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Functional abdominal pain syndrome.

Ray E Clouse1, Emeran A Mayer, Qasim Aziz

  • 1Division of Gastroenterology, Washington University, St Louis, Missouri 63110, USA. rclouse@im.wustl.edu

Gastroenterology
|May 9, 2006
PubMed
Summary
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Functional abdominal pain syndrome (FAPS) is a complex disorder distinct from other functional bowel issues, often linked to psychiatric conditions. Management involves physician-patient trust, targeted medications like antidepressants, and psychological therapies.

Area of Science:

  • Gastroenterology
  • Pain Medicine
  • Psychiatry

Background:

  • Functional abdominal pain syndrome (FAPS) is a distinct functional bowel disorder characterized by its lower prevalence and symptoms unrelated to food or defecation.
  • FAPS exhibits a higher comorbidity with psychiatric disorders, suggesting complex underlying mechanisms.
  • The etiology and pathophysiology of FAPS remain incompletely understood, potentially involving peripheral neuropathic pain or altered endogenous pain modulation.

Purpose of the Study:

  • To differentiate Functional abdominal pain syndrome (FAPS) from other functional bowel disorders.
  • To outline diagnostic criteria and management strategies for FAPS.
  • To explore potential pathophysiological mechanisms in FAPS.

Main Methods:

  • Diagnosis relies on positive symptom criteria and a history of symptoms, avoiding extensive evaluation in the absence of alarm signs.

Related Experiment Videos

  • Management strategies emphasize a strong physician-patient relationship and empirical treatment algorithms.
  • Treatment modalities include centrally acting drugs (antidepressants, anticonvulsants) and psychological therapies (psychotherapy, relaxation, hypnosis).
  • Main Results:

    • FAPS presents unique characteristics compared to other functional bowel disorders.
    • Diagnosis is primarily clinical, guided by symptom criteria.
    • Treatment is multimodal, incorporating pharmacotherapy and psychological interventions, with drug selection influenced by comorbidities.

    Conclusions:

    • Functional abdominal pain syndrome (FAPS) requires a distinct approach due to its unique clinical features and potential pathophysiological underpinnings.
    • Effective management hinges on a therapeutic alliance and tailored empirical treatments.
    • Multidisciplinary pain clinic approaches may benefit patients with refractory FAPS.