Intended for healthcare professionals

Clinical Review

Investigating dyspepsia

BMJ 2008; 337 doi: (Published 15 September 2008) Cite this as: BMJ 2008;337:a1400

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

1. Zagari RM, Fuccio L, Bazzoli F. Investigating Dypepsia. BMJ

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

Competing interests:
None declared

Competing interests: No competing interests

23 September 2008
Raj L Sharma
Specialist in Medical & Clinical Hypnosis
Royal London Homeopathic Hospital, UCLH NHS Foundation Trust. WC1N 3HR