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Non-pharmacological management of abdominal pain-related functional gastrointestinal disorders in children 
 
Non-pharmacological management of abdominal pain-related functional gastrointestinal disorders in children
  Siba Prosad Paul, Dharamveer Basude
 [Abstract] [Full Text] [PDF]   Pageviews: 757 Times
 
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.
 
Key words: abdominal pain; behavioral intervention; diet; gastrointestinal diseases; hypnosis; Rome IV criteria
 
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