Hypnosis Named the #1 Treatment Recommendation for IBS and Chronic Abdominal Pain in Children
Did you miss the big news???
Am I referring to the latest in national politics? Celebrity breakups? Potential alien invasions? Well, no. But in my small corner of the medical world, we had a major shift.
New Guidelines for Treating Pediatric IBS and Chronic Abdominal Pain
In August, NASPGHAN and ESPGHAN—the pediatric GI professional societies in North America and Europe (the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition and the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition)—published their new guidelines on the management of irritable bowel syndrome (IBS) and chronic abdominal pain in children ages 4-18. And the top treatment recommendation was…. (drumroll, please)… clinical hypnosis!
Yes, rather than any medication, dietary change, supplement, or procedure, hypnosis is the #1 intervention for abdominal pain in kids. The recommendation is based both on the strength of the evidence and the magnitude of the clinical impact. Guidelines like these are created painstakingly by groups of experts who conduct systematic searches of the medical literature. They then analyze the results of published clinical trials, following the World Health Organization’s approach, known as “Grading of Recommendations Assessment, Development and Evaluation” (GRADE).
Some of the clinical trials analyzed in preparation for the guidelines are the same studies that first piqued my interest in hypnosis and prompted me to start training in it. By now, I’ve also conducted well over a thousand hypnosis sessions and have seen its effectiveness in “real life,” not just on paper. In fact, sometimes it works even better than you might expect! The studies generally use a standardized treatment protocol of six sessions, but I have seen dramatic results after just a few appointments.
I’m thinking of one child I recently saw for abdominal pain that recurred every night, severe enough to make him cry and disrupt the whole family’s sleep. Despite months of suffering, he was able to resolve his pain and return to a normal sleep pattern after only two visits. He was understandably proud of the way he had learned to help himself, using creative and decidedly un-standardized imagery—including light sabers and marshmallows!
Clinicians’ Reactions to the New Guidelines
I’ve been visiting local pediatric practices to go over the guidelines since they were published. The reactions have been quizzical, confused, and even shocked. Because even though the studies on hypnosis for abdominal pain have been around for years, somehow, they have flown “under the radar.”
I think there are a few reasons for this under-recognition:
- Misperception. Most people are familiar only with the Hollywood or stage versions of hypnosis, used either for nefarious purposes or to generate laughs. (We definitely have a branding issue in the clinical hypnosis world.)
- Access. It can be hard to find a clinician versed in the use of hypnosis for abdominal pain. Even if someone has hypnosis training, they may be familiar with its use only for the treatment of anxiety-related conditions.
- Time commitment. Hypnosis is not meant to be a “quick fix.” The standard protocols last for about three months and require regular practice. It is often more appealing—both to doctors and to their patients—to try yet another medication in the hope that it will lead to an immediate decrease in symptoms.
My hope is that, with the publication of the guidelines, more healthcare providers will be motivated to learn about the uses of this powerful technique and pursue training to offer it as a treatment in their own offices. In fact, this coming spring, for the first time, the American Society of Clinical Hypnosis will be offering a training program specifically for pediatric GI providers.
If your child is seeing a gastroenterologist for chronic abdominal pain and clinical hypnosis hasn’t been raised as a treatment option, ask about it! You may inspire your provider to reevaluate the new guidelines and become an early adopter of these evidence-based practices.
