Researcher receives funding to develop an innovative new app for children with chronic abdominal pain

Dr. John Hollier, pediatric gastroenterologist at Texas Children’s Hospital, recently received a Mentored Patient-Oriented Research Career Development Award (K23) from the National Institutes of Health (NIH) to support the development of a novel health care delivery initiative. Hollier is interested in a group of disorders called functional abdominal pain disorders (FAPDs), a common health issue that affects about 15% of school-age-children and adolescents worldwide.  One of the most common FAPDs is irritable bowel syndrome.

“These children come to the attention of medical professionals when they come in complaining of chronic abdominal pain.  Affected children often have decreased quality of life compared to their healthy peers.  Unfortunately, their abdominal pain can be long-lasting – many pediatric patients with FAPDs continue to suffer similar pain as adults,” Hollier said.

One of the prevailing theories about FAPDs is the importance of the mind-gut connection.  Under normal circumstances, the brain does a good job of suppressing sensations from the gut. However, in some children with FAPDs, the brain’s ability to suppress pain sensations from the gut is impaired. Psychological therapies can be used to ‘retrain’ the brain to do a better job of suppressing gut pain sensations.

Unfortunately, access to effective psychological therapies like guided imagery therapy (GIT) is rarely offered to FAPDs patients due to many systemic hurdles. According to Hollier, “Most primary care physicians, pediatricians and pediatric gastroenterologists encounter children with FAPDs but are not trained to deliver psychological therapies directly to their patients. Even if all patients with FAPDs were referred to a psychologist, we do not have enough trained therapists nationally to deal with the sheer number of affected patients. More importantly, many patients and their families may hesitate to consult with mental health professionals due to lack of, or insufficient insurance coverage.”

To meet this huge demand for optimal care of FAPDs, Hollier proposes a non-traditional solution of turning smartphones into therapeutic devices that will deliver on-demand GIT to FAPDs patients. “Given how ubiquitous cell phones are and how popular they are among kids, we think this approach would be the ideal way to deliver effective ‘brain-gut training’ to patients. We developed a mobile smartphone application (app) prototype, which provides GIT to children with FAPDs anywhere, anytime they like.  We believe this approach will dramatically improve access to optimal care for many children with FAPDs and improve their quality of life,” Hollier added.

This mobile app has the potential to help many children with FAPDs but it is not ready for debut. Through his NIH grant support, the GIT mobile app is currently in a rigorous pre-development program.  Dr. Hollier’s multidisciplinary team will develop this app based on the feedback of various stakeholders.

“Based on the feedback we receive from our patients and their parents, physicians, and mental health clinician partners, we will refine the app to make it engaging for children. We then will use the refined app in a randomized clinical trial to assess its ability to reduce abdominal pain and improve quality of life in affected children. Our eventual goal is to make this GIT mobile app widely available to pediatric patients with FAPDs.  None of this would be possible without the incredible mentorship and support from Drs. Robert Shulman, director of the Center for Pediatric Abdominal Pain Research at Texas Children’s Hospital, Deborah Thompson, professor at Baylor College of Medicine, and Miranda van Tilburg, associate professor at Campbell University.  We are also grateful for the support of Texas Children’s Hospital Pediatric Associates and the technological support of Dr. C. Michael Fordis and his mobile app development team at the Center for Collaborative and Interactive Technologies at Baylor College of Medicine; this is the perfect environment where medicine and technology can work synergistically to quell chronic abdominal pain,” Hollier said.