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Hypnotherapy for Gastrointestinal DisordersCertain gastrointestinal (GI) disorders are amenable to treatment with clinical hypnosis.Functional Abdominal Pain (JAP), previously called Recurrent Abdominal Pain (RAP), can be difficult problem to treat. The diagnosis is made when there are at least three episodes of pain severe enough to affect a child’s activities over a three-month period. The pain is unrelated to meals, activity, or stool patterns. It may be accompanied by nausea, dizziness, headache, and fatigue. The patient may become pale during an episode. The episodes last less than an hour. The patient has normal growth and development. Often there is a family history of GI problems. There is no organic etiology. That means that all diagnostic tests are negative, including blood tests, ultrasound, and endoscopy (when a doctor uses a special scope to look at the patient’s upper intestinal tract, including the stomach and esophagus, as well as the lower gastrointestinal tract, including the rectum and colon). In addition, all radiographic studies are negative, including CT scans and x-ray studies such as upper GI series (barium swallow) and lower GI series (in which a barium enema is given). Additional tests may be ordered and these, too, will also turn out to have normal results. Irritable bowel syndrome (IBS) is characterized by chronic abdominal pain and altered bowel habits. There may be constipation or diarrhea. The pain is sometimes made worse by eating or stress. It is often better after a bowel movement.* Here, again, test results are negative. And, it is important to realize that even though the test results are negative, the pain is still quite real. Many of these patients may have “visceral hypersensitivity,” which means that they have a lower threshold for pain. Abdominal migraine (AM) may cause recurrent abdominal pain. These patients typically also have migraine headaches, but not always.** Cyclic vomiting syndrome (CVS) is a condition in which patients have three or more episodes of vomiting in one year. They are completely normal between episodes, and each episode is virtually the same. The vomiting may last anywhere from hours to days. In addition, there is no organic cause for the vomiting. CVS has been associated with abdominal migraine and migraine headaches. One difference between abdominal migraine and CVS is that abdominal migraines are characterized by pain and not vomiting. Both conditions may include headaches and respond to medications used for migraine.*** It is interesting that patients with IBS, AM, and CVS are often treated with the same medication that is used to treat migraine headaches. And, the time frame may be similar. For example, patients with migraine headaches often experience an “aura.” This is a sensation, a warning sign of some sort, that in 10 to 30 minutes, the migraine headache will occur. IBS and AM patients may also experience an aura. Often, their pain begins slowly and then escalates. If the pain starts slowly, that can be the equivalent of an aura. So, in the past, the aura was the signal that the IBS episode or AM or migraine headache was going to occur. Patients who learn self-hypnosis can use the aura or beginning of the episode to use this technique to prevent the episode from occurring. In fact, a prospective study of patients with IBS and FAP was done comparing hypnotherapy (HT) and standard medical therapy (SMT). The HT group did far better both short-term and long-term. Specifically, at one year follow-up, success was 85% in the HT group compared with 25% in the SMT group.**** Click here for more on hypnosis in the treatment of Migraine Headaches *Chun, Andrew B, and Wald, Arnold, in Uptodate, online, November
4, 2009. Download the Imagery Discomfort Questionnaire (PDF) If your child has an issue you would like to me to hear about, please fill out this form. |
Jeffrey E. Lazarus, MD |
