ABSTRACT

Functional gastrointestinal disorders (FGIDs) are common among children and adolescents. This chapter focuses on the pain-predominant FGIDs, in particular irritable bowel syndrome (IBS), as these are most commonly encountered in clinical pediatric practice. The pathogenesis of FGIDs is multifactorial and is the result of complex interplay between genetic, environmental, physiologic and psychosocial factors. This forms the basis for the biopsychosocial model which is essential to understanding and treating FGIDs. Abdominal pain-predominant FGIDs are divided into four separate categories based on Rome III criteria: functional abdominal pain (FAP), IBS, functional dyspepsia, and abdominal migraine. The evaluation of recurrent abdominal pain and diagnosis of potential FGIDs frequently present a diagnostic dilemma to the clinician. There are many strategies for the treatment of FGIDs, including pharmacologic, dietary, cognitive-behavioral, and complementary approaches. Because data on specific treatments for pediatric FGIDs are sparse, empiric therapy is typically employed.