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Gut-Directed Hypnotherapy: Can It Treat Crohn’s?

Medically Reviewed by Sabrina Felson, MD on June 20, 2022

Despite medication, diet and lifestyle changes, and even surgery, you can still have symptoms of Crohn’s disease. Painful flare-ups can take a toll on your mental health and quality of life. Like many people trying to manage this type of inflammatory bowel disease (IBD), you may have heard about using hypnosis – also known as gut-directed hypnotherapy. But is hypnotherapy hype or hope for Crohn’s disease?

What Is Gut-Directed Hypnotherapy?

If you’re interested in exploring gut-directed hypnotherapy to manage Crohn’s disease, you’re not alone. Between 21% to 60% of people with IBD use complementary or alternative therapies.

Gut-directed hypnotherapy is a type of talk therapy that explores the connection between your mind and body.

Hypnosis to treat gastrointestinal conditions, specifically irritable bowel syndrome (IBS), started in the 1980s at the University Hospital of South Manchester in England. Since then, some 35 studies have focused on what’s now known as gut-directed hypnotherapy. In recent years, researchers have started studying how it can help those with IBD.

While IBS and IBD are different diseases, people with Crohn’s often have IBS-type symptoms. Here’s the breakdown:

  • Some 35%-40% of people with IBD have IBS-type symptoms.
  • Compared with people without IBD, people with active IBD are nearly five times more likely to have IBS-type symptoms.
  • Even people whose IBD is in remission are nearly four times more likely than those without IBD to have IBS-type symptoms.
  • People with Crohn’s disease face a slightly higher risk of IBS-type symptoms than people with ulcerative colitis, another inflammatory bowel disease.

How Does Gut-Directed Hypnotherapy Work?

In theory, hypnotherapy works on your brain-gut axis – the exchange of information between your brain and your gastrointestinal (GI) tract. If you can control how you think about your GI symptoms, you can control how you feel. But exactly how gut-directed hypnotherapy improves symptoms isn’t clear.

Gut-directed hypnotherapy is not like stage-show hypnosis, where you lose control of what you do. It’s a deep relaxation guided by a specially trained psychologist or other mental health professional.

During gut-directed hypnotherapy, you’ll first decide on several suggested phrases and images with your hypnotherapist. These will help reframe how your mind thinks about your symptoms. Your first session will include a review of your gut anatomy and physiology, and how problems in your normal function can cause symptoms. This background is necessary to help you understand and visualize what’s going on inside you.

In following sessions, your hypnotherapist will guide you into a trance state or deep relaxation. That’s when they will introduce and repeat specific phrases and images aimed at helping you control and improve your symptoms.

What Does the Evidence Say?

Most of the research on gut-directed hypnotherapy for adults has focused on IBS.

Studies looking at the use of gut-directed hypnotherapy for adults with IBD have focused on ulcerative colitis. For those with ulcerative colitis, one study found adding gut-directed hypnotherapy resulted in 78 days without a flare-up. One year later, 68% of people in the study still felt better and had fewer symptoms.

Whether that kind of remission and symptom improvement applies to Crohn’s disease remains to be seen. There’s no direct evidence on the use of gut-directed hypnotherapy for adults with Crohn’s disease for those who don’t have IBS-type symptoms.

For teens with Crohn’s disease, gut-directed hypnotherapy has shown some promise. A study of 40 teens found they had significant improvement in abdominal pain after gut-directed hypnotherapy. They also missed fewer days of school. But while their parents reported an improvement in their teens’ quality of life, the teens themselves did not report an improvement.

While some studies show that hypnotherapy is better than standard medical treatment alone to manage IBS symptoms, others show it is not better than standard medical treatment for IBS-type symptoms in IBD patients.

Is Gut-Directed Hypnotherapy Right for You?

Hypnotherapy isn’t a quick fix. You need to spend some time on it. The majority of gut-directed hypnotherapy studies involved weekly sessions, lasting from 30 to 60 minutes each, for 6 to 12 weeks. For best results, you need to continue the sessions at home using audio recordings.

Your doctor can help you decide whether gut-directed hypnotherapy is right for you.

Where Can You Get Gut-Directed Hypnotherapy?

Hypnotherapists are psychologists or other mental health professionals trained in the use of hypnosis for treating or managing physical or mental health conditions. Finding the right hypnotherapist may take time. To find gut-directed hypnotherapy practitioners you can:

  • Ask your doctor or gastroenterologist for a referral.
  • Reach out to the behavioral and mental health department of your current clinic or hospital system.

Risks and Side Effects

Gut-directed hypnotherapy is considered extremely safe for most people. However, it’s a complementary therapy. That means it’s used with standard treatment. You shouldn’t use it on its own. And it’s not appropriate for everyone. If you have a serious psychiatric disorder, you should talk to your doctor first.

It’s important to keep following your current medical treatment plan for Crohn’s, including taking prescribed medications and making dietary and lifestyle changes. Left untreated, your Crohn’s disease can get worse, cause serious problems, and lead to the need for surgery.

Practice guidelines

Medical society practice guidelines help gastroenterologists – specialists who treat IBD and IBS – determine what works and what doesn’t for treating and managing Crohn’s. Here’s what the latest guidelines say about gut-directed hypnotherapy:

  • For the management of IBS in adults, the American College of Gastroenterologists (ACG) suggests using gut-directed psychotherapies for IBS symptoms. The recommendation is “conditional” because of the “very low quality of evidence.”
  • For the management of Crohn’s disease in adults, the ACG does not specifically list hypnotherapy. However, it strongly recommends therapies for getting anxiety, depression, and stress under control. That’s because these psychological symptoms are common in those with IBD. In people with Crohn’s they lead to worse health-related quality of life. And those with stress, anxiety, and depression are also less likely to follow their treatment plan.
  • To improve symptom control and quality of life in adults with IBD, the British Society of Gastroenterology also suggests psychological therapies, including hypnotherapy, as part of treatment plans, especially for people with depression and anxiety. The recommendation is “weak” because of the “very low quality of evidence.”
  • Hypnotherapy is not listed as a treatment by the American Gastroenterological Association’s 2021 clinical guidelines for the management of moderate to severe Crohn’s disease.

When used as a complementary therapy, hypnotherapy may help some people. But more research is needed to find out whether it offers real benefits for most people with IBD or Crohn’s.

Show Sources

SOURCES:

Gastroenterology & Hepatology: “The Use of Complementary and Alternative Medicine in Patients With Inflammatory Bowel Disease,” “Overlap Between Irritable Bowel Syndrome and Inflammatory Bowel Disease.”

Alimentary Pharmacology & Therapeutics: “Review Article: Gut-directed Hypnotherapy in the Management of Irritable Bowel Syndrome and Inflammatory Bowel Disease.”

Crohn’s & Colitis Foundation.

American Journal of Clinical Hypnosis: “Hypnosis Treatment of Gastrointestinal Disorders: A Comprehensive Review of the Empirical Evidence.”

Neurogastroenterology & Motility: “Gut‐focused Hypnotherapy for Functional Gastrointestinal Disorders: Evidence‐base, Practical Aspects, and the Manchester Protocol.”

Journal of Pediatric Gastroenterology & Nutrition: “Clinical Hypnosis in Pediatric Crohn's Disease: A Randomized Controlled Pilot Study.”

American Journal of Gastroenterology: “ACG Clinical Guideline: Management of Irritable Bowel Syndrome,” “ACG Clinical Guideline: Management of Crohn's Disease in Adults.”

British Medical Journals: Gut: “British Society of Gastroenterology Consensus Guidelines on the Management of Inflammatory Bowel Disease in Adults.”

Gastroenterology: “AGA Clinical Practice Guidelines on the Medical Management of Moderate to Severe Luminal and Perianal Fistulizing Crohn’s Disease.”

Journal of Crohn’s & Colitis: “Hypnotherapy for Irritable Bowel Syndrome-Type Symptoms in Patients with Quiescent Inflammatory Bowel Disease: A Randomized, Controlled Trial.”

Mayo Clinic Proceedings: “Crohn Disease: Epidemiology, Diagnosis, and Management.”

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