International Foundation for Functional Gastrointestinal Disorders
IFFGD
700 W. Virginia St., #201 Milwaukee, WI 53204
Phone: 414-964-1799 Toll-Free (In the U.S.): 888-964-2001
Fax: 414-964-7176
Internet: www.iffgd
(837) © Copyright 2007-2012 by the International Foundation for Functional Gastrointestinal Disorders Report from IFFGD Rearch Award Winner:
Home Bad Guided Imagery to Treat Pediatric Functional Abdominal Pain Making one of the most effective treatments for FAP available to the majority of children with this disorder
By: Miranda A. L. van Tilburg, Ph.D., University of North Carolina Center for Functional GI and Motility Disorders, Chapel Hill, NC
yeshiIntroduction
Functional Abdominal Pain (FAP) is a common childhood disorder defined by the American Academy of Pediatrics and the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition as “long lasting intermittent or constant abdominal pain without evidence of an organic cau.” It afflicts 8–20% of children and is associated with disability and decread quality of life.
FAP is a frustrating condition for the family. The stomachaches and accompanying symptoms are unpredictable and not easily modifiable. Children may miss school and miss out on other things such as peer and family events. Many parents feel unable to cope and rely on medical professionals for diagnosis and treatment. Since there is no readily identifiable cau for FAP, treatment is focud on reductions of symptoms and disability rather than a cure. Standard medical care consists of reassurance that nothing major is wrong with the child, education, tting of realistic treatment goals
and medications to relieve symptoms. This approach is helpful, but in many cas children continue to have debilitating symptoms and are in need of additional therapies.
Guided imagery: a non medicated way to
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Behavioral treatments have been shown to be effective for the treatment of FAP. Guided imagery and lf-hypnosis, which are two related techniques, are widely ud to treat all sorts of pain – from headaches and stomachaches to pain resulting from medical procedures such as bone marrow aspirations, in both children and adults. Two recent placebo controlled studies, one by Weydert and colleagues (published in BMC Pediatrics 2006) and another by Vlieger and colleagues (published in Gastroenterology 2006), show that guided imagery and lf-hypnosis are very effective at treating FAP, with 70%–85% of patients cured at follow-up.
erinIn guided imagery the therapist us verbal guidance to help the patient experience detailed vivid imagery that has beneficial effects on their behavior, cognitions, emotions, or physiology. An example that is often ud to demonstrate the effect of guided imagery on your body is to imagine that you are holding a fresh, juicy lemon in your hand. As you pick up the lemon you are struck by its
bright yellow color and feel the bumpy texture of its skin. You cut a piece of th
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e lemon and can smell the lemon’s tart aroma that fills the air. Imagine you stick this piece in your mouth and suck on it. You can taste the sour flavor as the juices roll over your tongue . . . More than likely your body reacted in some way to that imagery. For example, you may have begun to salivate. Children are especially good candidates for guided imagery as they are ud to imaginative play and have a natural ability to get absorbed in stories and experience them vividly in their mind.
Making guided imagery available to all FAP patients Guided imagery is very effective for pain control, widely liked by children, and has no known side effects. However, guided imagery is currently not available to the majority of children with pain problems. There is a shortage of trained therapists who specialize in pediatric pain and the treatment is costly and time consuming. To overcome the challenges, Olafur Palsson, Psy.D., Marsha Turner, M.S., and I developed a 2-month home bad program in which guided imagery is delivered through audio and video materials that can be prescribed by any health care professional such as a therapist, pediatrician, or school nur who do not need to be trained in guided imagery and do not need to deliver any of the
treatment in person. We therefore eliminated the need for a therapist and for weekly visits as well as greatly reducing the cost of the treatment.
The treatment materials are given to the child who can u them independently at home. The materials consist of a bag containing:
1.An instructional DVD that is watched by the
人与自然 英语作文children and their parents.
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2.Three biweekly ssions and a booster ssion of
about 25 minutes each, delivered through CDs.
3.Three daily ssions (one ud each day)
delivered through CDs.
4. A calendar on a clipboard showing the child whensjt
to u the ssions. The child puts stickers on the
calendar after practice ssions to track
compliance.
All materials are lf-explanatory. Parents are assigned as ‘problem solvers’ and clinicians are ‘on call’ if problems ari.
This picture shows a child receiving guided imagery treatment at home. All that is required from the child is to listen to the CDs daily (or at least 5 days each week) and imagine as well as he or she can everything that is heard in the recordings.
In a randomized trial we compared the home bad guided imagery program described above to standard medical care in a group of 30 children. All children reported that they enjoyed listening to the CD’s; compliance was 98.5%; parents did not need to be involved; and nobody contacted the rearch staff with questions, showing the acceptability and feasibility of the treatment. Abdominal pain frequency and duration were significantly lower after treatment in the guided imagery group versus the standard medical care group. Eighty-five percent (85%) of children in the guided imagery group were defined as treatment success with parents reporting their child’s symptoms to be somewhat to remarkably better.
Thus, home-bad guided imagery is successful at treating children’s pain, is low in cost, and easy to administer. The treatment was well liked and accepted by both parents and children who felt a ne
w n of control over the pain. It gave families a non-medicated alternative to treating their child’s pain. We included children who were new to a pediatric GI clinic. The were not only patients where prior treatment was unsuccessful, children with vere symptoms or children with a concurrent psychiatric diagnosis. In fact the treatment worked well for children independent of the factors and can therefore be applied as a first line treatment modality. One of the children in our study gave us this great quote: “I ud to u medications for my stomachaches. But now guided
i magery is my medication and it doesn’t even taste bad.”How can I obtain the program?
Currently the program is only available to children participating in rearch studies at the University of North Carolina at Chapel Hill and Goryeb Children’s Hospital in New Jery. We are working hard to make this treatment available within the next year for limited u. Clinicians working with chronic pain patients can sign up for our e-mail list at We will notify them about any developments in the availability of this treatment.
We do not intend to make this program available directly to the general public any time soon. During its testing phas – which may take veral years – the program can only be prescribed by a health care provider. If you are a parent of a child suffering from functional abdominal pain, plea contact your health care provider.
Opini ons expresd are an author’s own and not necessarily tho of the International Foundation for Functional Gastrointestinal Disorders (IFFGD). IFFGD does not guarantee or endor any product in this publication nor any claim made by an author and disclaims all liability relating thereto.
This article is in no way intended to replace the knowledge or diagnosis of your doctor. We advi eing a physician whenever a health problem aris requiring an expert's care.
IFFGD is a nonprofit education and rearch organization. Our mission is to inform, assist, and support people affected by gastrointestinal disorders. For more information, or permission to reprint this article, write to IFFGD, 700 W. Virginia St., #201,
Milwaukee, WI 53204. Toll free: 888-964-2001. Visit our websites at: www.iffgd or www.aboutkidsgi.
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