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

Childhood functional abdominal pain: mechanisms and management.

Author information

1
Department of Paediatric Gastroenterology &Nutrition, Emma Children's Hospital, Academic Medical Centre, Meibergdreef 9, 1105 AZ, Amsterdam, Netherlands.
2
Department of Physiology and Department of Paediatrics, Faculty of Medicine, University of Kelaniya, Thalagolla Road, 11010 Ragama, Sri Lanka.
3
Department of Paediatrics, St. Antonius Hospital, 3430 EM, Nieuwegein, Netherlands.

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.

PMID:
25666642
DOI:
10.1038/nrgastro.2015.21
[Indexed for MEDLINE]

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