Functional Abdominal Pain

What is FAP?

Functional Abdominal Pain (FAP) was previously called Recurrent Abdominal Pain (RAP).  The diagnosis is made when the following occur at least once a week for at least 2 months:

1.    Episodic or continuous pain

2.    All diagnostic tests are negative.

One of the most commonly used medications for Irritable Bowel Syndrome (IBS) and FAP is amitriptyline, an antidepressant.  Studies have shown repeatedly that this medication is no more effective than placebo for this problem.^1,2

Hypnotherapy Offers Superior Treatment for Functional Abdominal Pain

A pioneering study of children and adolescents with Irritable Bowel Syndrome and FAP was done comparing hypnotherapy (HT) and standard medical therapy (SMT).  The HT group did far better both short-term and long-term.^3,4

In order to better describe this condition, I will tell you about “Jane” (not her real name),  a former patient of mine. 

Jane was 11 years old and had stomach aches on Monday, Tuesday, Wednesday, Thursday, and Friday mornings.  On Saturdays and Sundays, she was fine. Then, on Monday morning, that stomach ache would start again.

Now, you don’t have to be a doctor to figure this one out!  She was obviously experiencing “school avoidance,” also known as “school anxiety.”  Something at school was bothering her.

Perhaps it was a mean teacher, or a bully, or a certain subject that was challenging.

Remember, the pain was real!  She was not faking it.  And this was how Jane unconsciously dealt with her anxiety.   Fortunately, Jane had the insight to recognize this.

So, I asked her which was getting in the way of her life more, the worrying or the symptom? She replied, “Those tummy aches,” so we decided to work on those, first.

I told her, “You have a very smart tummy!  When you get a tummy ache like that, you know there is nothing physically wrong with you.  Rather, it’s because you’re upset about something, or something is bothering you!”

She was taught hypnosis skills to control and get rid of the tummy aches. After only 2 visits, the tummy aches were gone, she was able to return to school comfortably and confidently, and we worked on the worrying.  She also learned that when she was angry, this triggered the tummy aches, too.  So she learned cognitive behavioral therapy (CBT) skills to help her control the worrying and the anger.  We met a total of only 4 times.

I treat individuals of all ages, including children, adolescents, and adults, and I incorporate both hypnotherapy and TEAM-Cognitive Behavioral Therapy (CBT) for all of them. TEAM-CBT is the new, more powerful iteration of CBT, developed by David Burns, MD.

My home video program, Controlling Your Gut Feelings®, incorporates hypnotherapy, cognitive behavioral strategies, and motivational interviewing techniques, for patients with FGIDs (DBGIs). For more information about this online, video-streamed program, click here:  ControllingYourGutFeelings.com

References:

1.    Bahar RJ, Collins BS, Steinmetz B, Ament ME. Double-blind placebo-controlled trial of amitriptyline for the treatment of irritable bowel syndrome in adolescents. J Pediatr. 2008;152(5):685-689.

2.    Saps M, et al. Multicenter, Randomized, Placebo-Controlled Trial of Amitriptyline in Children With Functional Gastrointestinal Disorders. Gastroenterology. 2009 Oct;137(4):1261-1269.

3.    Vlieger AM, Menko-Frankenhuis C, Wolfkamp SC, Tromp E, Benninga MA. Hypnotherapy for children with functional abdominal pain or irritable bowel syndrome: a randomized controlled trial. Gastroenterology. 2007;133(5):1430-1436.

4.    Vlieger et al. Long-term follow-up of gut-directed hypnotherapy vs. standard care in children with functional abdominal pain or irritable bowel syndrome. Am J Gastroenterol. 2012 Apr; 107(4):627-31.