Gastroenterology Irritable bowel syndrome

AP-DGBIs have a pooled worldwide prevalence of ۱۳.۵% in children aged ۴-۱۸ years old. These disorders have a significant impact on quality of life, resulting from chronic pain and increased psychological comorbidities, such as anxiety and depression. The Rome IV criteria propose a subcategorization of ۴ subtypes of AP-DGBIS, that is, IBS, functional abdominal pain- not otherwise specified (FAP), functional dyspepsia (FD) and abdominal migraine (AM). Management approaches predominantly target the reduction of chronic pain to restore function and include various pharmacological therapies, dietary modifications, gut brain psychotherapies, probiotics, and percutaneous electrical nerve field stimulation (PENFS). Hypnotherapy is recommended as a treatment option (Strong recommendation, Moderate certainty evidence). Cognitive Behavioral therapy (CBT) is recommended as a treatment option (Strong recommendation, Low certainty evidence). Percutaneous Electrical Nerve Field Stimulation (PENFS) is suggested as a treatment option (Conditional recommendation, Moderate certainty evidence). Probiotics (Multi-strain) and Synbiotics (multi strain probiotics and prebiotic) may be suggested as a treatment option (Conditional recommendation, Low certainty evidence). Enteric-coated peppermint capsules may be suggested as a treatment option (Conditional recommendation, Low certainty evidence). Amitriptyline may be suggested as a treatment option (Conditional recommendation, Low certainty evidence). Domperidone may be suggested as a treatment option (Conditional recommendation, Low certainty evidence). Cyproheptadine may be suggested as a treatment option (Conditional recommendation, Low certainty evidence). Buspirone is NOT suggested as a treatment option (Conditional recommendation, Low certainty evidence). Mebeverine is NOT suggested as a treatment option (Conditional recommendation, Low certainty evidence). Drotaverine is NOT suggested as a treatment option (Conditional recommendation, Low certainty evidence). Citalopram is NOT suggested as a treatment option (Conditional recommendation, Low certainty evidence). Yoga is NOT suggested as a treatment option (Conditional recommendation, Low certainty evidence). Irritable Bowel Syndrome (IBS) Specific recommendations Soluble dietary fiber supplements (i.e., hydrolized guar gum, glucomannan, psyllium) are suggested as a treatment option for IBS only (Conditional recommendation, Moderate certainty evidence). Lactobacillus rhamnosus GG is suggested as a treatment option for IBS (Conditional recommendation, Moderate certainty evidence).

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Gastroenterology ، Irritable bowel syndrome