New advances in the treatment of paediatric functional abdominal pain disorders

Lancet Gastroenterol Hepatol. 2020 Mar;5(3):316-328. doi: 10.1016/S2468-1253(19)30256-0. Epub 2019 Dec 16.

Abstract

This Review summarises recent pharmacological and upcoming alternative interventions for children with functional abdominal pain disorders (FAPDs). Pharmacological targets include prokinetics and drugs affecting gastric accommodation to treat postprandial distress and nausea. Similarly, anti-inflammatory agents, junctional protein regulators, analgesics, secretagogues, and serotonin antagonists have a therapeutic role for irritable bowel syndrome. Non-pharmacological treatments include peripheral electrical nerve field stimulation to the external ear, gastric electrical stimulation, dietary interventions such as low fructose and fibre based diets, and nutraceuticals, which include probiotics, prebiotics, and synbiotics. Newer psychological advances such as exposure-based cognitive behavioural therapy, acceptance and commitment therapy, and mindfulness meditation are being investigated for paediatric functional pain. Lastly, alternative therapies such as acupuncture, moxibustion, yoga, and spinal manipulation are also gaining popularity in the treatment of FAPDs.

Publication types

  • Review

MeSH terms

  • Abdominal Pain / drug therapy*
  • Abdominal Pain / physiopathology
  • Abdominal Pain / therapy
  • Acceptance and Commitment Therapy / methods
  • Acupuncture / methods
  • Adolescent
  • Analgesics / therapeutic use
  • Anti-Inflammatory Agents / therapeutic use
  • Child
  • Child, Preschool
  • Cognitive Behavioral Therapy / methods
  • Diet Therapy / methods
  • Dietary Supplements / statistics & numerical data
  • Electric Stimulation / methods
  • Female
  • Humans
  • Irritable Bowel Syndrome / drug therapy*
  • Male
  • Manipulation, Spinal / methods
  • Mindfulness / methods
  • Moxibustion / methods
  • Nausea / drug therapy*
  • Postprandial Period / drug effects*
  • Prebiotics / statistics & numerical data
  • Probiotics / therapeutic use
  • Psychological Distress
  • Secretagogues / therapeutic use
  • Serotonin Antagonists / therapeutic use
  • Synbiotics / administration & dosage
  • Treatment Outcome
  • Yoga
  • Young Adult

Substances

  • Analgesics
  • Anti-Inflammatory Agents
  • Prebiotics
  • Secretagogues
  • Serotonin Antagonists