August 09, 2022
2 minute read
Disclosures: The authors report no relevant financial information.
According to research, hypnotherapy and medical treatment, combined with psychological support, reduced symptoms of chronic nausea in pediatric patients with functional nausea and functional dyspepsia.
“Treatment of [functional nausea] is difficult and generally based on empirical strategies due to the lack of published therapeutic trials in chronic nausea. …Previous studies have suggested that hypnotherapy may be a promising treatment option for targeting the causative biopsychosocial factors of chronic nausea,” Pamela D. Browne, MD, PhD, from the Department of Pediatric Gastroenterology, Hepatology and Nutrition at Emma Children’s Hospital in Amsterdam, and colleagues wrote in Clinical gastroenterology and hepatology. “Led by the gut [hypnotherapy] is very effective in adults and children with functional abdominal pain and irritable bowel syndrome. … To our knowledge, no study has examined the effectiveness of [hypnotherapy] in children with chronic nausea.
In a randomized controlled trial, Browne and colleagues evaluated 100 pediatric patients (mean age, 14.7 years; 73% female) who met the Rome criteria for functional nausea (FN; 65%) or functional dyspepsia ( DF; 35%). Patients underwent either hypnotherapy (HT) and received six 50-60 minute sessions over 3 months, or standard medical treatment (SMT), which involved six visits to a pediatrician over 3 months and six additional sessions of a half hour of supportive therapy. . Children could start co-interventions, including HT or cognitive behavioral therapy, if treatment was not successful at 3 months.
The primary outcome was a reduction of at least 50% in the severity, incidence and frequency of nausea at 12 months, with secondary outcomes including improvement in abdominal pain, dyspeptic symptoms and health-related quality of life. Children were asked to rate symptoms of nausea in a 7-day diary, and researchers assessed outcomes at baseline, midline, after treatment, and at 6- and 12-month follow-ups.
Immediately after treatment and at 6-month follow-up, patients in the HT group had higher treatment success than in the TMS group (45% versus 26% and 57% versus 40%, respectively). Similar treatment success was reported between the groups at 12 months (60% versus 55%).
Researchers noted that NF patients who underwent HT had higher success rates during (40% vs. 13%) and after (50% vs. 23%) treatment, but there was no difference in success rates among patients with FD who received HT. Additionally, younger age was correlated with an increased success rate at 12-month follow-up (OR = 0.8; 95% CI, 0.652-0.982), although differences between intervention groups did not differ. were not significant.
The researchers further reported higher rates of adequate relief at 6 months in patients in the HT group (81% vs. 55%) and their parents (79% vs. 53%), although this measure was not significant in the HT group. patients (70% versus 55%). 66%) and parents (72% versus 57%) at 12 months.
Thirteen patients in the HT group and 15 in the SMT group initiated co-interventions, which increased treatment success rates to 62% in the modified HT group and 52% in the SMT group at 12 months follow-up.
“This study showed that hypnotherapy and medical treatment, combined with supportive therapeutic talks and education, were effective in reducing symptoms of chronic nausea in children diagnosed with FN or FD, with HT being more effective for the first 6 months after treatment, especially in the group of children with FN,” concluded Browne and colleagues. “Based on these findings and consistent with the shared decision-making approach, it It would be desirable to discuss both pharmacological therapies and HT as potential treatments, applied separately or in combination, for chronic nausea with children and parents during consultations.”