Background and aims: Abdominal bloating is a difficult symptom to treat. Hypnotherapy and diaphragmatic intervention have separately shown benefit on bloating in prior work but have not been united into a single intervention. We aimed to obtain data on the potential therapeutic impact of a novel audio-recorded bloating treatment for bloating integrating hypnosis and diaphragmatic breathing, with proposed synergistic effect.
Methods: Patients with non-organic bowel disorders with predominant bloating symptoms completed a digitally delivered seven-session audio-recorded hypnotherapy program without clinician involvement. The intervention combined bloating-targeted hypnotic suggestions and guided diaphragmatic breathing delivered under hypnosis, supplemented with interval self-guided breathing exercises. Participants completed online REDCap assessments at baseline, mid-treatment, at end-of-treatment and at 3-month follow-up, evaluating symptom severity, GI symptom specific anxiety, overall anxiety/depression, and quality of life. Outcomes were assessed in an intention-to-treat manner with repeated measures ANOVAs with Bonferroni-adjusted pairwise post-hoc tests.
Results: Of 23 patients who started treatment, 22 (95.6%) completed follow-up. Bloating severity on IBS-SSS and PAGI-SYM showed reduction in bloating with large effect sizes (Cohen's d of ∼0.8) at the end of treatment, as did VSI bloating-related anxiety. At end of treatment, 16 patients (69.6 %) were IBS-SSS treatment responders (>30% symptom reduction) on bloating, and 17 (73.9%) on overall bowel symptom severity. Anxiety, depression, and quality of life scores were unchanged. Outcome measures were fully maintained at 3-month follow-up.
Conclusions: Results suggest the therapeutic utility of a new cost-effective self-administered bloating intervention. A randomized controlled trial is planned to confirm these therapeutic effects.
Copyright © 2025 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The American College of Gastroenterology.