Am J Gastroenterol. 2024 Jun 28. doi: 10.14309/ajg.0000000000002921. Online ahead of print.

Ellen J Anderson ^1 2, Simone L Peters ¹, Peter R Gibson ^1 2, Emma P Halmos ^1 2

Author information

¹Department of Gastroenterology, School of Translational Medicine, Monash University.

²Alfred Health, Melbourne, Australia.

Abstract

Objectives: Gut-directed hypnotherapy (GDH) treats irritable bowel syndrome (IBS) but its accessibility is limited. This problem may be overcome by digital delivery. This study aimed to perform a randomised control trial comparing the efficacy of a digitally-delivered program with and without GDH in IBS.

Methods: Adults with IBS were randomized to a 42-session daily digital program with the GDH Program (Nerva) or without (Active Control). Questionnaires were completed to assess gastrointestinal symptoms via IBS-SSS, quality of life (IBS-QOL) and psychological symptoms (DASS-21) at regular intervals during the program and 6 months following conclusion on the intervention. The primary endpoint was the proportion of participants with ≥50-point decrease in IBS-SSS between the interventions at the end of the program.

Results: Of 240/244 randomized participants, 121 received GDH Program - median age 38 (range 20-65) years, 90% female, IBS-SSS 321 (IQR 273-367) - and 119 Active Control - 36 (21-65), 91% female, IBS-SSS 303 (255-360). At program completion, 81% met the primary endpoint with GDH Program versus 63% Active Control (p=0.002). IBS-SSS was median 208 (IQR 154-265) with GDH and 244 (190-308) with Control (p=0.004), 30% reduction in pain was reported by 71% compared with 35% (p<0.001), and IBS-QOL improved by 14 (6-25) compared with 7 (1-15), respectively (p<0.001). Psychological status improved similarly in both groups.

Conclusions: A digitally-delivered GDH Program provided to patients with IBS was superior to the active control, with greater improvement in both gastrointestinal symptoms and quality of life and provides an equitable alternative to face-to-face behavioural strategies.