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ARS Home » Plains Area » Houston, Texas » Children's Nutrition Research Center » Research » Publications at this Location » Publication #395900

Research Project: Microbiota and Nutritional Health

Location: Children's Nutrition Research Center

Title: Paediatric functional abdominal pain disorders

item THAPAR, NIKHIL - Great Ormond Street Hospital For Children
item BENNINGA, MARC - University Medical Center Amsterdam
item CROWELL, MICHAEL - Mayo Clinic College Of Medicine
item DI LORENZO, CARLO - Nationwide Children'S Hospital
item MACK, ISABELLE - University Of Tubingen
item NURKO, SAMUEL - Boston Children'S Hospital
item SAPS, MIGUEL - University Of Miami
item SHULMAN, ROBERT - Children'S Nutrition Research Center (CNRC)
item SZAJEWSKA, HANIA - University Of Warsaw
item VAN TILBURG, MIRANDA - University Of North Carolina
item ENCK, PAUL - University Of Tubingen

Submitted to: Nature Review Disease Primers
Publication Type: Review Article
Publication Acceptance Date: 9/1/2020
Publication Date: 11/5/2020
Citation: Thapar, N., Benninga, M.A., Crowell, M.D., Di Lorenzo, C., Mack, I., Nurko, S., Saps, M., Shulman, R.J., Szajewska, H., Van Tilburg, M.A., Enck, P. 2020. Paediatric functional abdominal pain disorders. Nature Review Disease Primers. 6. Artticle 89.

Interpretive Summary:

Technical Abstract: Paediatric functional abdominal pain disorders, currently referred to as disorders of gut–brain interaction, comprise irritable bowel syndrome, functional dyspepsia, abdominal migraine and functional abdominal pain not otherwise specified, as defined by the Rome IV diagnostic criteria. Functional abdominal pain disorders are common disorders with a prevalence of 3–16% depending on country, age and sex. A greater understanding of aetiopathogenesis and pathophysiology is emerging and includes intestinal components (inflammation, motility and the microbiota), central factors (psychological aspects, sensitization and/or differences in connectivity or activity of certain brain regions) as well as extrinsic factors (infections). In particular, the timing of disruption of the microbiota–gut–brain axis seems to be important. Diagnosis is challenging but is primarily based on clinical symptoms and exclusion of other organic causes, with an emphasis on avoiding unnecessary invasive diagnostic procedures. The available pharmacological interventionsare limited in children and, therefore, management has focused on combined approaches, including mind-targeted interventions (hypnotherapy and cognitive behavioural therapy), diet (probiotics) and percutaneous electrical nerve field stimulation. The evidence for their clinical efficacy, although limited, is favourable, with positive impacts on symptoms and overall quality of life. The coming decades hold promise for improved understanding and management of these enigmatic disorders.