Study Explores Hypnotherapy For Gastrointestinal Issues

Loyola Medicine is among the first to conduct a clinical study using hypnotherapy to treat functional dyspepsia, a gastrointestinal disorder affecting approximately 10% of the population.

People affected by functional dyspepsia experience frequent stomach upset, including symptoms of stomach pain or burning, nausea, bloating, belching and a prolonged feeling of fullness. Medical testing does not reveal any abnormalities that explain these symptoms, and the condition is thought to be related to dysfunction of the nerves and muscles of the stomach.

Recent scientific research indicates that this dysfunction is explained in part by the brain-gut axis, communication pathway between the gut's nervous system and the brain. In conditions like functional dyspepsia, disruption in this pathway causes the nerves and muscles to go awry, resulting in uncomfortable digestive symptoms. Functional dyspepsia is more common in women than men, and psychological issues such as stress and anxiety can worsen symptoms.

There are currently no FDA-approved medications for functional dyspepsia, therefore treatment options are limited. Recommendations often include lifestyle and diet adjustments, and short-term trials of acid-reducing medication. Treatment is generally more symptom-management focused rather than cure focused because this is a chronic condition and symptoms may come and go throughout a patient's life.

The clinical study being conducted at Loyola Medicine explores a new way of approaching functional dyspepsia, by exploring the use of a psychological treatment, gut-directed hypnotherapy. Sarah Kinsinger, PhD, director of behavioral medicine for digestive health at Loyola Medicine, specializes in psychological interventions for gastrointestinal conditions, also referred to as "brain-gut therapies."

Dr. Kinsinger states that brain-gut therapies such as hypnotherapy can be helpful for conditions like functional dyspepsia because they use the mind to restore normal communication patterns between the brain and the gut and prevent stress from aggravating symptoms.

"Functional dyspepsia is a difficult condition to treat and the symptoms have a significant impact on patients' quality of life," Kinsinger said. "Hypnotherapy is an exciting and promising approach and may be effective for many patients that have failed other treatments, because it works through a different mechanism by influencing the brain-gut axis."

Throughout history, hypnotherapy has been utilized as a tool for pain management. In the 1800s, some surgeons would use hypnotherapy in place of anesthesia for surgeries. In 1984, a landmark study showed that patients with severe irritable bowel syndrome had dramatic improvements in their digestive symptoms after participating in a course of hypnotherapy treatment. There is now over 30 years of research demonstrating that hypnotherapy is an effective treatment for irritable bowel syndrome. This approach also shows promise for functional dyspepsia, which has many overlapping features with irritable bowel syndrome.

Kinsinger's study is unique in that patients participate in treatment from their home by using pre-recorded audio files that are accessed through a secure website. Using these audio files, patients learn to enter a special mental state, referred to as a hypnotic trance state. While in this state, patients are deeply relaxed, their minds are focused, they can visualize things more vividly, and analytical thinking falls away, making the mind more receptive to therapeutic suggestions. The imagery and suggestions utilized in gut-directed hypnotherapy focus on normalizing digestive functioning and reducing gut sensitivity.
For example, a hypnotherapy session may involve asking a patient to visualize drinking a cool, therapeutic drink that coats the stomach, while hearing suggestions such as:

"This cool, healing liquid settles deep in your stomach, healing and restoring the nerves and muscles of your stomach...The nerves of your stomach are becoming much less sensitive to pain and discomfort... and this healing effect will continue and grow stronger in the coming days and weeks, making you feel healthier and more comfortable inside day by day."

Being in this special mental state allows the suggestions to have a lasting effect on the mind and body even after the session is completed.

The clinical trial, aside from the initial screening appointment, is conducted entirely online, so patients are able to participate from their own home. Kinsinger said, "Home-based treatment allows us to overcome many of the barriers that may prevent patients from being able to participate in treatment."

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