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Nutrients
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Nutrition and Functional Abdominal Pain
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Nutrition and Functional Abdominal Pain

A special issue of Nutrients (ISSN 2072-6643).

Deadline for manuscript submissions: closed (30 September 2018) | Viewed by 60868

Special Issue Editors

Prof. Dr. Miguel Saps

E-Mail Website
Guest Editor
Pediatric Gastroenterology, Hepatology and Nutrition Division, University of Miami Miller School of Medicine, Miami, FL 33136, USA
Interests: pediatric gastroenterology; functional bowel disorders; digestive disorders
Special Issues, Collections and Topics in MDPI journals
Dr. Amanda Fifi

E-Mail Website
Guest Editor
Division of Pediatric Gastroenterology, Hepatology & Nutrition, University of Miami Miller School of Medicine, USA
Interests: pediatric gastroenterology; functional abdominal pain disorders; human nutrition
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The worldwide pooled prevalence of functional abdominal pain disorders (FAPDs) in pediatrics is 13.5%. FAPDs account for up to 75% of all pediatric gastroenterology consultations. The Rome IV criteria classifies these as functional dyspepsia, irritable bowel syndrome, abdominal migraine and functional abdominal pain - not otherwise specified. The role of nutrients in functional abdominal pain disorders is an active area of research. This special issue will focus on the latest evidence on the treatment of functional abdominal pain disorders in children in realtion to:

  • Obesity
  • Cow’s milk protein allergy
  • Gluten
  • Disaccharidases deficiency
  • Fiber
  • Low FODMAP diet
  • Probiotics
  • Herbs and Spices
  • Eating behaviors
Prof. Miguel Saps
Assist. Prof. Amanda C. Fifi
Guest Editors

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Keywords

  • Functional abdominal pain disorders
  • Bioactive peptides
  • Irritable bowel syndrome
  • Gluten
  • FODMAPs
  • Probiotics
  • Cow’s milk protein allergy
  • Fiber
  • Disaccharidases

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Published Papers (7 papers)

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Editorial

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3 pages, 167 KiB  
Editorial
Diet and Functional Gastrointestinal Disorders in Children. Is the Focus on Food Exaggerated?
by Amanda C. Fifi and Miguel Saps
Nutrients 2019, 11(2), 250; https://doi.org/10.3390/nu11020250 - 23 Jan 2019
Cited by 3 | Viewed by 3320
Abstract
Almost all children (93%) who consult for irritable bowel syndrome (IBS) report food intolerances [...] Full article
(This article belongs to the Special Issue Nutrition and Functional Abdominal Pain)

Research

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16 pages, 3000 KiB  
Article
Alleviation of Irritable Bowel Syndrome-Like Symptoms and Control of Gut and Brain Responses with Oral Administration of Dolichos lablab L. in a Mouse Model
by Eunho Chun, Soojung Yoon, Amna Parveen and Mirim Jin
Nutrients 2018, 10(10), 1475; https://doi.org/10.3390/nu10101475 - 10 Oct 2018
Cited by 18 | Viewed by 5449
Abstract
Irritable bowel syndrome (IBS) is a common gastrointestinal disorder manifesting as unexplained abdominal pain and bowel habit changes. The pathogenesis of post-infectious IBS is associated with gut–brain axis dysfunction, including low-grade colonic inflammation and anxiety-related long-term brain changes. This study analyzed the efficacy [...] Read more.
Irritable bowel syndrome (IBS) is a common gastrointestinal disorder manifesting as unexplained abdominal pain and bowel habit changes. The pathogenesis of post-infectious IBS is associated with gut–brain axis dysfunction, including low-grade colonic inflammation and anxiety-related long-term brain changes. This study analyzed the efficacy of a standardized extract of Dolichos lablab L. extract (DL), a bean species, in an IBS mouse model resembling post-infectious, diarrhea-dominant IBS. Using a zymosan-induced animal IBS model, we found that oral administration of DL significantly attenuated zymosan-induced increases in colonic macroscopic scores and minimized weight loss without affecting food intake. In the DL-treated mice, the mast cell count and tumor necrosis factor-α level in the colon markedly decreased, similar to results in sulfasalazine-treated mice and in mice with lipopolysaccharide-stimulated bone marrow-derived mast cells. The number of visceral pain-related behaviors was much lower in the DL-treated mice. Anxiety-like behaviors significantly improved, comparable to that after treatment with amitriptyline. The c-Fos expression level in the prefrontal cortex was significantly reduced. Our data suggest that DL could be beneficial for treating IBS by acting on the gut and brain. Full article
(This article belongs to the Special Issue Nutrition and Functional Abdominal Pain)
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Review

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8 pages, 469 KiB  
Review
The Role of Disaccharidase Deficiencies in Functional Abdominal Pain Disorders—A Narrative Review
by Mora V. Puertolas and Amanda C. Fifi
Nutrients 2018, 10(12), 1835; https://doi.org/10.3390/nu10121835 - 29 Nov 2018
Cited by 12 | Viewed by 9651
Abstract
Disaccharidase deficiencies are reportedly underdiagnosed in pediatric populations. Though typically thought to cause diarrheal disease, they can also be a cause of abdominal pain and dyspepsia, and patients diagnosed with these functional disorders may actually have associated enzyme deficiencies. While the effects of [...] Read more.
Disaccharidase deficiencies are reportedly underdiagnosed in pediatric populations. Though typically thought to cause diarrheal disease, they can also be a cause of abdominal pain and dyspepsia, and patients diagnosed with these functional disorders may actually have associated enzyme deficiencies. While the effects of lactose deficiency have been widely studied, sucrase, maltase, and isomaltase are less frequently considered when approaching a patient with an apparent functional abdominal pain disorder. This review seeks to provide an up-to-date narrative on the current scientific literature on the possible role of sucrase, maltase, and isomaltase deficiency in pediatric functional gastrointestinal disorders. Full article
(This article belongs to the Special Issue Nutrition and Functional Abdominal Pain)
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15 pages, 475 KiB  
Review
Cow’s Milk Protein Allergy in Infancy: A Risk Factor for Functional Gastrointestinal Disorders in Children?
by Licia Pensabene, Silvia Salvatore, Enza D'Auria, Francesca Parisi, Daniela Concolino, Osvaldo Borrelli, Nikhil Thapar, Annamaria Staiano, Yvan Vandenplas and Miguel Saps
Nutrients 2018, 10(11), 1716; https://doi.org/10.3390/nu10111716 - 9 Nov 2018
Cited by 53 | Viewed by 9139
Abstract
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 [...] Read more.
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. Full article
(This article belongs to the Special Issue Nutrition and Functional Abdominal Pain)
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21 pages, 454 KiB  
Review
Herbs and Spices in the Treatment of Functional Gastrointestinal Disorders: A Review of Clinical Trials
by Amanda C. Fifi, Cara Hannah Axelrod, Partha Chakraborty and Miguel Saps
Nutrients 2018, 10(11), 1715; https://doi.org/10.3390/nu10111715 - 9 Nov 2018
Cited by 44 | Viewed by 16760
Abstract
More than fifty percent of all new patient visits to pediatric gastroenterology clinics consult for functional abdominal pain disorders (FAPDs). In 2005, a technical report of the American Academy of Pediatrics and the North American Pediatric Gastroenterology, Hepatology and Nutrition society (NASPGHAN) found [...] Read more.
More than fifty percent of all new patient visits to pediatric gastroenterology clinics consult for functional abdominal pain disorders (FAPDs). In 2005, a technical report of the American Academy of Pediatrics and the North American Pediatric Gastroenterology, Hepatology and Nutrition society (NASPGHAN) found limited or inconclusive evidence for most therapeutic interventions for this group of disorders. The report did not include studies on herbs and spices. Since then, there has been an increasing interest in the use of complementary and alternative medicine (CAM) for the treatment of chronic pain disorders in children. About 40% of parents of pediatric gastroenterology patients have utilized CAM. This review evaluated the published literature on the effectiveness of CAM, specifically the use of herbs and spices, for the treatment of FAPDs. We found little evidence for most of the commonly used herbs and spices. Despite its common use, research on the efficacy, safety, and optimal dosage remains limited. There is evidence to suggest the benefit of peppermint oil and STW 5 for the treatment of FAPDs in children. The paucity of data on most therapies underscores the need for large clinical trials to assess their efficacy. Full article
(This article belongs to the Special Issue Nutrition and Functional Abdominal Pain)
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16 pages, 682 KiB  
Review
The Role of Fiber in the Treatment of Functional Gastrointestinal Disorders in Children
by Cara Hannah Axelrod and Miguel Saps
Nutrients 2018, 10(11), 1650; https://doi.org/10.3390/nu10111650 - 3 Nov 2018
Cited by 46 | Viewed by 9209
Abstract
We reviewed the available evidence on the role of fiber in the treatment of Functional Constipation (FC) and Irritable Bowel Syndrome (IBS) in children. The vast majority of toddlers and preschoolers do not consume enough fiber. Two of the most common reasons for [...] Read more.
We reviewed the available evidence on the role of fiber in the treatment of Functional Constipation (FC) and Irritable Bowel Syndrome (IBS) in children. The vast majority of toddlers and preschoolers do not consume enough fiber. Two of the most common reasons for consultation to a pediatric gastroenterology practice include FC and IBS. The North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) and the European Society of Pediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) guidelines state that the evidence does not support the use of fiber supplements in the treatment of FC in children, and the Rome IV criteria do not recommend an increase in fiber consumption, in children with IBS. Despite this, in general practice, it is commonly recommended that children who experience constipation and IBS to increase their fiber intake. We conducted a systematic review of the available evidence on the role of fiber in the treatment of FC and IBS in children. Thirteen full-text articles with a total of seven hundred and twenty-three pediatric participants were included in this review. Three clinical trials found positive effects of dietary fiber for the management of IBS. Nine out of ten trials found fiber to be either more effective than placebo, or just as effective as laxative treatment. Most studies on the use of fiber for the treatment of FC and IBS have shown its benefit. However, due to the heterogeneity in study design, length of treatment, outcome measures, and amount and type of fiber, we were unable to make a definitive recommendation supporting the use of fiber for the treatment of FC and IBS in children. Full article
(This article belongs to the Special Issue Nutrition and Functional Abdominal Pain)
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16 pages, 449 KiB  
Review
Gluten and Functional Abdominal Pain Disorders in Children
by Alejandro Llanos-Chea and Alessio Fasano
Nutrients 2018, 10(10), 1491; https://doi.org/10.3390/nu10101491 - 12 Oct 2018
Cited by 20 | Viewed by 6322
Abstract
In children, functional gastrointestinal disorders (FGIDs) are common at all ages. Consumption of certain foods, particularly gluten, is frequently associated with the development and persistence of FGIDs and functional abdominal pain disorders (FAPDs) in adults and children. However, this association is not well [...] Read more.
In children, functional gastrointestinal disorders (FGIDs) are common at all ages. Consumption of certain foods, particularly gluten, is frequently associated with the development and persistence of FGIDs and functional abdominal pain disorders (FAPDs) in adults and children. However, this association is not well defined. Even without a diagnosis of celiac disease (CD), some people avoid gluten or wheat in their diet since it has been shown to trigger mostly gastrointestinal symptoms in certain individuals, especially in children. The incidence of conditions such as non-celiac gluten sensitivity (NCGS) is increasing, particularly in children. On the other hand, CD is a chronic, autoimmune small intestinal enteropathy with symptoms that can sometimes be mimicked by FAPD. It is still unclear if pediatric patients with irritable bowel syndrome (IBS) are more likely to have CD. Abdominal, pain-associated FGID in children with CD does not seem to improve on a gluten-free diet. The threshold for gluten tolerance in patients with NCGS is unknown and varies among subjects. Thus, it is challenging to clearly distinguish between gluten exclusion and improvement of symptoms related solely to functional disorders. Full article
(This article belongs to the Special Issue Nutrition and Functional Abdominal Pain)
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