If you've been diagnosed with IBS, sometimes still referred to as a functional GI disorder or, in more current clinical language, a disorder of gut-brain interaction (DGBI), and you've tried the usual first steps: dietary changes, fiber, antispasmodics, maybe a low-FODMAP protocol, and you're still not where you want to be, you're not out of options. Gut-directed hypnosis is one of the better-studied non-pharmacological treatments for IBS, and it's not a last resort. The American College of Gastroenterology and the American Gastroenterological Association both include it in their treatment guidelines, and the AGA specifically recommends offering it early, not after everything else has failed.

GDH is a structured clinical protocol that targets the communication between your brain and your gut, the same pathway responsible for a lot of what makes IBS so disruptive: visceral hypersensitivity, motility changes, and the feedback loop between anxiety and symptoms.

I treat IBS using a modified version of the North Carolina Protocol, developed by Dr. Olafur Palsson and colleagues at the University of North Carolina at Chapel Hill. My version is delivered over 8 sessions, every other week, which gives most patients enough time between sessions to notice and integrate changes without losing momentum. I see patients in person in Calimesa and across the Inland Empire, and via telehealth throughout California.

This treatment is designed for adults with a confirmed diagnosis of IBS from a licensed medical provider. If you haven't been formally diagnosed, gut-directed hypnosis is not the right starting point. GI symptoms can have a lot of causes, some of which need medical workup first, and this treatment works best when we're targeting a confirmed diagnosis.

If you've been diagnosed with IBS (any subtype: IBS-C, IBS-D, or IBS-M) and you're looking for a non-pharmacological option, or you want to add this alongside medical treatment you're already receiving, this is worth a conversation.

The North Carolina Protocol has been studied in multiple clinical trials since the early 2000s. Response rates across those trials have ranged from roughly 53% to 94%, with the original published studies finding benefit in more than 80% of patients treated. Follow-up studies have found that improvement tends to hold up well at 6, 10, and 12 months after treatment ends.

A few things worth knowing as you weigh this:

• These are response rates from controlled studies, not promises about what will happen for any individual patient. IBS is variable, and so are people.

• "Response" in these studies generally means a meaningful, measurable reduction in symptom severity, not necessarily complete resolution of all symptoms.

• I'm using a modified, 8-session version of the original 7-session protocol. The modification reflects clinical judgment about pacing and includes a full assessment/intake, not a deviation from the evidence base itself.

Most people who complete the full course of treatment see some sort of meaningful improvement in their symptoms, however, I cannot promise or guarantee a specific outcome.

• 8 sessions, every other week (roughly 4 months start to finish)

• Each session builds on the last

• Sessions include hypnotic suggestion specifically targeting gut function, sensation, and the brain-gut feedback loop, along with discussion of how things are going between sessions

• You'll likely be given recordings or practice material to use between sessions

• Available in person at my Calimesa office, or via telehealth for patients located in California

I offer this treatment via telehealth for any patient located in California, when telehealth is clinically appropriate and medically necessary for that patient's care.

In practice, this usually applies to:

• Patients whose IBS symptoms make travel unpredictable or physically difficult, especially on flare days

• Patients located far enough from Calimesa, Riverside, or San Bernardino that regular in-person sessions aren't realistic

• Patients for whom the privacy and comfort of being treated from home is clinically relevant to their engagement in treatment

Telehealth isn't a lesser version of this treatment. The protocol translates well to a virtual format, and for a condition like IBS, where symptom unpredictability is often part of the problem, being able to do a session from home on a hard day can be the difference between continuing treatment and falling off.

If you're not sure whether telehealth applies to your situation, that's a normal question to bring to a consultation.