US Edition
Hypnotherapy and talking therapy are the best treatments for stomach pain in children, a new study has suggested.
Researchers analysed various treatments for children with chronic stomach pain, including irritable bowel syndrome, abdominal migraines and unexplained pain.
The conditions affect as many as one in eight children, and recent analysis by the Organisation for Economic Co-operation and Development found that children in England were among the most likely in Europe to report suffering with mental health, stomach pains, and other aches.
The experts from the University of Central Lancashire analysed 91 studies, which involved 7,200 children aged four to 18.
The studies assessed the effectiveness of different treatments including dietary interventions, medicines, probiotics, hypnotherapy and cognitive behavioural therapy (CBT) – also known as talking therapy.
They found that hypnotherapy and CBT were the most effective in relieving pain and improving symptoms and called for better access to such services.
Hypnotherapy was 68 per cent more successful than taking no action, while CBT was 35 per cent more effective, the university said.
One in 20 children’s appointments
Writing in the journal Lancet Child and Adolescent Health the authors added that “no conclusions can be made about the other therapies and treatment success” because of a lack of quality evidence.
Professor Morris Gordon, from the University of Central Lancashire’s School of Medicine, said “almost one in 20 of every single children’s appointment in a hospital outpatients will be explicitly for this problem [stomach pain]”.
He added: “It’s a huge burden, not just on the NHS, but more importantly for the kids and of course their families.
“They can’t go to school, they can’t function... You’ve got someone who was a high-flying gymnast or had a really good hobby – BMXing, and you name it – I’ve heard both of those examples in the last couple of years, and it’s gone. It’s done.
“We have found that hypnotherapy and CBT have the best evidence of providing successful treatment and to reduce pain. Other therapies have evidence of an effect, but due to systematic concerns with the findings, no conclusions can be drawn at the moment.”
‘Prejudice’ against talking therapies
Professor Gordon, who carried out the study with colleagues from the Netherlands and Florida, said there were “no guidelines available for medical practitioners so treatment methods are sporadic with no real evidence to underpin them”.
It’s common, he said, for some GPs to prescribe probiotics, while others suggest pain medication or diet changes. Additionally, there is an expectation for “medicalisation” which has led to a “prejudice” against psychosocial therapies.
Although, he said it was “important to point out that we’re not suggesting the condition is psychological because we don’t know of a single definite cause in these cases”.
He added: “What we’re suggesting is the best way to manage it, taking into consideration the frequency and severity of the pain, the way they impact a patient’s life, and the side-effects of treatments.
“Think about it in the same way we don’t take paracetamol to cure a cold but to manage the pain. You can’t stop the music playing but you can turn down the volume.”
He said that therapies to tread abdominal pain were difficult to access, despite being safe and easy to offer.
Professor Marc Benninga, a paediatric gastroenterologist from Emma Children’s Hospital in Amsterdam, who worked on the project, called for more trials to assess other treatments for abdominal pain in children.
He said: “This study highlights the low quality of the scientific research that has been performed to date in a very common condition as abdominal pain.”