Gastrointestinal Pharmacology

Saps, Miguel; Miranda, Adrian

doi:10.1007/164_2016_119

Cited by 23 publications

(24 citation statements)

References 143 publications

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“…After 2 weeks, 75% of children receiving peppermint oil reported reduced pain intensity compared with the placebo group, although none of the antispasmodics routinely used in clinical practice in the USA was studied. Trimebutine is an opioid agonist that induces the release of motilin (which controls the pattern of smooth muscle cell contraction) and modulates the release of vasoactive intestinal peptide, glucagon and gastrin 197 . An RCT found trimebutine to be effective in relieving pain in children with IBS 197,198 (TABle 1).…”

Section: Pharmacological Therapymentioning

confidence: 99%

“…Trimebutine is an opioid agonist that induces the release of motilin (which controls the pattern of smooth muscle cell contraction) and modulates the release of vasoactive intestinal peptide, glucagon and gastrin 197 . An RCT found trimebutine to be effective in relieving pain in children with IBS 197,198 (TABle 1). Additionally, a double-blind placebo-controlled trial in children with FAP-NOS showed significant benefit with the use of mebevirine (an anticholinergic agent that relaxes the intestinal smooth muscles and decreases peristalses) on pain compared with placebo 199 .…”

Section: Pharmacological Therapymentioning

confidence: 99%

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Paediatric functional abdominal pain disorders

Thapar

Benninga

Crowell

et al. 2020

Nat Rev Dis Primers

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110

119

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Section: Pharmacological Therapymentioning

confidence: 99%

Section: Pharmacological Therapymentioning

confidence: 99%

Paediatric functional abdominal pain disorders

Thapar

Benninga

Crowell

et al. 2020

Nat Rev Dis Primers

Self Cite

110

119

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“…FAPDs [ 20 ] define a group of FGIDs with pain as the driving symptom. Within this group, four subgroups have been defined: Irritable bowel syndrome (IBS), functional dyspepsia, functional abdominal pain-not otherwise specified (FAP-NOS), and abdominal migraine [ 71 ] with the first three diagnostic categories being more prevalent than the latter.…”

Section: Functional Abdominal Pain/irritable Bowel Syndromementioning

confidence: 99%

Cow’s Milk Protein Allergy in Infancy: A Risk Factor for Functional Gastrointestinal Disorders in Children?

et al. 2018

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The role and prevalence of cow’s milk protein allergy (CMA) in functional gastrointestinal disorders remains unclear. The aim of this review is to update knowledge on the relationship between CMA and functional abdominal pain disorders (FAPDs) in children. Cochrane Database and Pubmed were searched from inception using general and specific terms for CMA and functional gastrointestinal disorders. CMA is reported as a predisposing or coexisting factor in a wide range of functional gastrointestinal disorders in infants and children. Pathogenesis of both conditions is complex and multiple mechanisms including dysmotility and hypersensitivity might contribute to the clinical manifestations. Data supporting the possible role of food allergies in the pathogenesis of FAPDs are limited. CMA may predispose to early life inflammation and visceral hypersensitivity, which in turn might manifest as FAPDs. The diagnosis of either CMA or FAPDs and distinction between them is challenging because of nonspecific and overlapping symptoms. Lack of accurate allergy tests in non-IgE (immunoglobulin E) mediated cases is also problematic. Oral food challenge, following an elimination diet, should be performed to diagnose a suspected non-IgE CMA allergy in children with FAPDs. In the management of FAPDs, an elimination diet should be considered for a limited period to verify if the symptoms improve or resolve.

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“…Although many clinicians rely on the pharmacological approach, the overall efficacy of pharmacological agents in IBS is low. Several systematic reviews have pointed out the lack of well-designed high quality clinical trials in this area and lack of therapeutic efficacy of these agents[ 204 , 205 ]. The other issue pertaining to the clinical trials in children with FAPDs is that almost all paediatric trials have lumped together all FAPDs rather than including one specific FAPD such as IBS or FD.…”

Section: Management Of Ibsmentioning

confidence: 99%

“…Rifaximin elicits its antimicrobial properties by binding to the beta-subunit of the bacterial DNA-dependent RNA polymerase and thus inhibiting bacterial RNA syn283 synthesis. It has been approved for the treatment of IBS-D in adults[ 204 ].…”

Section: Management Of Ibsmentioning

confidence: 99%

Irritable bowel syndrome in children: Current knowledge, challenges and opportunities

Devanarayana¹,

Rajindrajith²

2018

WJG

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Irritable bowel syndrome (IBS) is a common and troublesome disorder in children with an increasing prevalence noted during the past two decades. It has a significant effect on the lives of affected children and their families and poses a significant burden on healthcare systems. Standard symptom-based criteria for diagnosis of pediatric IBS have changed several times during the past two decades and there are some differences in interpreting symptoms between different cultures. This has posed a problem when using them to diagnose IBS in clinical practice. A number of potential patho-physiological mechanisms have been described, but so far the exact underlying etiology of IBS is unclear. A few potential therapeutic modalities have been tested in children and only a small number of them have shown some benefit. In addition, most of the described patho-physiological mechanisms and treatment options are based on adult studies. These have surfaced as challenges when dealing with pediatric IBS and they need to be overcome for effective management of children with IBS. Recently suggested top-down and bottom-up models help integrating reported patho-physiological mechanisms and will provide an opportunity for better understanding of the diseases process. Treatment trials targeting single treatment modalities are unlikely to have clinically meaningful therapeutic effects on IBS with multiple integrating patho-physiologies. Trials focusing on multiple combined pharmacological and non-pharmacological therapies are likely to yield more benefit. In addition to treatment, in the future, attention should be paid for possible prevention strategies for IBS.

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Gastrointestinal Pharmacology

Abstract: Little data support the use of most medications commonly used to treat FAPDs in children. More randomized, placebo-controlled studies are needed to assess the efficacy of pharmacological interventions in the treatment of FAPDs in children.

Cited by 23 publications

References 143 publications

Paediatric functional abdominal pain disorders

Paediatric functional abdominal pain disorders

Cow’s Milk Protein Allergy in Infancy: A Risk Factor for Functional Gastrointestinal Disorders in Children?

Irritable bowel syndrome in children: Current knowledge, challenges and opportunities

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