Yoga Therapy for Abdominal Pain‐Related Functional Gastrointestinal Disorders in Children

Korterink, Judith; Ockeloen, Lize; Hilbink, Mirrian; Benninga, Marc A.; Deckers-Kocken, Judith M.

doi:10.1097/mpg.0000000000001230

Cited by 53 publications

(41 citation statements)

References 42 publications

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“…Nineteen studies were excluded, of which four were new to this update (Jastrowski Mano 2013; Korterink 2016; Rapoff 2014; Rutten 2017). We excluded Connelly 2006, Hicks 2006, Palermo 2009, Rapoff 2014, Stinson 2010, Trautmann 2010 as they were delivered remotely, so did not meet the new inclusion criteria.…”

Section: Resultsmentioning

confidence: 99%

“…We excluded Connelly 2006, Hicks 2006, Palermo 2009, Rapoff 2014, Stinson 2010, Trautmann 2010 as they were delivered remotely, so did not meet the new inclusion criteria. Eight studies were excluded as they had fewer than 10 participants in a treatment arm at the end of treatment (Fentress 1986; Jastrowski Mano 2013; Kroener-Herwig 1998; Larsson 1986; Sanders 1989; Trautmann 2008; Weydert 2006; Youssef 2009), three studies were judged to have insufficient psychological content in the treatment (Koenig 2013; Korterink 2016; Olness 1987), one study reported only follow-up data of more than one year (Vlieger 2012), and one trial was had a non-inferiority design (Rutten 2017).…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Psychological therapies for the management of chronic and recurrent pain in children and adolescents

Fisher¹,

Law²,

Dudeney³

et al. 2018

Cochrane Database of Systematic Reviews

188

174

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Background This is an update of the original Cochrane review first published in Issue 1, 2003, and previously updated in 2009, 2012 and 2014. Chronic pain, defined as pain that recurs or persists for more than three months, is common in childhood. Chronic pain can affect nearly every aspect of daily life and is associated with disability, anxiety, and depressive symptoms. Objectives The aim of this review was to update the published evidence on the efficacy of psychological treatments for chronic and recurrent pain in children and adolescents. The primary objective of this updated review was to determine any effect of psychological therapy on the clinical outcomes of pain intensity and disability for chronic and recurrent pain in children and adolescents compared with active treatment, waiting-list, or treatment-as-usual care. The secondary objective was to examine the impact of psychological therapies on children’s depressive symptoms and anxiety symptoms, and determine adverse events. Search methods Searches were undertaken of CENTRAL, MEDLINE, MEDLINE in Process, Embase, and PsycINFO databases. We searched for further RCTs in the references of all identified studies, meta-analyses, and reviews, and trial registry databases. The most recent search was conducted in May 2018. Selection criteria RCTs with at least 10 participants in each arm post-treatment comparing psychological therapies with active treatment, treatment-as-usual, or waiting-list control for children or adolescents with recurrent or chronic pain were eligible for inclusion. We excluded trials conducted remotely via the Internet. Data collection and analysis We analysed included studies and we assessed quality of outcomes. We combined all treatments into one class named ‘psychological treatments’. We separated the trials by the number of participants that were included in each arm; trials with > 20 participants per arm versus trials with < 20 participants per arm. We split pain conditions into headache and mixed chronic pain conditions. We assessed the impact of both conditions on four outcomes: pain, disability, depression, and anxiety. We extracted data at two time points; post-treatment (immediately or the earliest data available following end of treatment) and at follow-up (between three and 12 months post-treatment). Main results We identified 10 new studies (an additional 869 participants) in the updated search. The review thus included a total of 47 studies, with 2884 children and adolescents completing treatment (mean age 12.65 years, SD 2.21 years). Twenty-three studies addressed treatments for headache (including migraine); 10 for abdominal pain; two studies treated participants with either a primary diagnosis of abdominal pain or irritable bowel syndrome, two studies treated adolescents with fibromyalgia, two studies included adolescents with temporomandibular disorders, three were for the treatment of pain associated with sickle cell disease, and two studies treated adolescents with inflammatory bowel disease. Finally, three...

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Psychological therapies for the management of chronic and recurrent pain in children and adolescents

Fisher¹,

Law²,

Dudeney³

et al. 2018

Cochrane Database of Systematic Reviews

188

174

View full text Add to dashboard Cite

show abstract

“…Yoga therapy in children with FAP aims to reduce anxiety, improve tone and increase feelings of well-being 58. Korterink et al 59 looked at yoga therapy in 69 children aged 8–18 with ‘abdominal pain-related’ FGIDs, noting significant improvements in pain intensity scoring and school absence but not in pain frequency or quality of life. A recent Cochrane review concluded that there was no robust evidence for the effectiveness of yoga therapy 55…”

Section: Clinical Questionsmentioning

confidence: 99%

Functional abdominal pain: what clinicians need to know

2020

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Abdominal pain in childhood is extremely common and presents frequently to both primary and secondary care, with many children having recurrent pain which impacts on daily functioning. Despite this most children have no discernible underlying pathology. We discuss the underlying mechanism for functional abdominal pain (visceral hypersensitivity), the evidence base linking parental anxiety and patient symptoms, and how parents can be supported in managing their children’s symptoms by addressing questions commonly asked by children and families. We look at the evidence for a one-stop rational approach to investigation including a coeliac screen, inflammatory markers and consideration of stool faecal calprotectin, in the absence of red flags. We evaluate commonly used treatments for functional abdominal pain, within a context of managing family expectations. Given the limitations in pharmacological treatment options, trials of probiotics, peppermint oil, mebeverine and (for short-term use only) hyoscine butylbromide may be appropriate. Psychological interventions including cognitive–behavioural therapy, distraction techniques and hypnotherapy have a better evidence base. There is also some evidence for other complementary therapies in children, including yoga and neurostimulation. Outcome is generally good providing there is child and family acceptance of the multiple factors implicated in the aetiology of the pain.

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“…The intervention group improved significantly in the management of children’s symptoms [ 42 ]. Yoga could be considered a particular type of CBT; in some studies, yoga resulted in a significant reduction in pain intensity in children with FAP and IBS [ 43 ]. Although the evidence is not yet strong enough to recommend yoga as a treatment, it can nonetheless be utilized together with standard medical care when requested, as it is not at all harmful.…”

Section: Managementmentioning

confidence: 99%

The Management of Paediatric Functional Abdominal Pain Disorders: Latest Evidence

et al. 2018

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Recurrent abdominal pain (RAP) is one of the most common health complaints in both children and adults. Although RAP is considered a functional disorder rather than an organic disease, affected children and their families can still experience anxiety and concerns that can interfere with school, sports, and regular daily activities and lead to frequent attendances at pediatric emergency departments or pediatric gastroenterology clinics. Our review shows experts do not agree on a universally proven management that will work on every child presenting with functional abdominal pain (FAP). Treatment strategies include both non-pharmacological and pharmacological options. Non-pharmacological treatments are usually very well accepted by both children and their parents and are free from medication side effects. Nevertheless, they may be as effective as the pharmacological interventions; therefore, according to many experts and based on the majority of current evidence, a non-pharmacological approach should be the first intervention attempt in children with RAP. In particular, the importance of the bio-psychosocial approach is highlighted, as a majority of children will improve with counselling and reassurance that no serious organic pathologies are suspected, especially when the physician establishes a trustful relationship with both the child and their family. Placebo and pharmacological interventions could be attempted when the bio-psychosocial approach is not applicable or not efficacious. In some difficult cases, finding an effective treatment for FAP can be a challenge, and a number of strategies may need to be tried before symptoms are controlled. In these cases, a multidisciplinary team, comprising a pediatric gastroenterologist, dietician, psychologist, and psychotherapist, is likely to be successful.

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Yoga Therapy for Abdominal Pain‐Related Functional Gastrointestinal Disorders in Children

Abstract: At 1-year follow-up, YT in addition to standard care was superior compared with SMC according to treatment success, PIS, and reduction of school absence. YT, however, was not significantly more effective in improving PFS or QoL, compared with SMC.

Cited by 53 publications

References 42 publications

Psychological therapies for the management of chronic and recurrent pain in children and adolescents

Psychological therapies for the management of chronic and recurrent pain in children and adolescents

Functional abdominal pain: what clinicians need to know

The Management of Paediatric Functional Abdominal Pain Disorders: Latest Evidence

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