Brief hypnotherapeutic–behavioral intervention for functional abdominal pain and irritable bowel syndrome in childhood: a randomized controlled trial

Abstract

Functional abdominal pain and irritable bowel syndrome are two prevalent disorders in childhood which are associated with recurrent or chronic abdominal pain, disabilities in daily functioning, and reduced quality of life. This study aimed to evaluate a brief hypnotherapeuticbehavioral intervention program in a prospective randomized controlled design. Thirty-eight children, 6 to 12 years of age, and their parents were randomly assigned to a standardized hypnotherapeutic-behavioral treatment (n=20) or to a waiting list condition (n=18). Both groups were reassessed 3 months after beginning. Primary outcome variables were child-completed pain measures and pain-related disability. Secondary outcome variables were parent-completed measures of their children's pain and pain-related disability. Health-related quality of life from both perspectives also served as a secondary outcome. In the treatment group, 11 of 20 children (55.0 %) showed clinical remission (>80 % improvement), whereas only one child (5.6 %) in the waiting list condition was classified as responder. Children in the treatment group reported a significantly greater reduction of pain scores and pain-related disability than children of the waiting list condition. Parental ratings also showed a greater reduction of children's abdominal pain and pain-related disability. Health-related quality of life did not increase significantly. Conclusions: Hypnotherapeutic and behavioral interventions are effective in treating children with long-standing AP. Treatment success of this brief program should be further evaluated against active interventions with a longer follow-up.

Nonpharmacologic Treatment of Functional Abdominal Pain Disorders: A Systematic Review

“…Thirteen articles remained for analysis: 7 systematic reviews 11,12,15,16,18,22,23 (including 18 RCTs) and 6 RCTs. [24][25][26][27][28][29] Two included trials concerned follow-up studies, 26,30 which will be discussed by using their original studies. 31,32 Two systematic reviews 11,12 included studies with ,10 patients per treatment arm, and these studies were therefore excluded.…”

“…39,40 Four trials investigated probiotics, 27,41-43 and 3 trials compared HT versus standard care or a wait-list. 25,32,44 Seven studies compared CBT with standard care, physiotherapy, fiber supplements, biofeedback, and/or parental support. 28,31,[45][46][47][48][49] One trial compared yoga with a wait-list, 50 and 1 trial evaluated written self-disclosure (WSD) in addition to standard care.…”

“…25,31,32,38,42,44,47,49,50 Four studies assessed quality of life, 25,28,29,44 and 8 studies assessed adverse effects. 24,25,37,38,[41][42][43][44] Data of 3 studies were pooled to perform a meta-analysis of the efficacy of fiber supplements, [36][37][38] and 3 studies were used to perform a meta-analysis on probiotics. [41][42][43] Table 1 presents the characteristics of the included studies.…”

“…36,[44][45][46]48,49 Due to the nature of HT, CBT, WSD, and yoga, blinding was not possible for the caregiver or patient. 25,28,29,31,32,[44][45][46][47][48][49][50] Dropout was considerable in 4 studies 36,40,41,47 or vaguely described in 3 others. 31,46,50 Two studies excluded patients due to poor compliance.…”

“…32,44 In 1 trial, school absenteeism was seldom reported, and therefore no calculation was performed. 25 One child dropped out because of transient headaches after listening to the CD. 44 Gulewitsch et al 25 reported no adverse effects.…”