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Summary: Functional abdominal pain, defined as recurrent abdominal pain in the absence of an identifiable physiologic cause, can respond to psychological intervention in appropriate patients. In this patient series, functional abdominal pain of 4 of 5 pediatric patients resolved within 3 weeks after a single session of instruction in self-hypnosis. The potential impact of widespread application of such hypnotherapy may be large, because abdominal pain is thought to be the most common recurrent physical symptom attributable to psychological factors among children and adolescents. Clin Pediatr. 2001;40:447-451
Introduction
Children and adolescents are known to present with physical symptoms attributable to psychological illness.1-5 In some patients an organic disease may be the cause of psychological problems that are manifested as physical symptoms in addition to those attributable to the organic disease, while in others a primary psychological disorder such as anxiety or depression can present with somatic symptoms.2,4 Once organic disease has been adequately evaluated, patients with symptoms thought to be amenable to psychological treatment can receive various therapies including pharmacotherapy, counseling, physical or occupational therapy, and training in biofeedback, hypnosis, meditation, or relaxation techniques.2,4
Functional abdominal pain, defined as recurrent abdominal pain in the absence of an identifiable physiologic cause, is an example of a symptom that can respond to psychological intervention in appropriate patients. 14,6 The following patients demonstrate that functional abdominal pain in childhood can resolve after a single sermon of inst in self-hypnosis.
Methods
The 5 patients described herein represent all pediatric patients with a primary diagnosis of functional abdominal pain who were referred for hypnotherapy at the SUNY Upstate Medical University in 1999-2000.
Self-hypnosis was taught to the patients individually in 1-hour sessions. Four of the patients returned for 1 or 2 follow-up sessions after resolution of their abdominal complaints. Imagery used for hypnosis was developed with input from each patient. The order of self-hypnosis steps that was introduced included the following: (1) imagination of what might be perceived by all 5 senses in a relaxing place of the patients' choice; (2) progressive relaxation from head to feet; (3) choosing a sign as a reminder of how to relax when the patient is not in a state of hypnosis; (4) an opportunity to control the abdominal pain by its hypnotic induction...