Pharmacological treatments for functional nausea and functional dyspepsia in children: a systematic review

The Effects of the Rome IV Criteria on Pediatric Gastrointestinal Practice

“…Education of families on the diagnosis can provide a sense of relief that can positively influence the prognosis [21]. Due to the recent inclusion of the diagnoses of functional and nausea and vomiting in children, there is still lack of evidence for specific pharmacological and non-pharmacological treatments [22]. In the absence of evidence-based recommendations for their treatment, management principles are extrapolated from clinical trials aimed at treating other diseases/disorders with common symptoms.…”

“…Thus, currently, there are neither guidelines for the treatment of children with functional dyspepsia nor prospective randomized studies to provide recommendations. A recent systematic review found that there is no available evidence to support the use of any pharmacological drugs to treat children with functional dyspepsia [22]. However, the committee made recommendations for the treatment of each subtype based on expert opinion and adult based data.…”

How does one choose the appropriate pharmacotherapy for pediatric patients with functional dyspepsia?

“…A systematic review evaluated evidence on the efficacy and safety of pharmacological treatments of FD in children [13]. Three randomized controlled trials (256 children with FD, 2-16 years of age) were included and all showed a considerable risk of bias.…”

“…Compared with baseline, mosapride reduced global symptoms compared to pantoprazole (p = 0.011; p = 0.009, respectively). The authors concluded that more high-quality clinical trials are needed [13].…”

Management of abdominal pain in pediatric emergency departments

“…H2수용체차단제 중 famotidine은 반복성 복통 소아환 자에서 복통의 호전은 없었으나 소화불량과 관련된 전체 적인 증상 호전을 보여 일부 효과는 있는 것으로 추정한다 43) . 이외에도 ranitidine, cimetidine, omeprazole 등도 소 화불량을 개선하지만 보다 체계적인 연구가 필요하다 44) . 이 외에 melatonin, 칼슘통로차단제인 flunarizine, 세로토닌 길항제인 pizotifen, 항생제인 rifaximin, co-trimoxazole 등에 대한 보고가 있으나 연구가 제한적일 뿐 아니라 대부분 효과도 불확실하다 33) .…”