Functional Dyspepsia


What is Functional Dyspepsia (FD)?

FD is characterized by all of the following at least once/week for 2 months:

• Persistent/recurrent pain in upper abdomen
• Not relieved with a bowel movement
• Not associated with change in stool frequency or form
• All diagnostic tests are negative1

All diagnostic tests are negative, including blood tests, ultrasound, and endoscopy.  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 turn out to have normal results.

And, it is important to realize that even though the test results are negative, the pain is still quite real.  Hypnosis is a very powerful tool for pain.

One of the most commonly used medications for Irritable Bowel Syndrome, Functional Abdominal Pain, and FD is amitriptyline, an antidepressant.  Studies have shown repeatedly that this medication is no more effective than placebo for this problem.2,3

Hypnotherapy Offers Superior Treatment For Functional Dyspepsia.

A pioneering study of children and adolescents with Irritable Bowel Syndrome and Functional Abdominal pain, both of which have similar symptoms to FD, was done comparing hypnotherapy (HT) and standard medical therapy (SMT).  The HT group did far better both short-term and long-term.4,5

Medical hypnosis can also help improve a patient’s vomiting, constipation, and/or diarrhea.

When I see patients with FD, they invariably act as if they are having an abdominal migraine.  For example, patients with abdominal migraine or migraine headaches usually experience an “aura.”  This is a sensation, a warning sign of some sort, that in 10 to 30 minutes, the abdominal migraine or migraine headache will occur. The timeline for FD is virtually the same as a migraine headache. Patients who learn self-hypnosis can use the aura or beginning of the episode to use this technique to prevent the episode from occurring and there is typically significant improvement after only 2 to 3 visits.

References:

1.    Yacob and DiLorenzo, Pediatric Annals 38:5, May, 2009.
2.    Bahar RJ, Collins BS, Steinmetz B, Ament ME. Double-blind placebo-controlled trial of amitriptyline for the treatment of irritable bowel syndrome in adolescents. J Pediatr. 2008;152(5):685-689.
3.    Saps M, et al. Multicenter, Randomized, Placebo-Controlled Trial of Amitriptyline in Children With Functional Gastrointestinal Disorders. Gastroenterology. 2009 Oct;137(4):1261-1269.
4.    Vlieger AM, Menko-Frankenhuis C, Wolfkamp SC, Tromp E, Benninga MA. Hypnotherapy for children with functional abdominal pain or irritable bowel syndrome: a randomized controlled trial. Gastroenterology. 2007;133(5):1430-1436.
5.    Vlieger et al. Long-term follow-up of gut-directed hypnotherapy vs. standard care in children with functional abdominal pain or irritable bowel syndrome. Am J Gastroenterol. 2012 Apr; 107(4):627-31.