Non-pharmacological management of abdominal pain-related functional gastrointestinal disorders in children

World J Pediatr. 2016 Nov;12(4):389-398. doi: 10.1007/s12519-016-0044-8. Epub 2016 Jun 30.


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.

Keywords: Rome IV criteria; abdominal pain; behavioral intervention; diet; gastrointestinal diseases hypnosis.

Publication types

  • Review

MeSH terms

  • Abdominal Pain / diagnosis*
  • Abdominal Pain / etiology
  • Abdominal Pain / therapy*
  • Adolescent
  • Behavior Therapy / methods
  • Case-Control Studies
  • Child
  • Cognitive Behavioral Therapy / methods
  • Cohort Studies
  • Complementary Therapies / methods*
  • Diet Therapy
  • Dietary Supplements
  • Female
  • Gastrointestinal Diseases / diagnosis*
  • Gastrointestinal Diseases / therapy*
  • Humans
  • Male
  • Pain Measurement
  • Probiotics / therapeutic use*
  • Prognosis
  • Randomized Controlled Trials as Topic
  • Risk Assessment
  • Severity of Illness Index
  • Treatment Outcome