with dietary advice, the use of appropriate medications and access to investigation, if necessary.  This approach to treatment conforms to the biopsychosocial model which is strongly recommended for managing complex conditions such as IBS.

References

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