Efficacy of Auricular Neurostimulation in Adolescents With Irritable Bowel Syndrome in a Randomized, Double-Blind Trial

Krasaelap, Amornluck; Sood, Manu R.; Li, B.U.K.; Unteutsch, Rachel; Yan, Ke; Nugent, Melodee; Simpson, Pippa; Kovacic, Katja

doi:10.1016/j.cgh.2019.10.012

Cited by 52 publications

(54 citation statements)

References 30 publications

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“… 233 In adolescents with IBS, Krasaelap and colleagues found a 59% response rate with neurostimulation as compared to 26% in sham controls with lower composite and usual pain scores. 236 …”

Section: Treatmentmentioning

confidence: 99%

An Update on the Assessment and Management of Pediatric Abdominal Pain

Friesen¹,

Colombo²,

Deacy³

et al. 2021

PHMT

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Chronic abdominal pain is very common in children and adolescent and results in high personal and social costs. Most youth with chronic abdominal pain fulfill criteria for a functional abdominal pain disorder (FAPD) as defined by Rome criteria. These are complex conditions with a wide array of biological, psychological, and social factors contributing to the experience of pain. The purpose of the current review is to provide an overview of the pathophysiology of FAPDs and an up-to-date summary of the literature related to FAPDs in children and adolescents, with additional focus on several areas (eg, diet and probiotics) where patients and families frequently have questions or implement self-directed care. We also provide an approach to the assessment and treatment of pediatric FAPDs focusing on the robust literature regarding psychological interventions and much sparser literature regarding medication treatment.

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“… 233 In adolescents with IBS, Krasaelap and colleagues found a 59% response rate with neurostimulation as compared to 26% in sham controls with lower composite and usual pain scores. 236 …”

Section: Treatmentmentioning

confidence: 99%

An Update on the Assessment and Management of Pediatric Abdominal Pain

Friesen¹,

Colombo²,

Deacy³

et al. 2021

PHMT

View full text Add to dashboard Cite

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“…Four studies had a high risk of bias [40,46,47,52], three studies had a risk of bias considered to be of concern [41,43,50], and four studies had a low risk of bias [39,48,49,51] (Figures S1-S6). All but one study [52] reported the use of a random component in the sequence generation process.…”

Section: Methodological Quality Of Studiesmentioning

confidence: 99%

“…e lack of double blinding accounted for the presence of high-performance bias in most trials [39,41,43,46,47,48,50]. In three trials [40,49,52], only advanced patients were blinded, and in only one trial [51] was double blinding possible.…”

Section: Methodological Quality Of Studiesmentioning

confidence: 99%

“…e 11 studies were parallel-group RCTs, of which four evaluated the effectiveness of hypnotherapy [39,[46][47][48], and seven evaluated body-directed therapies: acupuncture [40,41,43,49], osteopathic medicine [50], auriculotherapy [51], and reflexology [52] (Table 1). A sham control group was used in four body-directed therapy studies [40,49,51,52], while for the seven others, the control group was SMT (National Health Service (NHS) lifestyle, drugs, and extra fibres) or SMT associated with various antistress interventions (group educational support therapy, attentive listening, and home exercise), in order to obtain the same duration of interaction with therapists as in the intervention groups.…”

Section: Study Typesmentioning

confidence: 99%

“…e proportion of women ranged from 44.8% to 90%. Two studies investigated the subtypes of IBS [43,51]. Six studies specified IBS duration before inclusion, with participants who had suffered from IBS for at least 6 weeks [46], 3 months [49], 6 months [43], 12 months [48, 52], 13 years [41], and 15 years [52].…”

Section: Characteristics Of Included Subjectsmentioning

confidence: 99%

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Effectiveness of Non-Pharmacological Interventions for Irritable Bowel Syndrome: A Systematic Review

Amsallem

Sanchez

Armoiry

et al. 2021

Evidence-Based Complementary and Alternative Medicine

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Introduction. Given the complexity of the therapeutic management of irritable bowel syndrome (IBS), alternative non-pharmacological therapies are frequently offered to patients. The aim of this study was to conduct a systematic review in order to establish the current evidence base for non-pharmacological interventions (body-directed and mind-body therapies) in the management of IBS. Materials and Methods. The literature was searched in several electronic databases (PubMed (including Medline), Web of Science (Clarivate Analytics), Scopus (Elsevier), ScienceDirect (Elsevier), Cochrane Library (Wiley), and Wiley Online Library (Wiley)) for randomized controlled trials (RCTs) published in the English language from 1990 to 2020. Effectiveness outcomes were examined through the change in overall IBS symptoms or abdominal pain up to 12 months after treatment. Results. 11 studies (parallel-group RCTs) were identified that enrolled 1590 participants in total. Body-directed therapies (acupuncture and osteopathic medicine) showed a beneficial effect compared with standard medical treatment for overall IBS symptoms at 6 months follow-up, while no study found any difference between body-directed and sham therapies for abdominal pain or overall IBS symptoms. It was not possible to conclude whether hypnotherapy was superior to standard medical treatment or supportive therapy for overall IBS symptoms or abdominal pain due to discordant results. Conclusions. Although body-directed therapies such as acupuncture and osteopathic medicine may be beneficial for overall IBS symptoms, higher-quality RCTs are needed to establish the clinical benefit of non-pharmacological interventions for IBS. An important challenge will be the definition of the optimal control groups to be used in non-pharmacological trials.

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Effect of Open-label Placebo on Children and Adolescents With Functional Abdominal Pain or Irritable Bowel Syndrome

et al. 2022

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IMPORTANCEAlthough it is widely believed that concealment or deception is required to elicit a placebo response, recent studies with adults suggest that open-label placebo (OLP) (ie, honestly prescribed placebos) can yield significant benefits. No studies of OLP have been performed with children.OBJECTIVE To evaluate the efficacy of OLP for the treatment of children and adolescents with functional abdominal pain or irritable bowel syndrome.DESIGN, SETTING, AND PARTICIPANTS This multicenter crossover randomized clinical trial was conducted from July 1, 2015, to June 15, 2018, at 3 US centers among children and adolescents aged 8 to 18 years with functional abdominal pain or irritable bowel syndrome defined per Rome III criteria. Statistical analysis was performed from March 1, 2019, to September 30, 2020, on an intention-to-treat basis.INTERVENTIONS Patients completed 1 week of observation prior to randomization to 1 of 2 counterbalanced groups: OLP for 3 weeks followed by a 3-week control period or control period for 3 weeks followed by OLP for 3 weeks. During the OLP period, participants took 1.5 mL of an inert liquid placebo twice a day. A standardized method for explaining the OLP was used, and the interaction with clinicians had the same duration and style for both time periods. Hyoscyamine was allowed as a rescue medication. MAIN OUTCOMES AND MEASURESThe primary outcome was the mean daily pain score during each of the interventions, measured on a 0-to 100-mm visual analog scale, where higher scores indicated greater pain. The number of rescue medications taken during each intervention served as an objective secondary measure.RESULTS Thirty patients (mean [SD] age, 14.1 [3.4] years; 24 female participants [80.0%]; 16 [53.3%] with functional abdominal pain and 14 [46.7%] with irritable bowel syndrome) completed the study. The mean (SD) pain scores were significantly lower during OLP treatment compared with the control period (39.9 [18.9] vs 45.0 [14.7]; difference, 5.2; 95% CI, 0.2-10.1; P = .03). Patients took nearly twice as many hyoscyamine pills during the control period compared with during the OLP period (mean [SD] number, 3.8 [5.1] pills vs 2.0 [3.0] pills; difference, 1.8 pills; 95% CI, 0.5-3.1 pills). CONCLUSIONS AND RELEVANCEDuring OLP, patients with functional abdominal pain or irritable bowel syndrome reported significantly less pain and took significantly fewer pain medications. Open-label placebo may be an effective treatment for children and adolescents with functional abdominal pain or irritable bowel syndrome.

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Efficacy of Auricular Neurostimulation in Adolescents With Irritable Bowel Syndrome in a Randomized, Double-Blind Trial

Cited by 52 publications

References 30 publications

An Update on the Assessment and Management of Pediatric Abdominal Pain

An Update on the Assessment and Management of Pediatric Abdominal Pain

Effectiveness of Non-Pharmacological Interventions for Irritable Bowel Syndrome: A Systematic Review

Effect of Open-label Placebo on Children and Adolescents With Functional Abdominal Pain or Irritable Bowel Syndrome

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