Paul Siba Prosad, Basude Dharamveer
Torbay Hospital, Vowden Hall, Lowes Bridge, Torquay, TQ2 7AA, UK.
Bristol Royal Hospital for Children, Upper Maudlin Street, Bristol, BS2 8BJ, UK.
World J Pediatr. 2016 Nov;12(4):389-398. doi: 10.1007/s12519-016-0044-8. Epub 2016 Jun 30.
Abdominal pain-related functional gastrointestinal disorder (AP-FGID) comprises of 4 main conditions: functional dyspepsia, irritable bowel syndrome, abdominal migraine and functional abdominal pain. AP-FGIDs are diagnosed clinically based on the Rome IV criteria for FGIDs of childhood. There is limited evidence for pharmacological therapies.
This review article discusses nonpharmacological management of AP-FGID based on the current literature including systematic reviews, randomized controlled trials, cohort and case control studies. We aim to provide a comprehensive overview on the available evidence for the pediatricians and pediatric gastroenterologists involved in managing children with AP-FGID.
Managing AP-FGIDs can be challenging. This should follow a stepwise approach with focused history, identification of "red flag" signs and symptoms, physical examination and investigations done following initial consultation. Family needs explaining that there is nothing seriously wrong with the child's abdomen. This explanation and reassurance can achieve symptom control in large number of cases. Non-pharmacological interventions are delivered through lifestyle and dietary changes and bio-psychosocial therapies. Dietary interventions vary depending on the type of AP-FGID. Bio-psychosocial therapies such as hypnotherapy, cognitive behavioral therapy and yoga aim at stress reduction.
There is increasing evidence for use of non-pharmacological interventions in children with APFGID.
腹痛相关的功能性胃肠病（AP - FGID）包括4种主要情况：功能性消化不良、肠易激综合征、腹型偏头痛和功能性腹痛。AP - FGID根据儿童FGID的罗马IV标准进行临床诊断。药物治疗的证据有限。
这篇综述文章基于当前文献，包括系统评价、随机对照试验、队列研究和病例对照研究，讨论了AP - FGID的非药物管理。我们旨在为参与管理患有AP - FGID儿童的儿科医生和儿科胃肠病学家提供现有证据的全面概述。
管理AP - FGID可能具有挑战性。这应遵循逐步方法，包括详细的病史询问、识别“警示”体征和症状、体格检查以及初次咨询后进行的检查。需要向家庭解释孩子的腹部没有严重问题。这种解释和安慰在大量病例中可实现症状控制。非药物干预通过生活方式和饮食改变以及生物心理社会疗法来实施。饮食干预因AP - FGID的类型而异。生物心理社会疗法，如催眠疗法、认知行为疗法和瑜伽，旨在减轻压力。
越来越多的证据表明在患有AP - FGID的儿童中使用非药物干预。
