Functional gastrointestinal disorders: past and present.
BACKGROUND
Chronic abdominal pain is a common complaint in childhood and adolescence. Despite decades of clinical observations and research, it still poses a challenge to pediatric health care professionals. The aim of this review is to highlight the epidemiology of pediatric chronic abdominal pain and to describe the pathogenesis of this disorder, its clinical manifestations, evaluation and therapeutic options.


METHODS
Articles on chronic abdominal pain in the recent years from PubMed, MEDLINE, and reference textbooks were reviewed.


RESULTS
Chronic abdominal pain, a functional gastrointestinal disorder (FGID), is a multifactorial condition that results from a complex interaction between psychosocial and physiologic factors via the brain-gut axis. A thorough history coupled with a complete physical examination and normal screening studies rule out an organic cause in 95% of the cases. It is highly important for the physician to establish a trusting relationship with the child and parents because successful treatment including modification of physical and psychological stress factors, dietary changes, and drug therapy depends greatly on education, reassurance and active psychological support.


CONCLUSIONS
FGIDs are a cause of great anxiety, distress and morbidity in children as well as adults. As our understanding of these conditions improves, our therapeutic interventions will progress not only to overcome them but also to intervene early in the disease course so as to limit long-term impact.
Ammoury
Rana Fayez
RF
Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Indiana University School of Medicine, Indianapolis, IN, USA. rammoury@iupui.edu
Pfefferkorn
Marian Del Rosario
Mdel R
Croffie
Joseph Marino
JM
D015746:Abdominal Pain / Q000175:diagnosis / Q000628:therapy; D001521:Behavior Therapy; D002648:Child; D002908:Chronic Disease; D003937:Diagnosis, Differential; D004415:Dyspepsia / Q000175:diagnosis / Q000628:therapy; D019317:Evidence-Based Medicine; D005544:Forecasting; D005767:Gastrointestinal Diseases / Q000175:diagnosis* / Q000178:diet therapy / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D015994:Incidence; D007196:Indiana / Q000453:epidemiology; D043183:Irritable Bowel Syndrome / Q000175:diagnosis / Q000628:therapy; D008487:Medical History Taking; D008881:Migraine Disorders / Q000175:diagnosis / Q000628:therapy; D010808:Physical Examination; D015995:Prevalence; D012720:Severity of Illness Index