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Page last updated at 06:35 GMT, Monday, 12 October 2009 07:35 UK
Abdominal pain is common in children
Children can be taught to use their imagination to tackle frequent bouts of stomach pain, research shows.
A relaxation-type CD, asking children to imagine themselves in scenarios like floating on a cloud led to dramatic improvements in abdominal pain.
The US researchers said the technique worked particularly well in children as they have such fertile imaginations.
It has been estimated that frequent stomach pain with no identifiable cause affects up to one in five children.
The research, published in the journal Pediatrics, follows on from studies showing hypnosis is an effective treatment for a range of conditions known as functional abdominal pain, which includes things like irritable bowel syndrome.
There is really a dearth of information on how to manage children with abdominal pain


In this study, the children had 20 minute sessions of "guided imagery" - a technique which prompts the subject to imagine things which will reduce their discomfort.
One example is letting a special shiny object melt into their hand and then placing their hand on their belly, spreading warmth and light from the hand inside the tummy to make a protective barrier inside that prevents anything from irritating the belly
The researchers, from the University of North Carolina and Duke University Medical Center, said a lack of therapists led them to the idea of using a CD to deliver the sessions.
In all 30 children aged between six and 15 years took part in the study - half of whom used the CDs daily for eight weeks and the rest of whom got normal treatment.
Among those who had used the CDs, 73.3% reported that their abdominal pain was reduced by half or more by the end of the treatment course compared with 26.7% in the standard care group.
In two-thirds of children the improvements were still apparent six months later.
It is not clear exactly how the technique works but studies have shown it is partly about reducing anxiety but there is also a direct effect on the pain response.
Some researchers think hypnosis-like techniques reduce "hypersensitivity" in conditions such as irritable bowel syndrome.
Study leader Dr Miranda van Tilburg said it was especially exciting that the children were able to use the technique on their own.
"Such self-administered treatment is, of course, very inexpensive and can be used in addition to other treatments, which potentially opens the door for easily enhancing treatment outcomes for a lot of children suffering from frequent stomach aches.
"Children are very good at using their imagination - when you use this in adults you have to overcome a barrier first."
Professor David Candy, a consultant paediatric gastroenterologist at Western Sussex Hospitals, said his team had tried hypnosis in a small group of children with severe abdominal pain problems and had 100% success rate.
He added they are now keen to try the guided imagery technique to see if they can replicate the US findings.
"There is really a dearth of information on how to manage children with abdominal pain and it's a very common problem which keeps children out of school."
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Jo Cameron only realises her skin is burning when she smells singed flesh. She often burns her arms on the oven, but feels no pain to warn her.
That's because she is one of only two people in the world known to have a rare genetic mutation.
It means she feels virtually no pain, and never feels anxious or afraid.
It wasn't until she was 65 she realised she was different - when doctors couldn't believe she didn't need painkillers after a serious operation.
When she had surgery on her hand, doctors warned her she should expect pain afterwards.
When she felt nothing, her anaesthetist - Dr Devjit Srivastava - sent her to pain geneticists at University College London (UCL) and Oxford University.
After tests, they found gene mutations which meant that she did not feel pain like most people.
Jo, from Whitebridge, near Inverness, told the BBC Scotland news website that doctors didn't believe her when she said she wouldn't need pain relief after surgery.
"When he found I hadn't had any, he checked my medical history and found I had never asked for painkillers."
That's when she was referred to specialists in England.
Once diagnosed, Jo realised that she wasn't just "incredibly healthy", as she'd believed.
She said: "Looking back, I realise I hadn't needed painkillers, but if you don't need them you don't question why you don't.
"You are what you are, until someone points it out you don't question it. I was just a happy soul who didn't realise there was anything different about me."
She didn't even feel pain during childbirth, recalling: "It was just strange, but I didn't have pain. It was quite enjoyable really."
Jo does the Scotch Bonnet chilli challenge
Jo wouldn't change anything, but thinks pain is important and says: "Pain is there for a reason, it warns you - you hear alarm bells.
"It would be nice to have warning when something's wrong - I didn't know my hip was gone until it was really gone, I physically couldn't walk with my arthritis."
Doctors believe she might also be able to heal more quickly than normal. This particular combination of genes also makes her forgetful and less anxious.
"It's called the happy gene or forgetful gene. I have been annoying people by being happy and forgetful all my life - I've got an excuse now," she said.
Could Jo's genes hold the key to helping others?
Jo said recently she had a "minor bump" in the car, but was unmoved by what many would have found an upsetting experience.
"I don't have adrenalin. You should have that warning, it's part of being human, but I wouldn't change it."
The other driver, she said, was "shaking like anything", but she was able to stay calm. "I don't get that reaction... it's not brave, the fear just doesn't happen."
The researchers say it's possible there are more people like Jo.
"One out of two patients after surgery today still experiences moderate to severe pain, despite all advances in pain killer medications. It remains to be seen if any new treatments could be developed based on our findings," said Dr Srivastava.
"The findings point towards a novel painkiller discovery that could potentially offer post-surgical pain relief and also accelerate wound healing. We hope this could help the 330 million patients who undergo surgery globally every year."
Jo's case is the subject of a paper published in the British Journal of Anaesthesia, written by Dr Srivastava and Dr James Cox, of UCL.
Dr Cox said: "People with rare insensitivity to pain can be valuable to medical research as we learn how their genetic mutations impact how they experience pain, so we would encourage anyone who does not experience pain to come forward.
"We hope that with time, our findings might contribute to clinical research for post-operative pain and anxiety, and potentially chronic pain, PTSD and wound healing."
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