Related Experiment Video
Updated: Apr 17, 2026
Electroacupuncture Combined with Chinese Medicine Ironing Therapy for Functional Constipation
Published on: July 5, 2024
Nonpharmacologic treatment of functional abdominal pain disorders: a systematic review
Juliette M T M Rutten1, Judith J Korterink2, Leonie M A J Venmans3
1Department of Pediatric Gastroenterology and Nutrition, Emma's Children's Hospital, Academic Medical Center, Amsterdam, Netherlands; and j.m.rutten@amc.nl.
Insights
Nonpharmacologic treatments like hypnotherapy, cognitive behavioral therapy, and specific probiotics show promise for pediatric functional gastrointestinal disorders. However, high-quality evidence is limited, and results for fiber supplements are inconclusive.
Area of Science:
- Pediatric Gastroenterology
- Evidence-Based Medicine
- Nonpharmacologic Therapies
Background:
- Pediatric abdominal pain-related functional gastrointestinal disorders (AP-FGIDs) have limited data on nonpharmacologic treatment efficacy and safety.
- A comprehensive review of available interventions is needed.
Purpose of the Study:
- To systematically review the evidence on nonpharmacologic interventions for pediatric AP-FGIDs.
- To evaluate the efficacy and safety of lifestyle, dietary, behavioral, probiotic, and alternative medicine approaches.
Main Methods:
- Searched Medline and Cochrane Library databases for systematic reviews and RCTs.
- Included studies on children aged 3-18 with AP-FGIDs, extracting data on interventions and outcomes.
- Assessed evidence quality using the GRADE approach.
Main Results:
- Twenty-four RCTs involving 1390 children were analyzed.
- Hypnotherapy and cognitive behavioral therapy demonstrated significant abdominal pain improvement.
- Lactobacillus rhamnosus GG (LGG) and VSL#3 probiotics showed significantly more treatment responders compared to placebo.
- Guar gum improved IBS symptom frequency, but other fiber supplements and lactose-free diets showed no significant effect.
- No studies were found for lifestyle interventions or specific diets; evidence quality ranged from very low to moderate.
Conclusions:
- Hypnotherapy, cognitive behavioral therapy, and certain probiotics (LGG, VSL#3) show efficacy for pediatric AP-FGIDs.
- Evidence for fiber supplements is inconclusive.
- High-quality studies are needed to further validate these findings.
Background And Objective:
Various nonpharmacologic treatments are available for pediatric abdominal pain-related functional gastrointestinal disorders (AP-FGIDs). Data on efficacy and safety are scarce. The goal of this study was to summarize the evidence regarding nonpharmacologic interventions for pediatric AP-FGIDs: lifestyle interventions, dietary interventions, behavioral interventions, prebiotics and probiotics, and alternative medicine.
Methods:
Searches were conducted of the Medline and Cochrane Library databases. Systematic reviews and randomized controlled trials (RCTs) concerning nonpharmacologic therapies in children (aged 3-18 years) with AP-FGIDs were included, and data were extracted on participants, interventions, and outcomes. The quality of evidence was assessed by using the GRADE approach.
Results:
Twenty-four RCTs were found that included 1390 children. Significant improvement of abdominal pain was reported after hypnotherapy compared with standard care/wait-list approaches and after cognitive behavioral therapy compared with a variety of control treatments/wait-list approaches. Written self-disclosure improved pain frequency at the 6-month follow-up only. Compared with placebo, Lactobacillus rhamnosus GG (LGG) and VSL#3 were associated with significantly more treatment responders (LGG relative risk: 1.31 [95% confidence interval: 1.08 to 1.59]; VSL#3: P < .05). Guar gum significantly improved irritable bowel syndrome symptom frequency; however, no effect was found for other fiber supplements (relative risk: 1.17 [95% confidence interval: 0.75 to 1.81]) or a lactose-free diet. Functional disability was not significantly decreased after yoga compared with a wait-list approach. No studies were found concerning lifestyle interventions; gluten-, histamine-, or carbonic acid-free diets; fluid intake; or prebiotics. No serious adverse effects were reported. The quality of evidence was found to be very low to moderate.
Conclusions:
Although high-quality studies are lacking, some evidence shows efficacy of hypnotherapy, cognitive behavioral therapy, and probiotics (LGG and VSL#3) in pediatric AP-FGIDs. Data on fiber supplements are inconclusive.
More Related Videos
06:01Author Spotlight: Reliable and Reproducible In Vitro Assessment of Drug Impact on Rat Intestinal Tubes
Published on: July 26, 2024
03:50Acupoint Application Combined with Acupoint Massage for Treating Constipation in a Patient with Chronic Obstructive Pulmonary Disease
Published on: August 18, 2023
Related Concept Videos
01:17Drugs for Treatment of Diarrhea-Predominant IBS
Two specific drugs used in the treatment are alosetron (Lotronex) and eluxadoline (Viberzi). Alosetron, a 5-HT3 antagonist, works by slowing the movement of stools in the gut, reducing bowel...
01:21Drugs for Treatment of Constipation-Predominant IBS
01:30Irritable Bowel Syndrome III: Medical and Nursing Management
01:26Peptic Ulcer Disease IV: Management
The therapeutic approach involves ensuring adequate rest, implementing drug therapy, promoting smoking cessation, making dietary modifications, and emphasizing long-term follow-up care.
Pharmacological management
The prevailing therapy for peptic ulcers involves a combination of managing the patient's current...
01:29Inflammatory Bowel Disease IV: Pharmacological Management
Pharmacologic...
01:30Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...