Source:

Vlieger
AM
,
Rutten
JMTM
,
Govers
AMAP
, et al
.
Longterm follow-up of gut-directed hypnotherapy vs. standard care in children with functional abdominal pain or irritable bowel syndrome
.
Am J Gastroenterol.
2012
;
107
(
4
):
627
631
; doi:
https://doi.org/10.1038/ajg.2011.487

Investigators from St. Antonius Hospital and the Academic Medical Center in the Netherlands surveyed 49 pediatric participants with chronic functional abdominal pain (FAP) or irritable bowel syndrome (IBS) to assess the long-term effects of gut-directed hypnotherapy (HT). As part of a previous study, participants were randomized to receive either HT over a 3-month period or standard medical treatment plus 3 months of supportive medical therapy (SMT). HT was performed by a specially trained nurse over six 50-minute sessions, consisting of general relaxation, control of abdominal pain and gut functions, and ego-strengthening suggestions. The SMT included discussion of symptoms and exploration of possible symptom triggers and was provided over six 30-minute sessions in addition to standard medical treatment. By 1 year post-therapy 85% of the HT group had achieved clinical remission compared to 25% of the SMT group.

In the current study, the investigators sought to determine the percentage of participants in each group who were in clinical remission at long-term follow-up (>4 years). Participants in both the HT and SMT groups were asked to keep a 7-day diary to assess pain intensity and frequency as well as complete a set of validated questionnaires to assess medication use, school attendance, somatic complaints, and quality of life (QOL). Pain symptoms were converted to a standardized score and compared to baseline pain scores obtained at the start of the previous study. Clinical remission was defined as a decrease in pain scores by >80% compared to baseline.

Included in this current study were 27 participants from the HT group and 22 from the SMT group. The mean length of time post treatment was 4.8 years. Pain intensity and frequency scores were significantly decreased in both groups compared to baseline, but were significantly lower in the HT group compared to the SMT group. In the HT group, 68% of participants were in clinical remission compared to 20% of SMT participants (P = .005). Gastrointestinal and nongastrointestinal somatic complaints were both significantly lower in the HT group compared to the SMT group. However, there were no differences seen in QOL scores between the 2 groups.

The investigators conclude that HT has long-term benefits for pediatric patients with FAP and IBS and should therefore be considered as a therapeutic option.

Drs Plante and Mark have disclosed no financial relationship relevant to this commentary. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device.

HT has been shown to be a promising intervention for adults with IBS. The mechanism of action is unknown, but it is thought that its relaxing effect makes it possible to reframe patients’ problems, help patients dissociate from prior thoughts or feelings regarding the problems, and guide them to...

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