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A therapeutic guide on pediatric irritable bowel syndrome and functional abdominal pain-not otherwise specified

Journal

EUROPEAN JOURNAL OF PEDIATRICS
Volume 181, Issue 7, Pages 2603-2617

Publisher

SPRINGER
DOI: 10.1007/s00431-022-04459-y

Keywords

Children; Management; Therapy; Treatment; Chronic abdominal pain

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Disorders of the gut-brain interaction have a negative impact on quality of life and socio-economic burden. The understanding and guidelines for the treatment of functional abdominal pain disorders in children are lacking, making their management challenging. It is important to make an accurate diagnosis of irritable bowel syndrome or functional abdominal pain-not otherwise specified in children with chronic abdominal pain to prevent unnecessary referrals and costs.
Disorders of the gut-brain interaction negatively impact quality of life and carry a substantial socioeconomic burden. Irritable bowel syndrome (IBS) and functional abdominal pain-not otherwise specified (FAP-NOS) are common functional abdominal pain disorders in childhood. The pathophysiology is not fully understood, and high-quality intervention trials and international guidelines are missing. Therefore, the management of these disorders remains challenging. This review aims to provide an up-to-date overview of therapeutic possibilities for pediatric IBS or FAP-NOS and recommends management strategies. To prevent unnecessary referrals and extensive costs, it is fundamental to make a positive diagnosis of IBS or FAP-NOS in children with chronic abdominal pain with only minimal investigations. A tailor-made approach for each patient, based on the accompanying physical and psychological symptoms, is proposed to date. Conclusion: Shared decision-making including non-pharmacological and pharmacological interventions should be considered and discussed with the family.

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