Abstract
BackgroundChildren with pain-related functional gastrointestinal disorders (P-FGIDs) have an increased risk for school absenteeism, depression, anxiety and low quality of life. Exposure-based cognitive behavior therapy (CBT) has shown large treatment effects in adults with irritable bowel syndrome, but has not been tested for children 8–12 years with P-FGIDs.AimThe aim of this trial was to test the feasibility, acceptability and potential efficacy of a newly developed exposure-based CBT for children with P-FGIDs.MethodThe children (n = 20) with a P-FGID, were referred by their treating physicians. The participants received 10 weekly sessions of exposure-based CBT and were assessed at pre-treatment, post-treatment and 6-month follow-up.ResultsChildren improved significantly on the primary outcome measure pain intensity at post (Cohen’s d = 0.40, p = 0.049) and at 6-month follow-up (Cohen’s d = 0.85, p = 0.004). Improvements were also seen in pain frequency, gastrointestinal symptoms, quality of life, depression, anxiety, school absenteeism and somatic symptoms. Improvements were maintained or further increased at 6-month follow-up. The children engaged in the exposures and were satisfied with the treatment.ConclusionsExposure-based CBT for children with P-FGIDs is feasible, acceptable and potentially efficacious.
Highlights
Pain-related functional gastrointestinal disorders (P-FGIDs) are characterized by abdominal pain without an organic explanation
Improvements were seen in pain frequency, gastrointestinal symptoms, quality of life, depression, anxiety, school absenteeism and somatic symptoms
Patients with irritable bowel syndrome (IBS) have marked fecal disturbances accompanying the pain, whereas patients with functional dyspepsia (FD) have pain located to upper abdomen and patients with functional abdominal pain (FAP) experience pain in the lower or all of the abdomen [2]
Summary
Pain-related functional gastrointestinal disorders (P-FGIDs) are characterized by abdominal pain without an organic explanation. Pain is sometimes accompanied by other gastrointestinal symptoms such as bloating, nausea and fecal disturbances. Neither medication nor diet have been proven to be effective for children with P-FGIDs [6, 7], but different cognitive behavioral therapies (CBT) show promising results [7]. It is unclear which CBT components are effective [8]. Children with pain-related functional gastrointestinal disorders (P-FGIDs) have an increased risk for school absenteeism, depression, anxiety and low quality of life. Exposure-based cognitive behavior therapy (CBT) has shown large treatment effects in adults with irritable bowel syndrome, but has not been tested for children 8–12 years with PFGIDs.
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