Mysterious Pain

Amanda became part of the University of Arizona study early this year. Her experience with RAP was fairly typical. She first suffered cramping and bloating last Thanksgiving weekend, then continued to have stomachaches once or twice a week. Several weeks later she started having pain every other day. "It really began to dig into her activities like Girl Scouts and gymnastics," says Ann Mellencamp. "She used to love to go to sleepovers, but now she's more reluctant." When a battery of tests ruled out the usual suspects, Amanda was diagnosed with RAP and referred to the researchers at the University of Arizona.

During the study, the children have four sessions with a health psychologist. Half of them learn deep-breathing relaxation techniques, while the other half are schooled in guided imagery and muscle relaxation. The children are then instructed to practice the guided imagery twice a day, every day, and during times of distress. They also keep a diary of their daily occurrences of pain.

"The daily practice is aimed at preventing abdominal pain, but they can also use guided imagery to cope when they get in a stressful situation and have the pain," Ball says. Exactly how it works is uncertain, he says, but it may be that stress inhibits food from moving smoothly through the digestive system, and that relaxation techniques, by relieving the stress, may ease digestion and thus ease the pain, too.

Based on his own experience treating RAP, Cochran -- who sometimes refers patients to therapists who teach them relaxation techniques -- thinks the Arizona study makes a lot of sense. "It's a reasonable approach to treating RAP," he says. "I look forward to the results of the study." Since the study will continue through fall of 2001, the answers are still some time away.

In the meantime, guided imagery may already be helping patients like Amanda. So far, the balloon-and-hot-tea scenario has been working pretty well for her. Her stomachaches occur less often now, and they upset her less because she knows how to cope. "Instead of crying," she says, "I'm taking care of the pain."