Professional Referrers

Support for Refractory IBS & Functional Gastrointestinal Disorders

I provide specialist mind-body support for patients with persistent IBS and functional gastrointestinal disorders who have reached the end of the standard medical pathway.

This service aligns with NICE guidance, which recommends psychological therapies, including CBT and gut-directed hypnotherapy, for patients with refractory IBS.

This support is for patients who:

  • Have refractory IBS or ongoing functional gastrointestinal symptoms (e.g. dyspepsia, reflux, chronic abdominal pain)

  • Have had appropriate investigations with no concerning findings

  • Have tried first-line lifestyle and dietary advice (including low FODMAP) with limited benefits, or are experiencing delays accessing specialist dietetic services

  • Experience gut-focused anxiety, stress-related flares, symptom hypervigilance, and/or visceral hypersensitivity

Intervention Offered:

  • Individualised dietary guidance

  • CBT-informed gut-directed hypnotherapy

  • Nervous system-based and somatic techniques to support gut-brain interaction

Sessions are delivered 1:1 online or in person, typically over 6-8 sessions and focusing on:

  • Reducing symptom burden

  • Improving gut-brain regulation

  • Supporting long-term self-management

  • Reducing fear and preoccupation around symptoms

This intervention complements ongoing medical care, and does not replace medical investigation or treatment.

About the Practitioner - Natasha Hedges

I’m a UK registered Gastroenterology Dietitian with over 8 years’ NHS experience in primary and secondary care settings.

My clinical background includes extensive work within NHS outpatient gastroenterology services across East Sussex, supporting patients with complex and refractory gastrointestinal conditions. I have specialist experience in the management of:

  • Irritable Bowel Syndrome (IBS)

  • Functional Dyspepsia

  • Diverticular Disease

  • Inflammatory Bowel Disease (IBD)

  • Bile Acid Malabsorption

  • Gastroparesis

  • Coeliac Disease

  • Pancreatic Enzyme Insufficiency

  • Chronic liver disease

  • Eosinophilic Oesophagitis

  • Mast Cell Activation Syndrome

My area of speciality is helping patients with IBS and functional gastrointestinal disorders, particularly where symptoms persist despite standard medical and dietary management.

I have additional training in psychological therapies, including Cognitive Behavioural Hypnotherapy, supporting integration of gut-brain approaches alongside dietetic care. More recently, I have had additional training to support patients with disordered eating amongst Gastroenterology Patients, with Monash University.

Referral Pathway

  • Patients can self-refer directly via my website or email: tasha_hedges@hotmail.co.uk

  • Patients remain under routine medical care alongside this support

  • GP and Gastroenterology referrals are welcome, but not formally required

If helpful, I am happy to discuss whether this intervention may be appropriate for a particular patient:

Illustrative Clinical Case Examples

Shared with consent. Details anonymised.

Case Example 1

Bile Acid Malabsorption with Persistent Functional Overlay

Background
A patient with bile acid malabsorption (secondary to radiotherapy) reported ongoing abdominal cramping, bloating and wind despite appropriate pharmacological management. While diarrhoeal frequency had improved, daily symptoms continued to impact quality of life.

Presenting Issues

  • Persistent cramping and bloating

  • Anticipatory anxiety around leaving the house

  • Symptom hypervigilance

  • Sleep disturbance

  • Reduced confidence and social engagement

Intervention

The patient undertook CBT-informed gut-directed hypnotherapy alongside nervous system regulation techniques. Guided recordings were used to support daily practice and symptom regulation.

Outcome

Over the course of support, the patient reported:

  • Reduced gut-focused anxiety

  • Improved confidence in social situations

  • Greater perceived control over symptoms

  • Improved sleep

  • Reduced stress reactivity during flares

Family members also noted a visible reduction in anxiety. The patient described feeling more in control of both her gut symptoms and day-to-day life.

Case Example 2

Recurrent SIBO with Post-Infectious Fatigue and Food-Related Anxiety

Background
A patient presented with recurrent small intestinal bacterial overgrowth (SIBO), ongoing fatigue following COVID-19 infection, and persistent bloating and altered bowel habit. Following a previous low FODMAP diet, she reported significant anxiety around food reintroduction.

Presenting Issues

  • Recurrent SIBO requiring repeated treatment

  • Food-related fear and avoidance behaviours

  • Difficulty progressing FODMAP reintroductions

  • Insomnia and low mood

  • Heightened symptom anticipation

Intervention

Support included structured guidance through SIBO treatment and staged FODMAP reintroduction, alongside CBT-informed gut-directed hypnotherapy and nervous system regulation techniques. Digital gut-directed hypnotherapy tools (‘Nerva’) were incorporated to reinforce daily practice between sessions.

Outcome

The patient demonstrated:

  • Gradual expansion of dietary variety

  • Reduced anxiety around food

  • Improved sleep quality

  • Improved mood stability

  • Greater confidence managing flare-ups

She reported feeling more equipped to self-manage symptoms and less preoccupied by food-related concerns.

Additional Resources

Patients who are not ready to engage in 1:1 support may benefit from structured digital gut-directed hypnotherapy programmes such as the ‘Nerva’ app, which is based on established gut-brain therapy models. Click here for further information about ‘Nerva’.