Functional Abdominal Pain

Abstract

Functional gastrointestinal disorders (FGIDs) are common disorders characterized by chronic or recurrent gastrointestinal symptoms not explained by structural or biochemical abnormalities, or, as more recently defined, not attributable to another medical condition after appropriate medical evaluation. The aim of this narrative review was to provide practitioners a synthesis of the current knowledge on epidemiology, pathophysiology, and evaluation of functional abdominal pain disorders. The symptom-based Rome criteria, recently revised to produce Rome IV, allows selective or no testing to support a “positive” diagnosis of a FGID. Moreover, Rome III’s term “abdominal pain related FGIDs” has been changed to “functional abdominal pain disorders” and a new term: “functional abdominal pain–not otherwise specified” has been derived to describe children who do not fit a specific disorder, replacing two Rome III diagnoses (functional abdominal pain and functional abdominal pain syndrome). FGIDs are now defined as disorders of brain–gut interaction. Although the classification system is an important component for categorizing these disorders, effective management requires a biopsychosocial approach that addresses the variability and complexity of these patients.