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Recurrent abdominal pain in children
Donna K Zeiter1, Jeffrey S Hyams
1Division of Digestive Diseases and Nutrition, Connecticut Children's Medical Center, Hartford, USA.
Insights
Functional abdominal pain in children requires a biopsychosocial approach, recognizing the gut-brain interaction. This perspective helps manage pain effectively across multiple levels for the child, family, and physician.
Area of Science:
- Pediatric Gastroenterology
- Neurogastroenterology
- Child Psychology
Background:
- Functional abdominal pain is a common issue in children, presenting either as a distinct condition like Irritable Bowel Syndrome (IBS) or within broader clinical syndromes.
- Traditional approaches often focus on excluding organic disease, which may not fully address the complexity of these conditions.
Purpose of the Study:
- To advocate for a biopsychosocial model in understanding and managing functional abdominal pain in pediatric patients.
- To highlight the significance of the gut-brain axis in the manifestation and treatment of these disorders.
Main Methods:
- Literature review and clinical consensus on functional abdominal pain disorders in children.
- Application of the biopsychosocial framework to pediatric functional abdominal pain.
Main Results:
- The biopsychosocial approach offers a comprehensive understanding of functional abdominal pain by integrating biological, psychological, and social factors.
- Recognizing the gut-brain interaction is crucial for developing effective, multi-level treatment strategies.
Conclusions:
- A shift from solely disease exclusion to a biopsychosocial perspective is recommended for managing pediatric functional abdominal pain.
- Future research into the biochemical processes of the enteric and central nervous systems holds promise for advancing therapeutic options.
Abstract:
Functional abdominal pain can occur in a well-defined clinical entity (e.g., IBS) or as a part of a poorly defined clinical syndrome. Although the clinician may feel compelled to exclude disease in all cases, the authors suggest that it is more appropriate to take a biopsychosocial approach. In so doing, there can be an appreciation of the close interaction of the gut and the brain, allowing the child, family, and physician the opportunity to address the pain on many levels. Although the parameters set forth by the pediatric ROME II committee have facilitated the authors' description of these disorders greatly, basic research likely will further delineate biochemical processes in the enteric and central nervous systems that will expand therapeutic horizons.