A randomized controlled trial in the American Journal of Gastroenterology found digital gut-directed hypnotherapy helps IBS patients better manage abdominal pain, symptom severity, and quality of life.
The trial randomly assigned 244 IBS patients to a 42-session digital gut-directed hypnotherapy program or an active psychoeducation control, both delivered through the Nerva app.
The hypnotherapy group showed a statistically and clinically significant improvement on the IBS Symptom Severity Scale, with improvements maintained at six-month follow-up in both the hypnotherapy and active-control groups, suggesting durable effects of both.
With only around 400 GI psychologists worldwide, digitally delivered gut-directed hypnotherapy offers an accessible, at-home alternative to traditional in-person care.
A newly published randomized control trial (RCT) in the American Journal of Gastroenterology highlights how digital gut-directed hypnotherapy (GDH) helps IBS patients better manage their abdominal pain, calm symptom severity, and improve patient quality of life. Here’s why the Nerva team thinks these findings establish precedent that digital hypnotherapy should be considered a first-line management option for IBS.
Long wait times, high costs, and a shortage of GI psychologists (there are only ~400 worldwide!) are the barriers familiar to clinicians who have tried to refer patients for traditional in-person GDH.
This is why new research on accessible digital tools like Nerva matters for patient care.
Study methodology and design
This study included 244 IBS patients who were randomly assigned to either digital GDH group with an active control or an active control group who received psychoeducation (a recognized IBS management tool) through the Nerva app, but did not participate in hypnotherapy. Both groups followed a daily 42-session digital regimen.
Researchers at Monash University evaluated the participants' progress through questionnaires assessing gastrointestinal symptoms, quality of life, and psychological well-being at multiple points during and six months after the program.
Key insight: Management of abdominal pain
One of the most significant findings from the RCT was the better management of abdominal pain, given the chronic nature of IBS and the central role that abdominal pain plays in its overall symptom profile.
Abdominal pain occurring at least 1 day per week for 3 months is part of the Rome IV diagnostic criteria for IBS, underscoring its persistence in all patients. So, this research demonstrates that patients can relieve this challenging symptom through a digital gut-brain therapy program, and that program provides an equitable alternative to traditional face-to-face behavioral strategies.
The researchers at Monash utilized validated measures such as the IBS Symptom Severity Scale (IBS-SSS) to quantitatively assess the impact on overall symptom severity of IBS. They found the app-based GDH group experienced a statistically (and clinically) significant change to their IBS-SSS scores compared to the active control group, indicating a clinically meaningful response.
Nerva’s commentary on the RCT
Although this study did not assess any mechanisms of action, one current hypothesis is that GDH may modulate central pain processing pathways, thereby reducing visceral hypersensitivity.
Non-pharmacological approaches that use the mind-gut connection to help patients self-manage their symptoms provide an alternative to conventional treatments that often rely on medications with potential side effects.
By achieving clinically meaningful abdominal pain management through a digital platform, app-delivered GDH presents a promising option for chronic pain management in IBS patients, highlighting the importance of integrating innovative therapies into standard care practices.
Moreover, the RCT’s six-month data showed that IBS-SSS scores remained improved in both groups from baseline, suggesting durability of the effects of both the GDH program and the active control.
The lasting improvements highlight that the findings of this study are durable and unlikely to be attributed to a placebo response.
Effective, accessible IBS management
The study underscores several benefits of digitally delivered mind-gut therapies for healthcare providers seeking effective, accessible IBS management solutions that overcome the barriers of traditional in-person GDH. Nerva addresses these challenges by offering a digital solution that patients can use in the comfort of their homes.
High acceptance and convenience
The practicality of a digitally delivered GDH program provides an equitable alternative to face-to-face behavioral strategies, and the RCT indicated high patient acceptance. The on-demand format allows patients to complete sessions at their convenience, fostering a better patient experience and consistent results. This flexibility is particularly advantageous for those with busy schedules or mobility issues.
Evidence-based impact
The RCT results give healthcare providers strong evidence to confidently recommend a digital therapeutic tool. The long-term follow-up results suggest the durability of the effects of app-delivered GDH over time, crucial for chronic IBS management, though this is an area for future study
Embracing digital therapeutics
The findings from this RCT are a significant step forward in IBS management, showcasing the potential of digital therapeutics in modern healthcare. Digital solutions, like Nerva, offer a scalable, cost-effective alternative to traditional therapies, making it easier for patients to access the care they need without the common barriers of time, cost, and availability.
Integrating Nerva into clinical practice
The publication of this RCT marks a significant advancement in IBS management, shifting the paradigm towards more accessible, effective, and patient-friendly care.
As hypnotherapy and digital therapeutics become mainstream, this study provides the necessary evidence to incorporate digital hypnotherapy into standardized IBS management protocols.
To begin referring gut-directed hypnotherapy in your practice, the online form is the simplest way to begin.
Disclaimer: Nerva is a self-guided program that may help people self-manage and live well with their diagnosed irritable bowel syndrome. Nerva has not been evaluated by the FDA, TGA, MHRA or similar regulatory bodies. Users are directed to not make any changes to their prescribed medication or other type of medical treatment without seeking professional medical advice.
Anderson, E. J., Peters, S. L., Gibson, P. R., & Halmos, E. P. (2024). Comparison of digitally-delivered gut-directed hypnotherapy program to an active control for irritable bowel syndrome. The American Journal of Gastroenterology. https://doi.org/10.14309/ajg.0000000000002921
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