Detailed guides to painful problems, treatments & more

Hypnotizing your gut

 •  • by Paul Ingraham
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Weekly nuggets of pain science news and insight, usually 100-300 words, with the occasional longer post. The blog is the “director’s commentary” on the core content of a library of major articles and books about common painful problems and popular treatments. See the blog archives or updates for the whole site.
Detailed but abstracted silhouette image of the brain and vagus nerve in glowing blue, as though electrified.

I stumbled on a slick marketing campaign for hypnotherapy for irritable bowel syndrome, with lots of emphasis on it being based on the evidence. The pitch was for Nerva, “gut-directed hypnotherapy,” which leverages vagus nerve hype and essentially claims that stress is the cause of IBS, relaxation is the cure, and Nerva is the right way to chill out.

So I went looking for the touted evidence, and Nerva is not only “based on evidence,” but evidence produced by a lab with a good reputation for IBS research. By various measures, we are talking about Actual Science!®

So what’s the problem? Alas, the Actual Science consists of… one small clinical trial.

That’s it. One trial. The result is positive, obviously. But there’s no replication and nothing else in the literature that constitutes meaningful backup. It’s not a terrible trial or anything. It’s just a bit underwhelming and … alone.

And yet that single trial has clearly been made into the cornerstone of the marketing plan for a well-funded business venture, making big claims about IBS treatment.

What if those researchers knew in advance that they were going to be cashing in on the positive results, starting a lucrative new business? The risk of bias-powered methodological and statistical hijinks would just be off the charts. Did the business plan exist before the trial was done? Did someone have it in mind, have hopes for it? Or did they just know that that any positive result for any treatment is worth millions? Presumably, because that’s just how this works these days. But I’m just asking questions. The kind of questions we should be asking every time we see a new therapy being touted as “evidence-based.”