Recurrent Abdominal Pain in Children: Summary Evidence From 3 Systematic Reviews of Treatment Effectiveness
Abstract
Objectives Between 4% and 25% of school-aged children complain of recurrent abdominal pain (RAP) severe enough to interfere with their daily activities. Methods We carried out a systematic review of randomised controlled trials (RCTs) in eleven databases and 2 trials registries from inception to June 2016. An update search was run in November 2017. All screening was performed by 2 independent reviewers. Included studies were appraised using the Cochrane risk of bias tool and the evidence assessed using GRADE. We included any dietary, pharmacological or psychosocial intervention for RAP, defined by Apley or an abdominal pain-related functional gastrointestinal disorder, as defined by the Rome III criteria, in children and adolescents. Results We included 55 RCTs, involving 3572 children with RAP (21 dietary, 15 pharmacological, 19 psychosocial, and 1 multiarm). We found probiotic diets, cognitive-behavioural therapy (CBT) and hypnotherapy were reported to reduce pain in the short-term and there is some evidence of medium term effectiveness. There was insufficient evidence of effectiveness for all other dietary interventions and psychosocial therapies. There was no robust evidence of effectiveness for pharmacological interventions. Conclusions Overall the evidence base for treatment decisions is poor. These data suggest that probiotics, CBT, and hypnotherapy could be considered as part of holistic management of children with RAP. The evidence regarding relative effectiveness of…
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The majority of studies of CBT for functional somatic syndromes in children and adolescents are quite small and heterogeneous with regard to inclusion criteria, setting, dose and type of delivered treatment and therapist experience.
“However, the results should be interpreted with caution as the majority of these studies are quite small and heterogeneous with regard to e.g. inclusion criteria, setting, dose and type of delivered treatment and therapist experience (Abbott et al., 2018; Bonvanie et al., 2017).”
From Third wave treatments for functional somatic syndromes and health anxiety across the age span: A narrative review (2019) · cites this paper as Abbott et al., 2018
Across age groups, patient-activating therapies are the most promising treatments, and CBT has so far been the most prevailing in intervention studies.
“Across age groups, patient-activating therapies are the most promising treatments, and cognitive behavioural therapy (CBT) has so far been the most prevailing in intervention studies (Abbott et al., 2018; Bonvanie et al., 2017; Henningsen et al., 2018).”
From Third wave treatments for functional somatic syndromes and health anxiety across the age span: A narrative review (2019) · cites this paper as Abbott et al., 2018
With regard to functional somatic syndromes, existing studies have almost exclusively focused on CBT-based treatments for single symptoms or syndromes, primarily functional abdominal symptoms, chronic fatigue, tension-type headache, fibromyalgia or mixed pain complaints in children as young as 6 years of age.
“With regard to FSS, existing studies have almost exclusively focused on CBT-based treatments for single symptoms or syndromes; primarily functional abdominal symptoms, chronic fatigue, tension-type headache, fibromyalgia or mixed pain complaints in children as young as 6 years of age (Abbott et al., 2018; Bonvanie et al., 2017).”
From Third wave treatments for functional somatic syndromes and health anxiety across the age span: A narrative review (2019) · cites this paper as Abbott et al., 2018
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References 79 · Cited by 36
- Authors
- Abbott, R. A., Martin, A. E., Newlove‐Delgado, T. V., Bethel, A., Whear, R. S., Thompson Coon, J., & Logan, S.
- Affiliations
- University of Exeter (GB)
- University of Exeter Medical School Exeter UK
- NIHR CLAHRC South West Peninsula (PenCLAHRC) University of Exeter Medical School Exeter
- Corresponding author
- Abbott, Rebecca A.
- Martin, Alice E.
- Bethel, Alison
- Whear, Rebecca S.
- Logan, Stuart
- Venue
- Journal of Pediatric Gastroenterology and Nutrition
- Publisher
- Wiley
- Published
- 2018-07
- Volume
- 67
- Issue
- 1
- Pages
- 23-33
- ISSN
- 0277-2116 (ISSN-L)
- 1536-4801
- OpenAlex
- W2789334939
- Cited by
- 36
- References
- 79
- Citations by year
- 2025: 1 · 2024: 3 · 2023: 3 · 2022: 6 · 2021: 6 · 2020: 10 · 2019: 3 · 2018: 3 · 2017: 1
- FWCI
- 0.98
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Pediatric Gastroenterology and Nutrition (publishedVersion)
- PubMed (publishedVersion)
- Open Research Exeter (University of Exeter) (acceptedVersion)
- Royal Devon and Exeter Research Repository (Royal Devon and Exeter) (submittedVersion)
- Funders
- National Institute for Health and Care Research (NF-SI-0515-10062, CL-2016-23-001)
- Topics
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pediatric Pain Management Techniques
- Health Sciences › Health Professions › Pharmacy › Infant Health and Development
- Keywords
- recurrent abdominal pain, children, adolescents, functional gastrointestinal disorders, probiotics, dietary intervention, cognitive behavioral therapy, hypnotherapy, psychosocial interventions, pharmacological interventions, Rome III criteria, holistic management
- MeSH terms
- Adolescent, Antidepressive Agents, Tricyclic, Child, Child, Preschool, Diet Therapy, Dietary Fiber, Female, Humans, Hypnosis, Male, Parasympatholytics, Yoga, Abdominal Pain, Cognitive Behavioral Therapy, Randomized Controlled Trials as Topic, Treatment Outcome, Probiotics
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