Diagnostic and treatment approaches associated with functional gastrointestinal disorders in children and adolescents
This chapter provides information on the diagnosis and treatment of functional gastrointestinal disorders (FGIDs) in children and adolescents, with a particular focus on efficacious psychological approaches. There are effective psychological approaches to manage these conditions in children and adolescents, particularly for pain-related FGIDs, including cognitive behavioural therapy and hypnotherapy. Consistent with a biopsychosocial treatment approach, pharmacologic treatment of medical and psychiatric comorbidities may reduce symptoms or improve functioning by reducing nociceptive input and/or allostatic load. Anxiety, depression and somatic symptoms are associated with FGIDs in children and adolescents, as well as poor quality of life, school absence and health-care utilization. Children and adolescents with FGIDs have more anxious, depressive and somatic symptoms, experience poorer quality of life and have more school absences than healthy children. The best research support for the effective treatment of paediatric pain-related FGIDs comes from non-pharmacologic approaches.