You may have noticed a resurgence of interesting posts on this blog; it’s all part of an orchestrated campaign to get more paediatric clinical evidence discussion going. As part of that, Archi’s been touting for folk to write a couple of hundred words on something they’ve learned recently – a highlight – arising from evidence.

This first ‘guest’ post is by Richard Hansen (@PaedsRH), a gastroenterologist and twitterer who offers his thoughts on the recent BSPHGAN meeting:

“The recent British Society of Paediatric Gastroenterology, Hepatology and Nutrition meeting in Manchester revealed, quite firmly, that you can indeed teach old dogs new tricks. Not only was this the first meeting of the Society to be live-tweeted throughout on Twitter (@BSPGHAN), but the variety of presentations from both paediatric and adult gastroenterologists mixed old and new ideas. One particularly entertaining and educationally stimulating talk came from Prof Peter Whorwell on the use of “hypnosis in irritable bowel syndrome”. From a title that almost bred ridicule from a hardened and sceptical audience came a talk that inspired consideration of whether this avenue is worthy of exploration in children.

IBS is often a difficult clinical problem and pharmacological therapy is not always helpful. Prof Whorwell discussed that hypnosis is easy to learn over a few weekends and can result in symptom improvement and long-term remission from IBS. Hypnosis helps IBS patients change the way they think without specific cognitive behavioural therapy. The therapy appears to reduce the suffering from, but not perception of, painful stimuli. Sometimes in a medical world full of dogma and expensive pharmacological therapies, a fresh thinking approach is needed. Hypnosis for IBS may be just the kind of treatment that is needed for this difficult condition.”

Mark Beattie, Editor-in-Chief of the Archives of Diseases in Childhood adds:

“Functional abdominal pain and irritable bowel syndrome are common in children, frequently seen by paediatricians and often difficult to manage. The underlying pathophysiological mechanisms are complex with many potential contributing factors, the impact on patients and their families can be considerable and treatment can be very difficult particularly in the most symptomatic cases.

In the April edition of the journal Rutten and colleagues report a systematic review of the evidence base for gut directed hypnotherapy in such children looking at impact on pain, quality of life and school attendance. The studies (limited) are generally positive and suggest significant benefit. Peter Whorwell in an accompanying editorial (and the authors of the review) suggest that we should consider hypnotherapy as a first line treatment option in children with functional abdominal pain and irritable bowel syndrome, and, certainly for a group of children we don’t manage particularly well, this should be considered as a potentially cost effective strategy that may have a positive long term impact for children and their families.”

Some may scoff at hypnosis. I’m not one of them – buy me a bitter (beer, not lemon) and you may find out the whole story.

Archi

(Sheep from Ionics)