Family therapy helps ease kids’ stomach pain

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Kids suffering from unexplained tummy aches can feel better if they—and their parents—get some therapy, according to a new study.

Doctors, the researchers say, need to recognize parents’ role in how well a child is able to cope and function with this sort of pain. “Parent education and support for encouraging coping and wellness behaviors in their children may be an important aspect of working with these families,” they write in the American Journal of Gastroenterology.

So-called functional abdominal pain, which has no apparent physical cause, is a common problem among children, Dr. Rona L. Levy of the University of Washington in Seattle and her colleagues note. Drugs have little benefit in treating this type of stomach pain, they add, which can often persist into adulthood and may be related to irritable bowel syndrome.

When parents respond in a concerned, fearful way to their children’s reports of stomach problems and pain, Levy and her team say, this can make a child’s symptoms worse. Examples of such “solicitous” responses might include letting the child stay home from school and bringing him or her gifts and treats.

To investigate whether addressing how children and their parents cope with pain might help treat unexplained abdominal pain, Levy and her colleagues randomly assigned 200 parent-child pairs to a “Social Learning/Cognitive Behavioral Therapy” group or an education support group. The children ranged in age from 7 to 17.

The therapy group participated in three sessions that included relaxation training and discussion on how to move from unhelpful coping strategies to helpful approaches. In the education support group, parent-child pairs received the same amount of attention and time from therapists, but their sessions included information only on the anatomy and function of the gastrointestinal system and nutritional guidelines.

While both groups showed improvements, children’s “pain intensity” as reported by their parents and the severity of their stomach complaints as reported by both parents and kids improved more in the therapy group than in the education group.

Children in the therapy group also showed greater increases in their ability to distract themselves and ignore their pain, while their parents responded in more appropriate ways to the child’s pain.

“Most importantly,” the researchers say, many of these differences were maintained 6 months after the intervention.

Based on their findings, the researchers think that referral of kids with unexplained stomach pain and their parents to trained behavior therapists “may be appropriate in some situations.”

SOURCE: American Journal of Gastroenterology, online March 9, 2010.

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