Current and novel therapeutic strategies in pediatric irritable bowel syndrome and functional abdominal pain-not otherwise specified

Abstract

INTRODUCTION: Irritable bowel syndrome (IBS) and functional abdominal pain - not otherwise specified (FAP-NOS) are amongst the most common disorders affecting children worldwide, often associated with a lower quality of live, anxiety, and depression. The underlying mechanisms of these conditions remain poorly understood, posing significant challenges to effective treatment. Consequently, many children receive inadequate care. This highlights the urgent need for accessible and effective treatment strategies. AREA COVERED: Data were identified using CENTRAL, MEDLINE, and PUBMED databases up to 1 December 2024. This review will explore existing treatment approaches, from first-line reassurance to a spectrum of non-pharmacological and pharmacological interventions. We also discuss emerging therapies and future directions. EXPERT OPINION: IBS and FAP-NOS are now named disorders of gut-brain interaction in the Rome IV criteria, highlighting the complex interplay between central and peripheral gastrointestinal alterations. Psychological interventions, such as cognitive behavior therapy and gut hypnotherapy, have proven to be the most successful therapies in pediatric IBS and FAP-NOS, whilst the evidence for the efficacy of pharmacological interventions is mostly lacking due to poor quality of available studies and high placebo responses. Future studies are needed to investigate the value of novel treatment strategies such as fecal microbiota transplantation and open label placebo's.