Gut-directed hypnotherapy for functional abdominal pain or
irritable bowel syndrome in children: a systematic review Journal
club presentation 30.4.13 Rohini Rattihalli
Slide 2
Summary of paper Critically appraise against checklist
Slide 3
Abstract Systematic review to assess efficacy of HT in
paediatric FAP/IBS patients. Three RCT comparing HT to a control
treatment were included with sample sizes ranging from 22 to 52
children. All trials showed statistically significantly greater
improvement in abdominal pain scores among children receiving HT.
Therapeutic effects of HT seem superior to standard medical care in
children with FAP or IBS.
Slide 4
Introduction Functional abdominal pain (FAP) and irritable
bowel syndrome (IBS) are characterised by chronic or recurrent
abdominal pain without evidence of any underlying organic disorder.
affecting approximately 20% of all children. braingut axis standard
medical care: dietary advice, education and medication.
Slide 5
Methods Medline, Embase, PsychINFO, Cumulative Index to Nursing
and Allied Health Literature databases and the Cochrane Central
Register of Controlled Trials Search strategy was based on the
strategy used by Webb et al15 in their Cochrane Review. reference
lists of relevant studies identified in the literature search were
searched by hand No language restriction was applied.
Hypnotherapy/GI
Slide 6
Slide 7
Slide 8
Slide 9
Slide 10
Screening questions 1. Did the review address a clearly focused
issue? Trials for randomised controlled trials (RCT) in children
with FAP or IBS, investigating efficacy of HT on the following
outcomes: abdominal pain scores, quality of life, costs and school
absenteeism. 2. Did the authors look for the appropriate sort of
papers? RCTs Hypnotherapy and Guided imagery
Slide 11
3. Do you think that all the important, relevant studies were
included? All search terms not mentioned References checked No
language restrictions. No mention of - personal contact with
experts - search for unpublished as well as published studies
Slide 12
4. Did the review's authors do enough to assess the quality of
the included studies Delphi criteria and scores: ? Tabulated for
exact criteria met Bias Randomised Similar at baseline Person
assessing outcomes blind to allocation
Slide 13
5. If the results of the review have been combined, was it
reasonable to do so? Not combined Different outcomes Small
numbers
Slide 14
What are the overall results of the review? More studies
needed! Results not pooled NNT not expressed (outcome not binary)
Therapeutic effects of HT seem superior to standard medical care in
children with FAP or IBS.
Slide 15
How precise are the results? No CI
Slide 16
Can the results be applied to my patient care? No mention of
source of patients in individual papers Local accessibility for
hypnotherapy services
Slide 17
Were all clinically important outcomes considered? Costs (and
therefore local availability) not assessed Are the benefits worth
the harms and the costs No side effects noted. Costs not looked
into.