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Published online October 12, 2009
PEDIATRICS (doi:10.1542/peds.2009-0028)
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Audio-Recorded Guided Imagery Treatment Reduces Functional Abdominal Pain in Children: A Pilot Study

Miranda A.L. van Tilburg, PhDa, Denesh K. Chitkara, MDa, Olafur S. Palsson, PsyDa, Marsha Turner, MAa, Nanette Blois-Martin, PNPa, Martin Ulshen, MDb, William E. Whitehead, PhDa

aCenter for Functional Gastrointestinal and Motility Disorders, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; and
bDepartment of Pediatrics, Division of Gastroenterology, Hepatology, and Nutrition, Duke University Medical Center, Durham, North Carolina

Objective This study was designed to develop and to test a home-based, guided imagery treatment protocol, using audio and video recordings, that is easy for health care professionals and patients to use, is inexpensive, and is applicable to a wide range of health care settings.

Methods Thirty-four children, 6 to 15 years of age, with a physician diagnosis of functional abdominal pain were assigned randomly to receive 2 months of standard medical care with or without home-based, guided imagery treatment. Children who received only standard medical care initially received guided imagery treatment after 2 months. Children were monitored for 6 months after completion of guided imagery treatment.

Results All treatment materials were reported to be self-explanatory, enjoyable, and easy to understand and to use. The compliance rate was 98.5%. In an intention-to-treat analysis, 63.1% of children in the guided imagery treatment group were treatment responders, compared with 26.7% in the standard medical care–only group (P = .03; number needed to treat: 3). Per-protocol analysis showed similar results (73.3% vs 28.6% responders). When the children in the standard medical care group also received guided imagery treatment, 61.5% became treatment responders. Treatment effects were maintained for 6 months (62.5% responders).

Conclusion Guided imagery treatment plus medical care was superior to standard medical care only for the treatment of abdominal pain, and treatment effects were sustained over a long period.

Key Words: abdominal pain • functional colonic diseases • guided imagery • hypnosis • self administration

Accepted Jun 3, 2009.


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