Morphine 1mg/5ml / Peppermint oil 1.5microlitres/5ml oral solution

Background/Objectives: In the current opioid crisis, medical hypnosis has been proposed as an alternative to opioids to control acute and chronic pain. The aim of this study was to use a meta-analysis to conduct an objective assessment of the value of medical hypnosis for the management of acute and chronic pain and opioid consumption. Methods: An initial PubMed search showed 111 relevant studies out of 1115. Twelve randomized controlled studies (RCTs) were identified, published from January 2014 to December 2024, focusing on acute and chronic pain. These RCTs were analyzed to compare the effects of medical hypnosis vs. standard care. Results: The use of medical hypnosis for acute pain was found to decrease pain by 0.54 standard deviations (SD) compared to the standard care, and the effect was medium and statistically significant (95% CI [0.19-0.90]; p = 0.0024). Oral morphine equivalents (OME) in the hypnosis group were 1.5 SD lower than in the placebo group, which was statistically significant (95% CI [0.12, 2.88]; p = 0.03). Unlike the effectiveness of hypnosis for acute pain treatment, hypnosis was not found to have any impact on the treatment of chronic pain. The mean pain value difference in the hypnosis group had little effect and showed a statistically insignificant result-a Hedges' g score of 0.07 (95% CI [-0.14-0.27]; p = 0.518). Conclusions: The use of medical hypnosis was associated with a statistically significant decrease in acute pain scores and OME, suggesting it is a potential alternative to opioids, but our analysis indicates that hypnosis does not reduce chronic pain.

Abstract licence: CC BY

The pathophysiology of functional gastrointestinal disorders (FGIDs) is still unclear and various complex mechanisms have been suggested to be involved. In many cases, improvement of symptoms and quality of life (QoL) in patients with FGIDs is difficult to achieve with the single-targeted treatments alone and clinical application of these treatments can be challenging owing to the side effects. Herbal preparations as complementary and alternative medicine can control multiple treatment targets of FGIDs simultaneously and relatively safely. To date, many herbal ingredients and combination preparations have been proposed across different countries and together with a variety of traditional medicine. Among the herbal therapies that are comparatively considered to have an evidence base are iberogast (STW-5) and peppermint oil, which have been mainly studied and used in Europe, and rikkunshito and motilitone (DA-9701), which are extracted from natural substances in traditional medicine, are the focus of this review. These herbal medications have multi-target pharmacology similar to the etiology of FGIDs, such as altered intestinal sensory and motor function, inflammation, neurohormonal abnormality, and have displayed comparable efficacy and safety in controlled trials. To achieve the treatment goal of refractory FGIDs, extensive and high quality studies on the pharmacological mechanisms and clinical effects of these herbal medications as well as efforts to develop new promising herbal compounds are required.

Abstract licence: CC BY