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ESPGHAN/NASPGHAN guidelines for treatment of irritable bowel syndrome and functional abdominal pain-not otherwise specified in children aged 4–18 years

Groen, Jip, Gordon, Morris, Chogle, Ashish, Benninga, Marc, Borlack, Rachel, Borrelli, Osvaldo, Darbari, Anil, Dolinsek, Jernej, Khlevner, Julie, Di Lorenzo, Carlo, Person, Hannibal, Sanghavi, Rinarani, Snyder, Julie, Thapar, Nikhil, Vlieger, Arine, Sinopoulou, Vasiliki, Tabbers, Merit, Saps, Miguel·2025·Journal of Pediatric Gastroenterology and Nutrition
DOI 10.1002/jpn3.70070
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Abstract

Objectives: Abdominal pain related disorders of gut–brain interaction (AP‐DGBIs) such as irritable bowel syndrome (IBS) and functional abdominal pain‐not otherwise specified (FAP) are common conditions in children, significantly impacting quality of life. This treatment guideline for IBS and FAP in children of 4–18 years is a collaborative effort of the European and North American Societies for Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN and NASPGHAN). We aim to comprehensively review the current evidence on treatment options and offer evidence‐based recommendations with utility across all treatment settings worldwide, as well as to provide methodological directions for future research. Methods: The guideline development followed the “Grading of Recommendations Assessment, Development and Evaluation” (GRADE) approach, which is in accordance with the GRADE handbook and supported by the World Health Organization. The Guideline Development Group (GDG) comprised clinical experts, representing ESPGHAN, NASPGHAN, and Cochrane. Individual members have put forward a final consensus list of treatment options, which were then translated into “patient, intervention, comparison, outcome” (PICO) format options. Prospective agreement on decision thresholds for efficacy and safety outcomes was reached through a Delphi process among the GDG to support GRADEing of the literature. Consensus voting was used to finalize recommendations, and a treatment algorithm was developed. Results: Systematic literature searches for this output identified 86 original randomized controlled trials assessing treatment of IBS and FAP. Consensus was reached for 25 GRADEd recommendations. Ten best practice statements were formulated, and guidance for future research methodology was proposed. Conclusion: This guideline represents the first collaborative output of ESPGHAN and NASPGHAN on treatment options for AP‐DGBIs. Systematic review of the evidence has exposed major evidence gaps for the treatment of these disorders and incentivizes large pediatric trials, particularly on treatment options for which, to date, no evidence exists.

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Metadata

Authors
Groen, J., Gordon, M., Chogle, A., Benninga, M., Borlack, R., Borrelli, O., Darbari, A., Dolinsek, J., Khlevner, J., Di Lorenzo, C., Person, H., Sanghavi, R., Snyder, J., Thapar, N., Vlieger, A., Sinopoulou, V., Tabbers, M., & Saps, M.
Affiliations
  • Amsterdam UMC, Pediatric Gastroenterology Amsterdam The Netherlands
  • School of Medicine University of Central Lancashire Preston UK
  • Children's Hospital of Orange County Orange California USA
  • The Children's Hospital at Montefiore, Albert Einstein College of Medicine New York New York USA
  • Great Ormond Street Hospital London UK
  • Children's National Hospital, George Washington University School of Medicine and Health Sciences Washington District of Columbia USA
  • University Medical Centre Maribor Maribor Slovenia
  • Columbia University Vagelos College of Physicians and Surgeons New York New York USA
  • Nationwide Children's Hospital Columbus Ohio USA
  • Seattle Children's Hospital Seattle Washington USA
  • Children's Medical Center Dallas Texas USA
  • Boston Children's Hospital Boston Massachusetts USA
  • Queensland Children's Hospital, School of Medicine University of Queensland Brisbane Queensland Australia
  • St. Antonius Hospital Nieuwegein The Netherlands
  • University of Central Lancashire Preston UK
  • University of Miami Miami Florida USA
ORCID
Groen, Jip
Venue
Journal of Pediatric Gastroenterology and Nutrition
Publisher
Wiley
Published
2025-05-30
Volume
81
Issue
2
Pages
442-471
ISSN
  • 0277-2116
  • 1536-4801
DOI
10.1002/jpn3.70070
Cited by
52
References
22
Language
en
Licence
creativecommons.org/licenses/by-nc/4.0/ (vor)

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

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Data sources

Bibliographic data: Semantic Scholar, OpenAlex, Crossref.

Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.