Does hypnotherapy improve symptoms of functional abdominal pain in children?

This small but well-designed trial found that hypnotherapy is an effective treatment for functional abdominal pain or irritable bowel syndrome (IBS) in children. (LOE = 1b-)

Vlieger AM, Menko-Frankenhuis C, Wolfkamp SC, Benninga MA. Hypnotherapy for children with functional abdominal pain or irritable bowel syndrome: a randomized controlled trial. Gastroenterology 2007;133(5):1430-6.  [PMID:17919634]

Randomized controlled trial (nonblinded)

Self-funded or unfunded

Concealed

Outpatient (specialty)

Children between the ages of 8 years and 18 years with either functional abdominal pain or IBS for at least 12 months were included. Those with an organic disease, who were taking medications, who were mentally retarded, or who had functional constipation were excluded. Most had not benefited from other therapies, such as proton pump inhibitors, laxatives, or psychotherapy. They were randomly assigned to undergo hypnotherapy (6 sessions of 50 minutes over 3 months) or supportive therapy (6 sessions of 30 minutes over 3 months). The primary outcome was pain intensity and frequency, and patients were followed up for 12 months. Analysis was by intention to treat, and groups were balanced at the start of the study. Of the 53 children initially recruited from a pediatric gastroenterology clinic, 1 in the hypnotherapy group refused the baseline assessment and 1 stopped supportive therapy and tried hypnotherapy (results from neither patient were available for analysis). Pain intensity and frequency were measured on 21-point scales. Pain intensity decreased from a mean of 13.5 to 1.3 after 1 year in the hypnotherapy group, and from 14.1 to 8.0 in the control group. The pain frequency score decreased from a mean of 13.5 to 1.1 in the hypnotherapy group, compared with 14.4 to 9.3 in the control group. Both differences were statistically significant. Clinical remission was observed in 59% in the hypnotherapy group versus 12% in the supportive therapy group (P < .001; number needed to treat = 2). Subgroup analysis found no difference between patients with functional abdominal pain and those with IBS, but found that younger patients (younger than 14 years) appeared to respond better than older patients to hypnotherapy.