Do older adults respond to digital gut-directed hypnotherapy for IBS? New data says yes

Older adults with IBS engage with and respond to digital gut-directed hypnotherapy at least as well as younger patients.¹ In a real-world analysis of 131,900 users, 65–74-year-olds showed higher program completion and greater abdominal pain response than under-45s.¹ 

This new engagement data presented at Australian Gastroenterology Week (AGW) 2026 upends the long-held assumption that older patients are poor candidates for a digital program like Nerva. 

How do older adults respond to gut-directed hypnotherapy for IBS?

Our new engagement data show older adults respond well, with program completion actually rising with age. 

The study looked at 131,900 people who enrolled in the program, including 13,454 aged 65 and over.¹ Among those aged 65–74, 61% finished the full six-week program, a higher completion rate than in the under-45 group.¹

Pain relief followed the same pattern. In the 65–74 group, 58.8% saw a meaningful drop in abdominal pain, again outpacing younger users.¹

This cuts against the common assumption that older patients struggle with app-based care. As the new data make clear, chronological age alone is a poor predictor of digital engagement, and steadier daily routines may make the 15–20 minute practice easier to sustain than it is for younger, busier patients.

Why age should not exclude older patients from digital GDH

Age on its own is a poor reason to rule a patient out, especially when digital delivery removes the barriers that hit older adults hardest. Traditional gut-directed hypnotherapy is effective but hard to access, usually needing six to twelve in-person sessions with a trained therapist.² Those are exactly the sessions an older patient may struggle to reach, whether from mobility limits, transport, or distance from a specialist.

A structured program delivered on a phone changes that. It brings the same protocol into the home, at a time that suits the patient.

It is also low-risk and non-pharmacological, so it sidesteps the drug interactions and polypharmacy concerns that complicate IBS care in older adults. For a patient already juggling several medications, a treatment with no added drug burden is a real advantage.

What else predicts who responds? Less than clinicians expect

Two more studies released at the same meeting found that the factors clinicians often screen on, mental health and food triggers, did not predict who responded either. 

The first looked at 76,138 users and sorted them by psychological symptom severity.³ Even among those with severe anxiety or depression, more than half of program completers still achieved a meaningful reduction in abdominal pain.³ Baseline mental health did not determine the physical result.

The second study analyzed 26,008 users grouped by what set off their symptoms.⁴ Whether IBS was driven by food, stress, or both, the research found engagement and improvement were nearly identical across the groups.⁴ Food-triggered patients are often steered straight to dietary change, yet they did just as well with gut-directed hypnotherapy.

Taken together with the age findings, the pattern is consistent. The characteristics used to screen patients out, older age, psychological comorbidity, and food triggers, do not predict who benefits.

Where does gut-directed hypnotherapy fit in IBS care for older patients?

Gut-directed hypnotherapy is a guideline-backed treatment, not a last resort. The 2021 ACG clinical guideline names gut-directed psychotherapies as evidence-based options for overall IBS symptoms.⁵ Earlier research also found GDH worked as well as the low FODMAP diet, with benefits still holding at six months.²

Nerva delivers this same therapy as a six-week gut-brain therapy program, in daily 15–20 minute sessions. In a randomized controlled trial, 81% of Nerva users saw a clinically significant improvement in their IBS symptoms, compared with 63% in the control group.⁶ Because the program is standardized and fully remote, older patients get the trial-tested protocol without needing to find a local hypnotherapist.

Watch: how to counsel patients over 65 on gut-directed hypnotherapy

Most gut-directed hypnotherapy trials have been run in younger adults, so counseling an older patient takes some nuance. In this webinar, gastroenterologist Dr. Stephanie Moleski, MD (Thomas Jefferson University), walks through where the evidence is strongest, why a 1,000-patient audit spanning ages 17 to 91 is reassuring when the RCT data skew young, and the practical barriers that matter most for older adults: device access, hearing, digital literacy, and cost.

Adding Nerva to your referral pathway

You can refer older patients to Nerva through the online referral form. The program is simple to navigate, and real human support is always on hand if a patient gets stuck, so age or comfort with technology is rarely a barrier. They go through intake and onboarding at their own pace, and you can see their week 1 and week 6 IBS-SSS scores, so there is something concrete to review together at the next visit.

Bookmark the referral form

Frequently asked questions

Is gut-directed hypnotherapy safe for elderly patients with IBS?

Gut-directed hypnotherapy carries no drug-related risk, which makes it a good fit for older patients on multiple medications. New engagement data show completion and symptom response are actually highest in the 65–74 group, with no drop-off in benefit with age.¹

Do older adults actually stick with health apps?

Older adults finish digital gut-brain therapy at higher rates than younger users, with 61% of 65–74-year-olds completing the full six-week program.¹ Concerns about low digital literacy in this group are not borne out by the real-world data.

Should anxiety or depression change who I refer for gut-directed hypnotherapy?

Psychological comorbidity should not on its own rule a patient out, since new data on 76,138 users found baseline anxiety and depression did not predict pain outcomes.³ Earlier research also showed app-delivered gut-directed hypnotherapy improved patients' PHQ-4 scores over six weeks.⁷

Is gut-directed hypnotherapy recommended in IBS guidelines?

Gut-directed psychotherapies are endorsed in the 2021 ACG clinical guideline as evidence-based options for overall IBS symptoms, not a last resort.⁵ This holds across adult age groups, including older patients.

References

1. Hall C, Dabash O, Peters SL. Older adults with irritable bowel syndrome demonstrate higher engagement and improved abdominal pain outcomes with digital gut-directed hypnotherapy: real-world analysis of 131,900 enrolled users. Abstract presented at: Australian Gastroenterology Week (AGW); 2026; Australia.

2. Peters SL, Yao CK, Philpott H, Yelland GW, Muir JG, Gibson PR. Randomised clinical trial: the efficacy of gut-directed hypnotherapy is similar to that of the low FODMAP diet for the treatment of irritable bowel syndrome. Aliment Pharmacol Ther. 2016;44(5):447-459.

3. Hall C, Dabash O, Peters SL. Baseline psychological comorbidity does not influence abdominal pain response to digital gut-directed hypnotherapy: real-world analysis of 76,138 users with IBS. Abstract presented at: Australian Gastroenterology Week (AGW); 2026; Australia.

4. Dabash O, Hall C, Peters SL, Raik-Allen S. No difference in adherence or clinical response to a digital brain-gut behavioural therapy program among 26,008 users reporting food-related or stress-related primary symptom triggers. Abstract presented at: Australian Gastroenterology Week (AGW); 2026; Australia.

5. Lacy BE, Pimentel M, Brenner DM, Chey WD, Keefer LA, Long MD, Moshiree B. ACG clinical guideline: management of irritable bowel syndrome. Am J Gastroenterol. 2021;116(1):17-44.

6. Anderson EJ, Peters SL, Gibson PR, Halmos EP. Comparison of a digitally delivered gut-directed hypnotherapy program with an active control for irritable bowel syndrome. Am J Gastroenterol. 2025;120(2):440-448.

7. Peters SL, Gibson PR, Halmos EP. Improvements in psychological outcomes following app-delivered gut-directed hypnotherapy. Am J Gastroenterol. 2023;118(10S):S694.