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Functional Symptoms in Gastroenterology: A Punch to the Gut

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Functional Symptoms in Pediatric Disease

Abstract

Functional gastrointestinal disorders (FGIDs) are highly prevalent in the USA and worldwide among children. These conditions can be broadly divided into those found in specific age groups as well as by symptom (e.g., nausea, vomiting, diarrhea, and abdominal pain). Collectively, these conditions account for a significant percentage of general and subspecialty practitioner visits. When unrecognized and/or untreated, these conditions can lead to significant morbidity including psychological and psychosocial disability for both patients and families. Furthermore, FGIDs are increasingly being recognized among patients with organic intestinal disorders such as Inflammatory Bowel Disease (IBD) and Celiac disease and affect disease-related management and utilization of healthcare resources. The Rome Foundation has identified key diagnostic criteria for these disorders. A majority of these disorders can be diagnosed on clinical grounds based on detailed and pertinent history and physical exam. Combined assessment of symptoms, illness experience, and psychosocial factors can be utilized to develop effective individualized treatment plans.

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Abbreviations

5-HT:

5-Hydroxytryptophan

AP:

Abdominal pain

CCK:

Cholecystokinin

CD:

Crohn’s disease

CIN:

Chronic idiopathic nausea

COMT:

Catechol-O-methyltransferase

FAP:

Functional abdominal pain

FD:

Functional dyspepsia

FGID:

Functional gastrointestinal disorder

FOBT:

Fecal occult blood test

GERD:

Gastroesophageal reflux disease

GPCR:

G-protein-coupled receptor

HPA:

Hypothalamic pituitary adrenal

IBD:

Inflammatory bowel disease

IBS:

Irritable bowel syndrome

IL:

Interleukin

NSAID:

Nonsteroidal anti-inflammatory drugs

PI:

Postinfectious

PPI:

Proton pump inhibitor

SES:

Socioeconomic status

SIBO:

Small intestinal bacterial overgrowth

TNF:

Tumor necrosis factor

UC:

Ulcerative colitis

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Authors and Affiliations

  1. Pediatric Gastroenterology, Hepatology and Nutrition, Children’s Hospital of Pittsburgh of UPMC, Pittsburgh, PA, USA

    Arvind I. Srinath MD

  2. Department of Behavioral Health, Children’s Hospital of Pittsburgh, Pittsburgh, PA, USA

    Susan A. Turner PsyD

  3. Department of Psychiatry, Children’s Hospital of Pittsburgh, University of Pittsburgh, 4401 Penn Avenue, Pittsburgh, PA, 15224, USA

    Eva Szigethy MD, PhD

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  1. Arvind I. Srinath MD
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  1. Department of Pediatrics, SUNY Upstate Medical University, Syracuse, New York, USA

    Ran D. Anbar

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Srinath, A.I., Turner, S.A., Szigethy, E. (2014). Functional Symptoms in Gastroenterology: A Punch to the Gut. In: Anbar, R. (eds) Functional Symptoms in Pediatric Disease. Springer, New York, NY. https://doi.org/10.1007/978-1-4899-8074-8_5

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