Pharmacological interventions for recurrent abdominal pain in childhood – Cochrane review

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Abstract

Background

Between 4% and 25% of school-aged children at some stage complain of recurrent abdominal pain (RAP) of sufficient severity to interfere with their daily lives. When no clear organic cause is found, the children are managed with reassurance and simple measures; a large range of pharmacological interventions have been recommended for use in these children.

Authors’ conclusions

There is currently no convincing evidence to support the use of drugs to treat RAP in children. Well-conducted clinical trials are needed to evaluate any possible benefits and risks of pharmacological interventions. In practice, if a clinician chooses to use a drug as a ‘therapeutic trial’, they and the patient need to be aware that RAP is a fluctuating condition and any ‘response’ may reflect the natural history of the condition or a placebo effect, rather than drug efficacy.

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Probiotics for recurrent abdominal pain in childhood

Journal or Paediatrics & Child Health

Worldwide, it is estimated that 13.5% of school-age children are affected by recurrent abdominal pain (RAP).  Although considered a relatively benign condition, RAP results in substantial morbidity, as well as concern for parents, and paediatricians. Pathophysiology, accurate diagnosis and optimal management remain unclear. Unsurprisingly, dietary approaches to RAP have been around since Apley’s original report of the condition in the 1950s. The good news is a recent systematic review and meta-analysis has identified at least one dietary intervention that appears beneficial, namely probiotics.

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Cochrane Review: Dietary interventions for recurrent abdominal pain in childhood

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This is an update of the original Cochrane review, last published in 2009 (Huertas-Ceballos 2009). Recurrent abdominal pain (RAP), including children with irritable bowel syndrome, is a common problem affecting between 4% and 25% of school-aged children. For the majority of such children, no organic cause for their pain can be found on physical examination or investigation. Many dietary inventions have been suggested to improve the symptoms of RAP. These may involve either excluding ingredients from the diet or adding supplements such as fibre or probiotics.

Link to review