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Placebo decreases pain and medication use in children with functional abdominal pain or irritable bowel syndrome
Clinical Question
Do open-label placebos decrease pain and medication use in children with functional abdominal pain or irritable bowel syndrome?
Bottom line
In this small study, children with functional abdominal pain or IBS who knowingly took placebo had slightly lower pain scores and took less rescue medication. 1b-
Reference
Study design: Cross-over trial (randomized)
Funding: Government
Setting: Outpatient (specialty)
Synopsis
These researchers enrolled children, 8 to 18 years of age, with functional abdominal pain or irritable bowel syndrome (IBS) who were receiving care at 1 of 3 academic children’s centers. At the initial visit, the children were introduced to the general concept of placebos and then they began 7 days of daily self-pain assessments using a 0- to 100-mm visual analog scale (VAS). The children with pain 25 mm or greater (n = 30) were then randomized to receive the control (symptom diary plus rescue analgesics) or the intervention (the placebo and additional details about the placebo). After 3 weeks the participants crossed over to the other group. After all the researchers' fancy analyses (crossover studies are analytically complex), 70% of the children reported higher pain scores during the control period (average VAS scores 45.0 vs 39.9). These differences are not, however, clinically significant. More noteworthy, 53% of the children took rescue analgesics during the control period compared with 6.7% during the placebo period. That translates to a number needed to treat of 3 (95% CI 2 - 5).
Reviewer
Henry C. Barry, MD, MS
Professor
Michigan State University
East Lansing, MI
Comments
Colon irritable chez les enfants
Un peu difficile de mettre cette recherche dans la pratique!
Effect of placebo in IBS and fictional abdominal pain
The selected patients should clearly be ascertained as a case of fictional abdominal pain or IBS by am available investigation before a trial,because there's a likelihood of empaneling placebo for non organic abdominal pains sometimes depriving the patient the need for analgesics during the trial period And needless to say the probability of missing an acute abdomen in a peripheral set up should not be forgotten since both placebos and painkillers may seem effective even in lucid intervals of spasmodic bowel pains
ibs in children
placebos can be effective for pain control