Faculty Collaboration Database

Current concepts in functional gastrointestinal disorders. Curr Opin Pediatr 2015 Oct;27(5):619-24

Date

07/25/2015

Pubmed ID

26208234

DOI

10.1097/MOP.0000000000000262

Scopus ID

2-s2.0-84960110357 (requires institutional sign-in at Scopus site)   15 Citations

Abstract

PURPOSE OF REVIEW: Functional gastrointestinal disorders (FGIDs) are some of the most common and challenging disorders in pediatrics. Recurrent abdominal pain is the central feature of pain-associated FGIDs such as irritable bowel syndrome. A thorough understanding of current pathophysiological concepts is essential to successful management.

RECENT FINDINGS: The brain-gut axis, role of microbiota and the biopsychosocial model are emerging concepts in FGIDs. The biopsychosocial model focuses on the interplay between genes, environment, and physical and psychosocial factors. Interactions between microbiota and the central, enteric and autonomic nervous systems form the link between gut functions and conscious perceptions. Irritable bowel syndrome is the most extensively studied and prototypical pain-associated FGIDs. An aberrant processing of pain or physiologic signals originating from the gut causes a state of visceral hypersensitivity - a central mechanism of functional pain. Psychosocial and autonomic influences also play large roles. Therapy is tailored to the individual patient and comorbid symptoms.

SUMMARY: This review highlights the complex mechanisms and the aberrant brain-gut neural connections forming the basis of FGIDs. Successful management of FGIDs requires knowledge of the underlying pathophysiology coupled with a multidisciplinary treatment approach. Management should focus on cognitive behavioral therapy, dietary factors along with gastrointestinal motility and psychotropic drug therapy.

Author List

Kovacic K

Author

Katja K. Karrento MD Associate Professor in the Pediatrics department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Abdominal Pain
Enteric Nervous System
Feeding Behavior
Gastrointestinal Diseases
Gastrointestinal Motility
Gastrointestinal Tract
Humans
Psychotropic Drugs