Current Issues in the Management of Pediatric Functional Abdominal Pain
Claudio Romano and Federica Porcaro
Affiliation: Pediatric Department, University of Messina, Italy.
Keywords: Cognitive behavioral therapy, functional gastrointestinal disorders, functional abdominal pain, pharmacotherapy.
Chronic abdominal pain (CAP) is a prevalent disorder related to functional gastrointestinal disorders (FGIDs).
In pediatric setting, CAP is a common presenting problem among children and adolescents ages 2 to 18 years with a median
prevalence rate of 12%. It was proposed that CAP is the result of the altered pain sensation due to a dysfunction of
the brain-gut axis after a complex interaction among biological, psychological and social factors. Children with CAP experience
decrease in quality of life compared to children with identifiable organic disease such as inflammatory bowel
disease. Despite treatment, 30% of children with CAP have long-lasting complaints with evidence that CAP is a risk factor
for the occurrence of irritable bowel syndrome in adults. Efforts have subsequently been made to standardize the diagnostic
criteria and adequate follow-up. CAP is associated with significative impairment with considerable impact on selfreported
quality of life. The direct and indirect costs are not known in pediatric population and the access to investigations
it’s frequent. A more appropriate use of Rome III criteria would allow for a clinical diagnosis. The focus of this article
will be to report the updated criteria for the diagnosis, follow-up and treatment of this condition.
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