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Abdominal pain-related functional gastrointestinal disorders in children
Jagrati Chopra1, Neal Patel1, Dharamveer Basude2
14th Year Medical Student, University of Bristol.
Insights
Recurrent abdominal pain in children is often functional, not organic. Management focuses on biopsychosocial interventions and nurse-led care, with minimal medication use.
Area of Science:
- Pediatrics
- Gastroenterology
- Psychology
Background:
- Recurrent abdominal pain affects 20% of children globally, frequently non-organic.
- Abdominal pain-related functional gastrointestinal disorders (FGIDs) are diagnosed using Rome IV criteria after excluding organic causes.
- Early identification and management are crucial for improving outcomes.
Purpose of the Study:
- To review the evaluation and management of non-organic recurrent abdominal pain in children.
- To highlight the role of biopsychosocial factors and nurse-led interventions.
- To discuss challenges in managing FGIDs and the importance of continuity of care.
Main Methods:
- Systematic review of literature on pediatric functional abdominal pain.
- Application of Rome IV criteria for FGID diagnosis.
- Assessment of 'red flag' symptoms and psychosocial factors.
- Evaluation of management strategies including dietary and biopsychosocial interventions.
Main Results:
- Non-organic recurrent abdominal pain is common, with FGIDs being the primary diagnosis.
- Effective management relies on explanation, reassurance, and individualized biopsychosocial interventions.
- Nurse-led services demonstrate effectiveness in managing FGIDs and ensuring continuity of care.
Conclusions:
- Functional gastrointestinal disorders are the leading cause of recurrent abdominal pain in children.
- A comprehensive approach integrating psychosocial support and nurse-led care is essential.
- Minimizing pharmacological interventions and focusing on holistic management improves patient outcomes.
Abstract:
Recurrent abdominal pain is a common presentation in children and mostly non-organic in origin. Nearly one-fifth of the childhood population are known to suffer from it worldwide, although only 50% of these may seek consultation with a health professional. Non-organic recurrent abdominal pain encompasses four main conditions broadly labelled as abdominal pain-related functional gastrointestinal disorders (FGIDs). These are diagnosed following exclusion of organic pathologies and by symptom concordance with defined parameters, published as the Rome IV criteria for FGIDs. Appropriate evaluation includes assessment for 'red flag' manifestations to rule out organic causes. Appropriate review of social and family circumstances is vital to identify triggers and protective factors. Management is based on explanation, reassurance and therapeutic interventions that need to be decided on an individual basis. Treatment focuses primarily on dietary and biopsychosocial interventions, with a minimal role for pharmacological agents. A case study is included to highlight some of the challenges that may arise while managing abdominal pain-related FGIDs. Nurses play a vital role in early identification, providing support and education to children and their families. There is increasing evidence for the effectiveness of nurse-led services in managing these disorders, as well as providing continuity of care.
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