Dietary interventions for recurrent abdominal pain in childhood

Abstract

Overall, we found moderate- to low-quality evidence suggesting that probiotics may be effective in improving pain in children with RAP. Clinicians may therefore consider probiotic interventions as part of a holistic management strategy. However, further trials are needed to examine longer-term outcomes and to improve confidence in estimating the size of the effect, as well as to determine the optimal strain and dosage. Future research should also explore the effectiveness of probiotics in children with different symptom profiles, such as those with irritable bowel syndrome.We found only a small number of trials of fibre-based interventions, with overall low-quality evidence for the outcomes. There was therefore no convincing evidence that fibre-based interventions improve pain in children with RAP. Further high-quality RCTs of fibre supplements involving larger numbers of participants are required. Future trials of low FODMAP diets and other dietary interventions are also required to facilitate evidence-based recommendations.

Elimination of Fermentable Carbohydrates to Reduce Gastrointestinal Symptoms in Pediatric Patients With Irritable Bowel Syndrome: A Narrative Review

“…Bloating, abdominal pain/discomfort, and changes in bowel function, namely stool frequency and consistency, characterize IBS. GI symptom resolution is the primary reason patients seek medical treatment . Currently, IBS in pediatric patients is diagnosed by Rome IV criteria, and was previously diagnosed by Rome III criteria (Table ) .…”

“…Irritable bowel syndrome (IBS) is the most common functional gastrointestinal (GI) disorder (FGID) in pediatric patients. [1][2][3][4] Bloating, abdominal pain/discomfort, and changes in bowel function, namely stool frequency and consistency, characterize IBS. GI symptom resolution is the primary reason patients seek medical treatment.…”

“…GI symptom resolution is the primary reason patients seek medical treatment. 1,3,5,6 Currently, IBS in pediatric patients is diagnosed by Rome IV criteria, and was previously diagnosed by Rome III criteria (Table 1). 7,8 Four subtypes of IBS have been identified based on stool consistency.…”

“…Dietary consumption of fermentable carbohydrates is implicated as one mechanism by which bottom-up gutbrain axis dysfunction occurs and is associated with GI symptoms of IBS. 3,7,[16][17][18] Fermentable carbohydrates include oligosaccharides (fructans and galactans) found in wheat, rye, onions, garlic, apples, and legumes; the disaccharide lactose found in dairy foods (predominantly milk and yogurt); the monosaccharide fructose found in fruits (apples, pears), vegetables (artichokes, asparagus), and nutritive sweeteners (agave, honey, and high-fructose corn syrup); and polyols found in fruits (apples, pears, peaches), vegetables (cauliflower, snow peas), and sugar alcohols (sorbitol, mannitol, and xylitol). 19 When all of the fermentable carbohydrates are eliminated in one dietary treatment strategy, it is known as a low-FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) diet.…”

“…13,[15][16][17]19 Subsequently, IBS-related symptoms result in increased family healthcare expenses, missed time from school, decreased quality of life, and associated anxiety and emotional stress for pediatric patients with IBS. 1,3,4,15,20,21 All of these negative consequences may extend into adulthood if an appropriate treatment is not identified.…”