# Hypnotherapy Highly Effective for Pediatric Irritable Bowel Syndrome and Functional Abdominal Pain: Presented at DDW



## cookies4marilyn (Jun 30, 2000)

DDW: Hypnotherapy Effective in Children With Bowel Pain By Michael Smith, Senior Staff Writer, MedPage Today Reviewed by Zalman S. Agus, MD; Emeritus Professor at the University of Pennsylvania School of Medicine. May 22, 2007Add Your Knowledge™ Additional DDW Coverage WASHINGTON, May 22 -- Hypnotherapy is superior to standard care in children and adolescents with functional abdominal pain and irritable bowel syndrome, a Dutch researcher said here. Action PointsExplain to interested patients that many children complain of functional abdominal pain and irritable bowel syndrome, but with no evidence of an underlying disorder. Note that this study suggests that hypnotherapy is highly effective in treating these children. This study was published as an abstract and presented orally at a conference. These data and conclusions should be considered to be preliminary as they have not yet been reviewed and published in a peer-reviewed publication. In a randomized controlled trial, hypnotherapy led to a cure by the end of treatment in 59% of 53 young patients compared with 12% of those getting standard care, according to Arine Vlieger, M.D., Ph.D., of St. Antonius Hospital in Nieuwegein. The difference was significant at P<0.001, Dr. Vlieger said during Digestive Disease Week sessions. What's more, after a year of follow-up, the hypnotherapy had resulted in a cure in 85% of the children, compared to 25% of those getting standard care, she said. The treatment -- using a modified Manchester protocol -- was "highly effective," Dr. Vlieger said, adding that further studies should be undertaken to confirm the results. The Manchester protocol is one of several hypnotherapy approaches to gut disorders shown to be effective in adults, but not previously been tested in children, she said. The children ranged in age from eight to 18, and had suffered from functional abdominal pain and irritable bowel syndrome -- with no evidence of an underlying disorder -- for an average of 3.4 years. The condition is a common cause for pediatric consultations, she said, with reported prevalence of between 1% and 19%. Standard care is pain medication, combined with explanations of a sensitive gut and attempts to modify pain triggers. In the study, the patients were randomized to six half-hour hypnotherapy sessions over three-months or to standard medical care combined with six half-hour sessions of supportive therapy, including such efforts as trying to identify pain triggers. The researchers defined a cure as more than an 80% improvement in pain scores. All but one of the patients completed treatment and pain scores decreased significantly in each group, Dr. Vlieger said. Specifically: Mean pain intensity scores in the hypnotherapy group decreased from 13.5 at the start of the study to 3.0 at the end of treatment and 1.4 after a year of follow-up. Scores in the standard care group fell from 14.2 to 9.8 at the end of treatment and 8.0 after a year. Other symptoms also fell significantly, but there was no difference between groups, she said. The finding is not a surprise, commented Maria Abreu, M.D., of Mount Sinai in New York, who moderated the press conference at which Dr. Vlieger discussed her findings. "If there was any group of humans who would be very prone to improve with hypnotherapy," she said, "it would be children -- they have less baggage than adults." Dr. Abreu, who was not involved in the research, said the trend in treating such patients is to use drugs. "It's much easier to write a prescription than to go through the process of hypnotherapy," she said. What's more, health insurance is more likely to pay for drug therapy than hypnotherapy, she said, "which may result in underuse of something with a tremendous effect." http://www.medpagetoday.com/MeetingCoverag...Meeting/tb/5725---Hypnotherapy Highly Effective for Pediatric Irritable Bowel Syndrome and Functional Abdominal Pain: Presented at DDW By Bruce Sylvester WASHINGTON, DC -- May 22, 2007 -- Hypnotherapy is effective for the treatment of children with irritable bowel syndrome (IBS) and functional abdominal pain (FAP), investigators reported here at Digestive Diseases Week (DDW). "The children we studied had very long-lasting symptoms, and hypnotherapy proved to be highly effective with this group," said lead investigator and presenter Arine Vlieger, MD, PhD, pediatrics fellow, St. Antonius Hospital, Nieuwegein, Netherlands. FAP and IBS are among the most common reasons for consultation in pediatrics, with reported prevalence rates of 1% to 19%, according to Dr. Vlieger and colleagues. Treatment usually consists of education, reassurance and dietary advice. Among children treated with the standard approach, 25% to 66% continue to experience symptoms. Gut-directed hypnotherapy has been shown to be highly effective in the treatment of adult patients with IBS. So Dr. Vlieger and colleagues conducted a study to evaluate this treatment approach in a pediatric population. The investigators enrolled 53 children between the ages of 8 and 18 years who had been diagnosed with IBS or FAP. The subjects were randomized to standard therapy or to 6 hypnotherapy sessions of 30 minutes over a 3-month period. The endpoints of the study were pain intensity, pain frequency, as nausea, headache and appetite. The investigators recorded findings at baseline and at 1, 2, and 3 months after randomization, and 6 and 12 months after therapy. They defined a cure as a greater than 80% improvement in pain. At 3 months, the investigators observed a cure rate of 59% for treated subjects versus 12% in subjects receiving conventional therapy. After 1 year, the cure rate reached 85% for hypnotherapy-treated subjects and 25% for those receiving conventional therapy. The authors concluded, "Gut-directed hypnotherapy is highly superior to conventional therapy in the treatment of children with longstanding FAP or IBS. Further studies are warranted to confirm our findings." http://www.docguide.com/news/content.nsf/n...52572E300752C7A


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