Gastroenterology

Gastroenterology

Volume 133, Issue 5, November 2007, Pages 1430-1436
Gastroenterology

Clinical–Alimentary Tract
Hypnotherapy for Children With Functional Abdominal Pain or Irritable Bowel Syndrome: A Randomized Controlled Trial

https://doi.org/10.1053/j.gastro.2007.08.072Get rights and content

Background & Aims: Functional abdominal pain (FAP) and irritable bowel syndrome (IBS) are highly prevalent in childhood. A substantial proportion of patients continues to experience long-lasting symptoms. Gut-directed hypnotherapy (HT) has been shown to be highly effective in the treatment of adult IBS patients. We undertook a randomized controlled trial and compared clinical effectiveness of HT with standard medical therapy (SMT) in children with FAP or IBS. Methods: Fifty-three pediatric patients, age 8–18 years, with FAP (n = 31) or IBS (n = 22), were randomized to either HT or SMT. Hypnotherapy consisted of 6 sessions over a 3-month period. Patients in the SMT group received standard medical care and 6 sessions of supportive therapy. Pain intensity, pain frequency, and associated symptoms were scored in weekly standardized abdominal pain diaries at baseline, during therapy, and 6 and 12 months after therapy. Results: Pain scores decreased significantly in both groups: from baseline to 1 year follow-up, pain intensity scores decreased in the HT group from 13.5 to 1.3 and in the SMT group from 14.1 to 8.0. Pain frequency scores decreased from 13.5 to 1.1 in the HT group and from 14.4 to 9.3 in the SMT group. Hypnotherapy was highly superior, with a significantly greater reduction in pain scores compared with SMT (P < .001). At 1 year follow-up, successful treatment was accomplished in 85% of the HT group and 25% of the SMT group (P < .001). Conclusions: Gut-directed HT is highly effective in the treatment of children with longstanding FAP or IBS.

Section snippets

Study Participants

Children were recruited from the Department of Pediatric Gastroenterology of the Academic Medical Centre Amsterdam, the Netherlands. All children between 8 and 18 years who were diagnosed with either FAP or IBS according to the Rome II criteria1 and with a history of abdominal complaints of at least 12 months were invited to participate. Exclusion criteria were: the use of medication influencing gastrointestinal functions, a concomitant organic gastrointestinal disease, functional constipation,

Results

Between October 2002 and June 2005 a total of 55 children with abdominal pain fulfilling the Rome II criteria for FAP or IBS were referred by general pediatricians, pediatric gastroenterologists, and psychiatrists to the outpatient clinic of our tertiary centre (Figure 1). Of these patients 53 children agreed to participate in the study. Twenty-five patients were allocated to SMT and 28 to HT. Only 1 patient of the HT group did not provide baseline assessments and refused further therapy;

Discussion

This randomized controlled study is the first to demonstrate that gut-directed HT is highly effective in the treatment of children with long-lasting complaints of either IBS or FAP. Treatment was successful in 85% of the participants at 1 year follow-up, whereas only 25% of the children were in clinical remission after standard medical care, given by an experienced pediatric gastroenterologist and an experienced general pediatrician. This high success rate is remarkable, given that most

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  • Cited by (0)

    All authors have seen and approved the final version.

    1

    A. M. Vlieger participated in patient selection and treatment of the patients, coordinated data analysis and interpretation, and was responsible for writing this report.

    2

    C. Menko-Frankenhuis carried out the HT and participated in data collection.

    3

    S. Wolfkamp compiled the data.

    4

    E. Tromp contributed to the data analysis and interpretation.

    5

    M. A. Benninga generated the initial idea for the study, coordinated the project, participated in patient selection and patient treatment, and contributed to the writing of this report.

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