Effectiveness of hypnotherapy for paediatric abdominal pain in primary care: a randomised controlled trial

Background. Functional abdominal pain (FAP) and irritable bowel syndrome (IBS) are associated with anxiety, depression, school absenteeism and reduced quality of life in children. In secondary care, hypnotherapy is often available. Aim. To determine the effectiveness of home-based guided hypnotherapy for children with FAP or IBS in primary care. Design and setting. A pragmatic randomised controlled trial in Dutch primary care with a follow-up of 12 months. Methods. Children aged 7–17 years with FAP or IBS diagnosed by a general practitioner were included. The intervention group received home-based guided hypnotherapy via a website for 3 months in addition to care as usual. The control group received care as usual only. The primary outcome was adequate relief of abdominal pain and/or discomfort at 12 months. Adjusted odds ratios (aOR) and 90% confidence intervals (90%CI) are reported. Results. In total, 152 children were included. No significant differences were observed in adequate relief at 12 months (79.5% in the intervention group (58/73 children) versus 74.3% in the control group (52/70 children); aOR 1.47, 90%CI 0.74–2.93), but more children in the intervention group had adequate relief compared to the control group at 3 months (aOR 2.74, 90%CI 1.22–6.13) and 6 months (aOR 4.26, 90%CI 1.81–10.04). The intervention group also showed reductions in abdominal pain severity, intensity, frequency, and threat, and higher proportions of fast sleep onset. Conclusion. While adequate relief after 12 months is high in both groups, adding hypnotherapy to care as usual may help achieve earlier relief and reduce pain.