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Children Use Guided Imagery to Reduce Abdominal Pain


Children who use guided imagery are nearly three times more likely to reduce their functional abdominal pain than those who use medical care alone, say researchers in a study published in the November 2009 issue of Pediatrics. This inexpensive approach to treatment of functional abdominal pain provides benefits for at least six months.

Functional abdominal pain is stomach pain that cannot be explained by any detectable or visible abnormality. According to the American College of Gastroenterology, nearly 25 percent of children who are seen for abdominal or intestinal problems have functional abdominal pain. The exact cause is unknown. Treatment can include anti-spasmodic drugs, laxatives, and antidepressants, along with changes to diet and behavior therapy to help children deal with the pain and stress.

In previous studies, researchers have found that guided imagery, when used along with behavioral therapy and medical care, has helped children reduce the pain associated with functional abdominal pain. The availability and expense of behavioral therapy, however, makes it inaccessible for many parents.

In a 2006 study conducted at Children’s Mercy Hospital in Kansas City, investigators evaluated children with abdominal pain who practiced either breathing exercises alone or guided imagery with progressive muscle relaxation. Those who used guided imagery and relaxation had significantly greater reduction in pain than those in the breathing exercise group.

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The current study, which was performed by investigators at the University of North Carolina at Chapel Hill and Duke University medical Center, involved 29 children ages 6 to 15 who had been diagnosed with functional abdominal pain. Fifteen children used guided imagery plus medical treatment for eight weeks and 14 received medical treatment alone. The children who used guided imagery were given CDs to use at home. The guided imagery CDs were developed by Miranda van Tilburg, PhD, assistant professor in the Division of Gastroenterology and Hepatology in the University of North Carolina School of Medicine.

Treatment with the guided imagery included four biweekly, 20-minute sessions and daily 10-minute sessions. As the children listened to the CDs, they were directed to imagine various relaxing scenarios to help them relax and reduce pain, such as imagining they were floating on a cloud while they practiced progressive relaxation.

Among the children who used the guided imagery CDs, 73.3 percent said their abdominal pain was reduced by 50 percent or more by the end of the eight-week study. Only 26.7 percent of the children who received medical treatment alone reported that level of pain relief. When the children in the medical treatment only group were later offered guided imagery sessions, 58.3 percent reported significant relief of abdominal pain. Overall, 62.5 percent of the children said the benefits of guided imagery lasted for six months.

The study’s authors concluded that guided imagery along with medical treatment provides significant and long-term improvement in pain among children who have functional abdominal pain. Use of guided imagery is an inexpensive alternative to costly and time-consuming behavioral therapy as well as an approach that allows children who suffer with functional abdominal pain to have a sense of control over their condition.

American College of Gastroenterology
EurekAlert October 12, 2009
Weydert JA et al. BMC Pediatrics 2006 Nov 8; 6:29