Childhood functional abdominal pain: mechanisms and management

Nat Rev Gastroenterol Hepatol. 2015 Mar;12(3):159-71. doi: 10.1038/nrgastro.2015.21. Epub 2015 Feb 10.

Abstract

Chronic abdominal pain is one of the most common clinical syndromes encountered in day to day clinical paediatric practice. Although common, its definition is confusing, predisposing factors are poorly understood and the pathophysiological mechanisms are not clear. The prevailing viewpoint in the pathogenesis involves the inter-relationship between changes in hypersensitivity and altered motility, to which several risk factors have been linked. Making a diagnosis of functional abdominal pain can be a challenge, as it is unclear which further diagnostic tests are necessary to exclude an organic cause. Moreover, large, well-performed, high-quality clinical trials for effective agents are lacking, which undermines evidence-based treatment. This Review summarizes current knowledge regarding the epidemiology, pathophysiology, risk factors and diagnostic work-up of functional abdominal pain. Finally, management options for children with functional abdominal pain are discussed including medications, dietary interventions, probiotics and psychological and complementary therapies, to improve understanding and to maximize the quality of care for children with this condition.

Publication types

  • Review

MeSH terms

  • Abdominal Pain / epidemiology
  • Abdominal Pain / etiology*
  • Abdominal Pain / therapy
  • Child
  • Chronic Pain
  • Gastrointestinal Diseases / complications*
  • Gastrointestinal Diseases / diagnosis
  • Gastrointestinal Diseases / epidemiology
  • Gastrointestinal Diseases / therapy
  • Humans
  • Prognosis
  • Risk Factors
  • Terminology as Topic