New advances in evaluation and management of paediatric abdominal pain predominant FGIDs

Abstract

Chronic abdominal pain is one of the most commonly encountered symptoms in childhood and adolescence with reported prevalence rates of 1 to 19% and accounts for 2 to 4% of pediatric office visits. It is characterized by chronic, recurrent or continuous abdominal pain which is not well localized. The pain may wax and wane, with asymptomatic episodes interposed with painful periods and can profoundly affect daily activities. Children often have feelings of anxiety and distress leading to significant school absence and their parents tend to be very worried. Studies of these children revealed self-reported quality of life scores comparable to children with inflammatory bowel diseases, highlighting the clinical significance of this problem. The etiology and pathogenesis of these disorders are still largely unknown, but a growing body of evidence suggests that abdominal pain is a result of disordered brain-gut communication. Visceral hypersensitivity, altered conscious awareness of gastrointestinal sensory input, gastrointestinal microbiota and gastrointestinal dysmotility play a role. Between 25 to 66% of children seeking medical help for recurrent abdominal pain continue to experience similar symptoms in adulthood and are at increased risk of developing other physical symptoms or psychiatric problems like anxiety.