Smartphone app‐delivered gut‐directed hypnotherapy improves symptoms of self‐reported irritable bowel syndrome: A retrospective evaluation

• Published in: Neurogastroenterology and motility Vol. 35; no. 4; pp. e14533 - n/a
• Main Authors: Peters, Simone L., Gibson, Peter R., Halmos, Emma P.
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01.04.2023
• Subjects: Abdominal Pain; app; Digestive system; Gastrointestinal tract; gut‐directed hypnotherapy; Humans; Hypnosis - methods; Hypnotherapy; IBS; Intestine; Irritable bowel syndrome; Irritable Bowel Syndrome - therapy; Mobile Applications; Pain; Patients; Probiotics; Retrospective Studies; Self Report; smartphone; Smartphones; Treatment Outcome; app; gut-directed hypnotherapy; smartphone; IBS
• ISSN: 1350-1925; 1365-2982
• DOI: 10.1111/nmo.14533

Background Gut‐directed hypnotherapy (GDH) has high rates of durable efficacy for treating irritable bowel syndrome (IBS) but its widespread use is limited due to high costs and poor access. A smartphone app delivering GDH was developed to fill gaps in accessibility but has not been assessed in IBS patients. The current retrospective evaluation aims to assess the efficacy of app‐delivered GDH in managing IBS symptoms and to investigate associating factors that predict response. Methods Irritable bowel syndrome patients who downloaded the app between June 2019 and April 2020 were retrospectively evaluated. The first seven sessions were free. Daily GDH, psycho‐education, and breathing exercises were included. Overall and individual gastrointestinal symptoms were assessed at baseline and completion using a 100‐mm visual analogue scale. Clinical data were extracted. Key Results 2843 patients with self‐reported IBS commenced the free sessions, 1428 (50%) purchased the app and 253 (9%) completed all 42 sessions. Outcome data were available for 190 users who completed all 42 sessions. 64% of patients who completed the GDH and provided outcome data responded (defined as >30% reduction in abdominal pain). Abdominal pain reduced from 60mm (50‐73mm) at baseline to 26mm (13‐50mm) on study completion (p<0.001 Wilcoxon). Similar results were seen for overall and individual symptoms. On multivariable analysis, symptom response was positively associated with being ≥ 40 years (estimated OR 0.398, p=0.025) and negatively associated with trying probiotics (0.323, p=0.042). Conclusions & Inferences Adherence to app‐delivered gut‐directed hypnotherapy was low but users who completed the program saw notable improvements in their IBS symptoms. Patients ≥40 years, with symptoms for ≥5 years, may respond better. A controlled trial comparing face‐to‐face to app‐delivered GDH is indicated. Smartphone app‐delivered gut‐directed hypnotherapy improves overall and individual symptoms of irritable bowel syndrome at similar rates to those seen in face‐to‐face trials and overcomes issues associated with high costs and poor access to therapy.