[http://www.reuters.com/article/2012/02/23/us‐hypnosis‐idUSTRE81M22C20120223] Feb 23, 2012 Hypnosis May Help Kids' Stomach Woes Long-Term By Amy Norton NEW YORK (Reuters Health) - Hypnosis may bring lasting relief to some kids with irritable bowel syndrome or chronic stomach pain, a small study suggests. Researchers found that of 52 children with the tummy troubles, those who had six hypnosis sessions -plus at-home "self-hypnosis" -- were still doing well five years later. More than two-thirds were free or mostly free of abdominal pain. That compared with just 20 percent of kids who were given standard therapy alone. Researchers led by Dr. Arine M. Vlieger, of St. Antonius Hospital in the Netherlands, reported the results in the American Journal of Gastroenterology. Many people may think of hypnosis as someone waving a pocket watch in front of your face, then making you do strange things, noted Miranda van Tilburg, an assistant professor of medicine at the University of North Carolina at Chapel Hill. But in medicine, hypnosis is used to help people create relaxing images in their minds to ease symptoms like pain and anxiety, explained van Tilburg, who was not involved in the current study but researches and uses "guided imagery" -- basically, self-hypnosis -- for kids' abdominal pain. "Gut-directed" hypnotherapy may, for instance, suggest images for normalizing bowel function -- like picturing a smoothly flowing river. A number of studies since the 1980s have found that hypnosis helps some people with irritable bowel syndrome (IBS) when standard treatment fails. There's also evidence it can help kids with so-called functional abdominal pain. Functional abdominal pain -- which is thought to affect up to 20 percent of children -- refers to persistent stomach pain that cannot be traced to a particular disorder. IBS involves abdominal pain too, but people also have bouts of constipation, diarrhea or both. Often, tactics like diet changes, pain medication or extra fiber are enough to ease the symptoms of either disorder. When that fails, there's behavioral therapy. Cognitive behavioral therapy -- which targets the unhealthy thinking patterns and behaviors that can contribute to health problems -- has been shown to help some cases of IBS or functional abdominal pain. But no one knows yet if cognitive behavioral therapy helps beyond one year, van Tilburg pointed out. The current findings are important, she told Reuters Health, because they suggest that hypnosis can offer lasting relief. "We've known that it has short-term effects, six months to a year," said van Tilburg. "But the hope is that people will master the skill, and then practice it as a lifelong skill." It's not clear whether kids in this study did keep using self-hypnosis over the long term, van Tilburg noted. But the advantage in pain relief was still there. The findings are based on 52 children and teenagers who were randomly assigned to either have gutdirected hypnotherapy or stick with standard care alone, like diet changes and fiber. Kids in the hypnosis group had six sessions with a therapist and were given CDs to help them practice self-hypnosis at home. Five years later, 68 percent of kids in the hypnosis group were still largely free of abdominal pain, compared with 20 percent of kids who'd received only standard care. The hypnosis group was also faring better in other symptoms, like bloating and bowel problems. It's not clear why hypnosis might help with abdominal pain or other gut symptoms, according to van Tilburg. One theory had been that it alters pain sensitivity in the intestines, she noted -- but recent research suggests that's not what is happening. Instead, hypnosis might affect how the brain processes pain signals from the gut. But for now, that's speculation, van Tilburg said. One obstacle to trying hypnosis for your child's belly problems is availability. More psychologists and pediatricians are doing training in hypnosis these days, Vlieger told Reuters Health by email. But there's still a dearth of properly trained professionals, van Tilburg said. And, she cautioned, "there are a lot of people out there who call themselves hypnotherapists, but they don't have the right training to treat medical conditions." If parents want to find a health professional who uses hypnosis, van Tilburg suggested trying the American Society of Clinical Hypnosis website, www.asch.net. Of course, there's a cost, which only some insurance plans would cover. Six or seven hypnotherapy sessions could run around $1,000, on average. Van Tilburg and her colleagues are looking at making the therapy more widely available via CD. In a small 2009 study, they found that kids who learned self-hypnosis by CD were able to soothe their functional abdominal pain over eight weeks; nearly three-quarters said their pain had lessened by at least half. Vlieger said her team is now doing a clinical trial to compare CD-based self-hypnosis against face-to-face hypnosis with a therapist. They should know how the two tactics size up -- in effectiveness and costs -- in about two years. SOURCE: Arine M Vlieger, Juliette M T M Rutten, Anita M A P Govers, Carla Frankenhuis and Marc A Benninga. Long-Term Follow-Up of Gut-Directed Hypnotherapy vs. Standard Care in Children With Functional Abdominal Pain or Irritable Bowel Syndrome. American Journal of Gastroenterology, online February 7, 2012. bit.ly/ADnKXt CONCLUSIONS: The beneficial effects of gut-directed HT are long lasting in children with FAP or IBS with two thirds still in remission almost 5 years after treatment, making it a highly valuable therapeutic option.