Saturday, February 13, 2010

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Do you know a child who has chronic stomach aches?

Twenty percent of all children report stomach pains that have no identifiable cause. I was one of those children.

The pain, at times, crippled me and interfered with my ability to attend school, play sports or socialize.

During high school, my doctor believed that reducing anxiety while eating would be beneficial to me. For one year, I was allowed to eat lunch at home. The “treatment” did help reduce the frequency of attacks, but not the severity.

As defined by the American College of Gastroenterology, “Functional abdominal pain is pain that cannot be explained by any visible or detectable abnormality, after a thorough physical examination and appropriate further testing if needed.”

Although functional abdominal pain can be extremely painful and demobilizing, it isn’t life threatening. But there are consequences, causing children to miss school or limit their ability to participate in sports-related or extracurricular activities. Sometimes the condition translates into a loss of appetite and disruption of sleep.

Pain and interruptions of daily life can impact the child’s emotional health by causing depression, sadness and/or stress.

Treatment needs to be focused on helping a child have a satisfactory quality of life, which might include medication, education, stress management and coping skills. One method of helping children that has popped up in recent years is to use behavioral therapy, which has proven to be effective.

Although a solution, it can be expensive and requires time as well as access to a qualified therapist.

A study by the University of North Carolina at Chapel Hill and Duke University Medical Center published in the November 2009 issue of Pediatrics offers a different approach that can be used by parents with children at home at the time the pain is occurring.

In the study led by Dr. Miranda van Tilburg, a total of 19 out of 34 children ages 6 to 15 used a combination of standard medical treatment and audio recordings that included guided instructions. Seventy-three percent of those children self-reported that their pain had been lessened by half or greater.

In comparison, only 26 percent of the control group using only medical treatment reported similar results. Later, the control group also had the option of adding guided imagery to their treatment protocol, improving the overall rate for the control group to 58 percent.

Combining both groups, 62.5 percent of the children reported improvement for up to six months.

"Such self-administered treatment is, of course, very inexpensive and can be used in addition to other treatments, which potentially opens the door for easily enhancing treatment outcomes for a lot of children suffering from frequent stomach aches,” said Tilburg.

Tilberg’s program included listening to a set of four 20-minute guided imagery CDs biweekly in combination with 10-minute daily sessions. The children reported them pleasant and easy to use. Suggestions include things like floating on clouds or spreading warmth and light from the hand to the belly.

Although there are no clear answers about why or how the program works, other research has led to the belief that reducing anxiety is key. There are also indications that listening to guided imagery helps reduce the pain response.

The good news is that typically the onset of functional abdominal pain usually goes away on its own. Reportedly, most cases will disappear after a few weeks or a month, but some (like mine) will linger for years. Maybe the better news is that now there are more tools to help your child manage the pain.

Allyn Evans
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