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CLINICAL REVIEW: Rocco Maurizio Zagari, Lorenzo Fuccio, and Franco Bazzoli Investigating dyspepsia BMJ 2008; 337: a1400 [Full text]

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At least recommend hypnotherapy for Functional Dyspepsia

Raj L Sharma   (23 September 2008)

At least recommend hypnotherapy for Functional Dyspepsia 23 September 2008
Raj L Sharma, Specialist in Medical & Clinical Hypnosis Royal London Homeopathic Hospital, UCLH NHS Foundation Trust. WC1N 3HR Send response to journal: Re: At least recommend hypnotherapy for Functional Dyspepsia	Zagari's article on investigating dyspepsia (1) recommends that functional dyspepsia be treated initially by H.Pylori eradication therpay, even though only "10% of patients with functional dyspepsia benefit from H pylori eradication when compared with placebo" (2). What? Just because its a one-off treatment doesnt make it a justifiable longterm approach. The article proceeds further by stating "reassurance and explanation of the benign nature of symptoms may be the best treatment for functional dyspepsia and may be sufficient for many patients. Prokinetics, antidepressants, and spasmolytics should be reserved for patients with refractory disease." Ok. What about the use of hypnotherpay for functional dypepsia by Calver et al (3)? This well conducted RCT clearly showed the benefits of hypnotherapy in this functional disorder, and states that "Hypnotherapy is highly effective in the long-term management of FD. Furthermore, the dramatic reduction in medication use and consultation rate provide major economic advantages." Need I say more. I think the author should have stuck to reviewing investigations for dyspepsia, as stated in the title, and left the management for another time. 1. Zagari RM, Fuccio L, Bazzoli F. Investigating Dypepsia. BMJ 2008;337:a1400 2. Tack J, Talley NJ, Camilleri M, Holtmann G, Hu P, Malagelada JR, et al. Functional gastroduodenal disorders. Gastroenterology 2006;130:1466-79. 3. Calvert EL, Houghton LA, Cooper P, Morris J, Whorwell PJ. Long-term improvement in functional dyspepsia using hypnotherapy. Gastroenterology 2002;123;6;1778-85 Competing interests: None declared