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

Vlieger, Arine M.; Menko-Frankenhuis, C; Wolfkamp, Simone C.; Tromp, Ellen; Benninga, Marc A.

doi:10.1053/j.gastro.2007.08.072

Cited by 258 publications

(259 citation statements)

References 36 publications

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“…At follow-up, the TG featured a high rate of treatment responders (55 %), whereas only one child of the WCG improved to this extent. This result corresponds to the finding by Vlieger and colleagues [48], who found a rate of 59 % treatment response (>80 % improvement) after 3 months in a group of children and adolescents with FAP or IBS receiving HT. Van Tilburg and colleagues reported in their HT trial a treatment response rate (≥50 % improvement) of 63 % after 1 month and 63 % after six months.…”

Section: Discussionsupporting

confidence: 91%

“…This makes it easy and cheap to implement. Although children with AP are affected by this condition from months to years [53], there is growing evidence of the efficiency of very brief psychosocial interventions in treating AP [35,47,48].…”

Section: Discussionmentioning

confidence: 99%

“…This procedure considers various symptom patterns (e.g., scarce but intensive AP or frequent but weak AP) and is similar to the API [55]. In many studies, a 50 % symptom improvement is considered to be a reasonable definition of a treatment responder [8], but we applied a more conservative categorization, which was also used in a previous trial addressing childhood FGIDs [48,49]. Participating children with >80 % improvement of the index were considered as responders with a clinical remission.…”

Section: Primary Outcome Measuresmentioning

confidence: 99%

“…Derived from good evidence in treating adults with long-standing IBS with hypnotherapy (HT) [16,18,58], this might also be a promising approach in handling FAP and IBS in childhood [47][48][49]. The most comprehensive study in HT treatment of FAP and IBS in children and adolescents (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18) years) by a Dutch workgroup [48,49] could demonstrate that HT was highly superior to standard medical care, even in a longterm follow-up. A study in the United States was able to show that self-administered audio-recorded HT for children and adolescents with FAP (6-15 years) was superior to a waiting list condition [47].…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2013

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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.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Primary Outcome Measuresmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

et al. 2013

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“…Compared to the standard treatment controls, the relaxation group evidenced significantly improved IBS symptom severity and quality of life, and reduced medical visits. In a recent RCT with 53 pediatric patients, gut-directed hypnotherapy was found to have long-term efficacy for children with IBS and RAP and was significantly more effective than standard medical treatment in reducing symptoms; 85% of patients treated with hypnotherapy were in clinical remission, defined as at least an 80% decrease in pain, at a one-year follow-up compared to 25% of the standard care group [41]. Despite the promise of mind-body treatments for functional disorders, there is limited research into approaches such as mindfulness and yoga.…”

Section: Introductionmentioning

confidence: 99%

Protocol for a randomized controlled study of Iyengar yoga for youth with irritable bowel syndrome

Evans

Cousins

Tsao

et al. 2011

Trials

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IntroductionIrritable bowel syndrome affects as many as 14% of high school-aged students. Symptoms include discomfort in the abdomen, along with diarrhea and/or constipation and other gastroenterological symptoms that can significantly impact quality of life and daily functioning. Emotional stress appears to exacerbate irritable bowel syndrome symptoms suggesting that mind-body interventions reducing arousal may prove beneficial. For many sufferers, symptoms can be traced to childhood and adolescence, making the early manifestation of irritable bowel syndrome important to understand. The current study will focus on young people aged 14-26 years with irritable bowel syndrome. The study will test the potential benefits of Iyengar yoga on clinical symptoms, psychospiritual functioning and visceral sensitivity. Yoga is thought to bring physical, psychological and spiritual benefits to practitioners and has been associated with reduced stress and pain. Through its focus on restoration and use of props, Iyengar yoga is especially designed to decrease arousal and promote psychospiritual resources in physically compromised individuals. An extensive and standardized teacher-training program support Iyengar yoga's reliability and safety. It is hypothesized that yoga will be feasible with less than 20% attrition; and the yoga group will demonstrate significantly improved outcomes compared to controls, with physiological and psychospiritual mechanisms contributing to improvements.Methods/DesignSixty irritable bowel syndrome patients aged 14-26 will be randomly assigned to a standardized 6-week twice weekly Iyengar yoga group-based program or a wait-list usual care control group. The groups will be compared on the primary clinical outcomes of irritable bowel syndrome symptoms, quality of life and global improvement at post-treatment and 2-month follow-up. Secondary outcomes will include visceral pain sensitivity assessed with a standardized laboratory task (water load task), functional disability and psychospiritual variables including catastrophizing, self-efficacy, mood, acceptance and mindfulness. Mechanisms of action involved in the proposed beneficial effects of yoga upon clinical outcomes will be explored, and include the mediating effects of visceral sensitivity, increased psychospiritual resources, regulated autonomic nervous system responses and regulated hormonal stress response assessed via salivary cortisol.Trial registrationClinicalTrials.gov NCT01107977.

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Home-Based Hypnotherapy Self-exercises vs Individual Hypnotherapy With a Therapist for Treatment of Pediatric Irritable Bowel Syndrome, Functional Abdominal Pain, or Functional Abdominal Pain Syndrome

et al. 2017

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Individual gut-directed hypnotherapy (HT) is effective in pediatric irritable bowel syndrome (IBS) and functional abdominal pain or functional abdominal pain syndrome (FAP[S]). It is, however, unavailable to many children.OBJECTIVE To compare the effectiveness of HT by means of home-based self-exercises using a CD with that of individual HT (iHT) performed by qualified therapists. DESIGN, SETTING, AND PARTICIPANTSThis noninferiority randomized clinical trial with a follow-up of 1 year after the end of treatment was conducted from July 15, 2011, through June 24, 2013, at 9 secondary and tertiary care centers throughout the Netherlands. A total of 303 children were eligible to participate. Of those, 260 children (aged 8-18 years) with IBS or FAP(S) were included in this study. Children were randomized (1:1 ratio) to home-based HT with a CD (CD group) or iHT performed by qualified therapists (iHT group). No children withdrew from the study because of adverse effects. INTERVENTIONSThe CD group was instructed to perform exercises 5 times per week or more for 3 months. The iHT group consisted of 6 sessions during 3 months. MAIN OUTCOMES AND MEASURESPrimary outcomes were treatment success directly after treatment and after 1-year follow-up. Treatment success was defined as a 50% or greater reduction in pain frequency and intensity scores. The noninferiority limit was set at 50% treatment success in the CD group, with a maximum of 25% difference in treatment success with the iHT group after 1-year follow-up. Modified intention-to-treat analyses were performed.RESULTS A total of 132 children were assigned to the CD group and 128 to the iHT group; 250 children were analyzed (126 in the CD group and 124 in the iHT group) (mean [SD] age, 13.4 [2.9] years in the CD group and 13.3 [2.8] years in the iHT group; 94 female [74.6%] in the CD group and 85 [68.5%] in the iHT group). Directly after treatment, 46 children (36.8%) in the CD group and 62 (50.1%) in the iHT group were successfully treated. After 1-year follow-up, the 62.1% treatment success in the CD group was noninferior to the 71.0% in the iHT group (difference, −8.9%; 90% CI, −18.9% to 0.7%; P = .002). CONCLUSIONS AND RELEVANCELong-term effectiveness of home-based HT with a CD is noninferior to iHT performed by therapists in pediatric IBS or FAP(S). Treatment with hypnosis using a CD provides an attractive treatment option for these children.

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

Cited by 258 publications

References 36 publications

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

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

Protocol for a randomized controlled study of Iyengar yoga for youth with irritable bowel syndrome

Home-Based Hypnotherapy Self-exercises vs Individual Hypnotherapy With a Therapist for Treatment of Pediatric Irritable Bowel Syndrome, Functional Abdominal Pain, or Functional Abdominal Pain Syndrome

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