Il dolore addominale ricorrente: tante novità, nessuna novità

Abstract

Recurrent abdominal pain of functional origin remains one of the most important challenges for the paediatrician. In most cases, the symptom reveals a functional cause. About 25 years ago, an international group of researchers and clinicians met in Rome to develop a classification system for DAR in functional gastrointestinal disorders that supports its diagnosis, standardization of research, and dissemination of information. Recurrent abdominal pain of functional origin is managed using a biopsychosocial model. Pain is the result of psychological and psychosocial factors as well as of events that have occurred from the earliest years of life. The pathogenesis is related to dysmotility, visceral hypersensitivity, changes in some transmission processes from the periphery to the central nervous system (CNS), changes in the mucosal-gut immune response and in the microbiota composition. There are numerous critical problems in the diagnosis and treatment: symptom-based diagnoses, high costs, uncontrolled use of drug therapies and lack of knowledge of the main strategies of approach. Dietary interventions (lactose, gluten, fibres and fermentable oligosaccharides) are very common in the adult population, but there is no evidence that they can be helpful in children.