Hypnotherapy, medical treatment reduces nausea in children with functional dyspepsia
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Both hypnotherapy and medical treatment, in combination with psychological support, reduced symptoms of chronic nausea among pediatric patients with functional nausea and functional dyspepsia, according to research.
“Treatment of [functional nausea] is challenging and generally based on empiric strategies because of the lack of published treatment trials on chronic nausea. ... Previous studies have suggested that hypnotherapy can serve as a promising treatment option to target the etiologic biopsychosocial factors of chronic nausea,” Pamela D. Browne, MD, PhD, of the department of pediatric gastroenterology, hepatology and nutrition at Emma Children’s Hospital in Amsterdam, and colleagues wrote in Clinical Gastroenterology and Hepatology. “Gut-directed [hypnotherapy] is highly effective in adults and children with functional abdominal pain and irritable bowel syndrome. ... To the best of our knowledge, no studies have 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% girls) who met Rome criteria for functional nausea (FN; 65%) or functional dyspepsia (FD; 35%). Patients underwent either hypnotherapy (HT) and received six 50- to 60-minute sessions over 3 months, or standard medical treatment (SMT), which entailed six visits to a pediatrician during 3 months and six additional, half-hour sessions of supportive therapy. Children could start co-interventions, including HT or cognitive behavioral therapy, in the absence of treatment success at 3 months.
The primary outcome was at least 50% reduction in severity, incidence and frequency of nausea at 12 months, with secondary outcomes including improvements in abdominal pain, dyspeptic symptoms and health-related quality of life. Children were asked to evaluate nausea symptoms in a 7-day diary, and researchers assessed outcomes at baseline, at the halfway mark, after treatment, and at 6- and 12-month follow-ups.
Immediately following treatment and at the 6-month follow-up, patients in the HT group had higher treatment success compared with the SMT group (45% vs. 26% and 57% vs. 40%, respectively). Similar treatment success was reported between groups at 12 months (60% vs. 55%).
Researchers noted patients with FN 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. In addition, younger age correlated with an increased success rate at the 12-month follow-up (OR = 0.8; 95% CI, 0.652-0.982), although differences between intervention groups were not significant.
Researchers further reported higher rates of adequate relief at 6 months among patients in the HT group (81% vs. 55%) and their parents (79% vs. 53%), although this metric was not significant among patients (70% vs. 66%) and parents (72% vs. 57%) at 12 months.
Thirteen patients in the HT group and 15 in the SMT group initiated co-interventions, which shifted treatment success rates to 62% in the modified HT group and 52% in the SMT group at the 12-month follow-up.
“This study showed that both hypnotherapy and medical treatment, in combination 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 during the first 6 months after treatment, especially in the group of children with FN,” Browne and colleagues concluded. “Based on these results and in line with the shared decision-making approach, it would be advisable to discuss both pharmacologic therapies and HT as potential treatments, applied separately or as a combination, for chronic nausea with children and parents during consultations.”
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