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Non-pharmacological management of abdominal pain-related functional gastrointestinal disorders in children
Siba Prosad Paul1, Dharamveer Basude2
1Torbay Hospital, Vowden Hall, Lowes Bridge, Torquay, TQ2 7AA, UK. siba@doctors.org.uk.
Insights
Non-pharmacological interventions are increasingly effective for managing childhood abdominal pain-related functional gastrointestinal disorders (AP-FGID). These approaches, including dietary changes and bio-psychosocial therapies, offer promising symptom control for affected children.
Area of Science:
- Pediatric Gastroenterology
- Functional Gastrointestinal Disorders
- Child Health
Background:
- Abdominal pain-related functional gastrointestinal disorders (AP-FGID) encompass conditions like functional dyspepsia and irritable bowel syndrome in children.
- Diagnosis relies on Rome IV criteria, with limited evidence for pharmacological treatments.
- Effective management strategies for pediatric AP-FGID are crucial.
Purpose of the Study:
- To review non-pharmacological management options for AP-FGID in children.
- To provide a comprehensive evidence-based overview for pediatricians and gastroenterologists.
- To highlight the efficacy of non-pharmacological interventions.
Main Methods:
- Systematic review of current literature, including RCTs, cohort, and case-control studies.
- Focus on non-pharmacological interventions for AP-FGID.
- Analysis of evidence for dietary and bio-psychosocial therapies.
Main Results:
- Management requires a stepwise approach including history, red flag identification, and physical examination.
- Explanation and reassurance are key components of initial management.
- Non-pharmacological interventions include lifestyle/dietary changes and bio-psychosocial therapies (hypnotherapy, CBT, yoga) for stress reduction.
Conclusions:
- There is growing evidence supporting the use of non-pharmacological interventions for pediatric AP-FGID.
- These strategies, including dietary modifications and stress-reduction therapies, are effective.
- Non-pharmacological approaches offer a viable alternative or adjunct to medication.
Background:
Abdominal pain-related functional gastrointestinal disorder (AP-FGID) comprises of 4 main conditions: functional dyspepsia, irritable bowel syndrome, abdominal migraine and functional abdominal pain. AP-FGIDs are diagnosed clinically based on the Rome IV criteria for FGIDs of childhood. There is limited evidence for pharmacological therapies.
Data Sources:
This review article discusses nonpharmacological management of AP-FGID based on the current literature including systematic reviews, randomized controlled trials, cohort and case control studies. We aim to provide a comprehensive overview on the available evidence for the pediatricians and pediatric gastroenterologists involved in managing children with AP-FGID.
Results:
Managing AP-FGIDs can be challenging. This should follow a stepwise approach with focused history, identification of "red flag" signs and symptoms, physical examination and investigations done following initial consultation. Family needs explaining that there is nothing seriously wrong with the child's abdomen. This explanation and reassurance can achieve symptom control in large number of cases. Non-pharmacological interventions are delivered through lifestyle and dietary changes and bio-psychosocial therapies. Dietary interventions vary depending on the type of AP-FGID. Bio-psychosocial therapies such as hypnotherapy, cognitive behavioral therapy and yoga aim at stress reduction.
Conclusion:
There is increasing evidence for use of non-pharmacological interventions in children with APFGID.
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