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A surprising treatment is helping people with gastrointestinal or stomach issues


At a time when mental health is in the spotlight - it's World Mental Health Day today - there's increased focus on how to bring effective therapies to people using digital on-demand care. This includes a hypnosis app to treat the stress and anxiety linked to common stomach problems which affect millions of Americans. NPR's Allison Aubrey reports.

ALLISON AUBREY, BYLINE: If you've struggled with gastrointestinal or stomach issues and you can't find relief, Ron Burley (ph) feels your pain. He's 75 years old, a retired advertising executive who lives in Grosse Pointe Park, Mich. He says for many years, every time he got stressed out or nervous, he felt it in one place - his gut.

RON BURLEY: Before an airline flight or a trip or a presentation - I mean, you'd always worry, is there a bathroom near? Will I have to excuse myself? And it was a vicious cycle, almost.

AUBREY: The more he worried, the more pain he had.

BURLEY: Cramps, diarrhea.

AUBREY: He went to see a couple of doctors who ran tests and told him they could not find anything wrong.

BURLEY: They said, well, it's probably just a temporary thing. And then they give me a pill.

AUBREY: The medicine slowed down his system temporarily. But he felt vulnerable, uncomfortable. Bouts of symptoms kept coming. This went on for years until he found a clinical psychologist at the University of Michigan, Megan Riehl. She does a kind of therapy called gut-directed hypnotherapy.

MEGAN RIEHL: Our brain and our gut are communicating all the time. And if you're somebody that has a digestive problem, oftentimes - I always think about it like it's - the communication is turned up way too high.

AUBREY: So if you eat something that upsets your stomach or you're thinking about something that provokes anxiety, the nerves throughout the digestive system are sending signals to the brain. When the communication gets out of whack, every sensation we feel can be amplified.

RIEHL: Hypnosis is a strategy to help address the hypervigilance and hypersensitivity that happens in patients that have IBS, for example, irritable bowel syndrome. And it really gets at the heart of that miscommunication and helping to kind of calm that conversation down.

AUBREY: In turning down the noise, the hypnosis helps to alleviate GI symptoms. That's what Ron Burley found. He says when people hear about hypnosis, they think it sounds kind of wacky.

BURLEY: It's evoked a lot of laughs, especially when you mention hypnotism. A lot of eyes roll. What is this, voodoo psychology they're using on you?

AUBREY: But in reality, there's no pendulum swinging before your eyes. It's nothing like what you might see in the movies. Burley found in his hypnotherapy sessions, it's actually a set of relaxation techniques combined with suggestions and guided imagery that can help reset the communication between the gut and the brain.

BURLEY: Typically start with deep breathing.

AUBREY: What follows is a type of body scan.

BURLEY: And you visualize, say, your chest relaxing or your stomach relaxing, your intestines relaxing. And you're not into a deep sleep. I would call it just a deep relaxation. It's almost like sitting in a hot tub.

AUBREY: What comes next is a set of suggestions delivered by the psychologist. Ron Burley was fortunate to be in person with Megan Riehl. But there are not enough GI psychologists to meet the demand. So one stand-in has become a digital app. It's called Nerva. I've logged in to hear how it works.


UNIDENTIFIED SPEAKER: Powerful changes are happening inside your body. Imagine the sensations of abdominal pain are becoming a thing of the past.

AUBREY: You're told to imagine that you've been welcomed into an apothecary, where smells of herbs and concoctions fill the air. A pharmacist has made an imaginary special medicine. It's in a glass vial just for you. You're told it will create comfort.


UNIDENTIFIED SPEAKER: Know that this medicine is not only coating your insides but is also sending messages to your brain, calming down this line of communication between your mind and your gut.

AUBREY: In the moment of deep relaxation, Ron Burley said the suggestions start to feel real. He could feel changes in his body.

BURLEY: I think because you are so relaxed, your mind is empty, and it's more open to suggestions.

AUBREY: And psychologist Megan Riehl points to published research showing that most patients do benefit from hypnotherapy.

RIEHL: I have seen it make a tremendous difference.

AUBREY: One small study found that about 70% of patients had significant improvement in symptoms.

RIEHL: They also feel that, you know, even if they have symptoms, they have strategies to manage it.

AUBREY: Ron Burley told me that he wished he'd found this strategy decades ago because his quality of life has improved so much.

BURLEY: When you're not worried about where the next restroom is, it gives you the opportunity to focus on what's important in life. I hate to sound like a born-again, but it has changed my life. It's made it a lot better.

AUBREY: He now has a daily meditation practice as part of his morning stretch routine, and he says he's learned to be more still and to let go of unimportant things.

BURLEY: I think, initially, I was unaware that there was the mind-gut connection, and I now know that they're hard-wired together. What you think has a big influence on how your stomach feels.

AUBREY: And how you feel overall - he says whenever he does get symptoms, he knows exactly what it takes to reset.

Allison Aubrey, NPR News.

(SOUNDBITE OF MUSIC) Transcript provided by NPR, Copyright NPR.

Allison Aubrey is a correspondent for NPR News, where her stories can be heard on Morning Edition and All Things Considered. She's also a contributor to the PBS NewsHour and is one of the hosts of NPR's Life Kit.

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