Hypnotherapy and cognitive behavioural therapy are the best treatments for long-term stomach pain in children, a new study suggests.
Experts said more needs to be done to make these therapies available for children in the UK and to tackle the ‘prejudice’ linked to psychosocial treatments for abdominal pain.
It comes after a new study saw researchers analyse various treatments for chronic stomach pain, including irritable bowel syndrome, abdominal migraines, and unexplained pain.
These conditions affect up to 12% of children and it is estimated they cause ‘chronic, debilitating pain’ in 300 million children globally.
The team examined 91 studies involving more than 7,200 children aged four to 18.
The studies assessed dietary treatments; medicines; probiotics; psychosocial treatments including cognitive behavioural therapy (CBT) and hypnotherapy.
The team of academics, led by experts at the University of Central Lancashire, found that ‘hypnotherapy and CBT show moderate certainty for treatment efficacy with clinically relevant effect sizes’.
Hypnotherapy is 68% more successful and CBT 35% more successful than taking no action, the university said.
But ‘no conclusions can be made about the other therapies and treatment success due to very low evidence certainty’, the authors wrote in the journal Lancet Child and Adolescent Health.
Study lead author Professor Morris Gordon, from the University of Central Lancashire’s School of Medicine said: ‘In the UK, almost one in 20 of every single children’s appointment in a hospital outpatients will be explicitly for this problem compared to all other problems.
‘So 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.’
He went on: ‘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.’
Professor Gordon, who carried out the study with colleagues from the Netherlands and Florida in the US, said a new guideline for treating abdominal pain in children has been created off the back of the study.
‘Currently, there no guidelines available for medical practitioners so treatment methods are sporadic with no real evidence to underpin them,’ he said.
‘One GP may prescribe probiotics while another may prescribe pain medication, whereas others prefer a diet or a psychological treatment.
‘This analysis provides, for the first time, an accurate way of grading the success rate of treatments.’
‘All that matters is the right outcome for the child and the family,’ he said.
The professor added: ‘It is 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.
‘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.
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