{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T12:23:44Z","timestamp":1785932624813,"version":"3.56.0"},"reference-count":83,"publisher":"American Academy of Pediatrics (AAP)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2015,3,1]]},"abstract":"<jats:sec>\n                  <jats:title>BACKGROUND AND OBJECTIVE:<\/jats:title>\n                  <jats:p>Various nonpharmacologic treatments are available for pediatric abdominal pain\u2013related functional gastrointestinal disorders (AP-FGIDs). Data on efficacy and safety are scarce. The goal of this study was to summarize the evidence regarding nonpharmacologic interventions for pediatric AP-FGIDs: lifestyle interventions, dietary interventions, behavioral interventions, prebiotics and probiotics, and alternative medicine.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS:<\/jats:title>\n                  <jats:p>Searches were conducted of the Medline and Cochrane Library databases. Systematic reviews and randomized controlled trials (RCTs) concerning nonpharmacologic therapies in children (aged 3\u201318 years) with AP-FGIDs were included, and data were extracted on participants, interventions, and outcomes. The quality of evidence was assessed by using the GRADE approach.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS:<\/jats:title>\n                  <jats:p>Twenty-four RCTs were found that included 1390 children. Significant improvement of abdominal pain was reported after hypnotherapy compared with standard care\/wait-list approaches and after cognitive behavioral therapy compared with a variety of control treatments\/wait-list approaches. Written self-disclosure improved pain frequency at the 6-month follow-up only. Compared with placebo, Lactobacillus rhamnosus GG (LGG) and VSL#3 were associated with significantly more treatment responders (LGG relative risk: 1.31 [95% confidence interval: 1.08 to 1.59]; VSL#3: P &amp;lt; .05). Guar gum significantly improved irritable bowel syndrome symptom frequency; however, no effect was found for other fiber supplements (relative risk: 1.17 [95% confidence interval: 0.75 to 1.81]) or a lactose-free diet. Functional disability was not significantly decreased after yoga compared with a wait-list approach. No studies were found concerning lifestyle interventions; gluten-, histamine-, or carbonic acid\u2013free diets; fluid intake; or prebiotics. No serious adverse effects were reported. The quality of evidence was found to be very low to moderate.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS:<\/jats:title>\n                  <jats:p>Although high-quality studies are lacking, some evidence shows efficacy of hypnotherapy, cognitive behavioral therapy, and probiotics (LGG and VSL#3) in pediatric AP-FGIDs. Data on fiber supplements are inconclusive.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1542\/peds.2014-2123","type":"journal-article","created":{"date-parts":[[2015,2,10]],"date-time":"2015-02-10T04:54:10Z","timestamp":1423544050000},"page":"522-535","source":"Crossref","is-referenced-by-count":100,"title":["Nonpharmacologic Treatment of Functional Abdominal Pain Disorders: A Systematic Review"],"prefix":"10.1542","volume":"135","author":[{"given":"Juliette M.T.M.","family":"Rutten","sequence":"first","affiliation":[{"name":"Department of Pediatric Gastroenterology and Nutrition, Emma\u2019s Children\u2019s Hospital, Academic Medical Center, Amsterdam, Netherlands; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judith J.","family":"Korterink","sequence":"additional","affiliation":[{"name":"Department of Pediatric Gastroenterology and Nutrition, Emma\u2019s Children\u2019s Hospital, Academic Medical Center, Amsterdam, Netherlands; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonie M.A.J.","family":"Venmans","sequence":"additional","affiliation":[{"name":"Pediatric Association of the Netherlands, Utrecht, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc A.","family":"Benninga","sequence":"additional","affiliation":[{"name":"Department of Pediatric Gastroenterology and Nutrition, Emma\u2019s Children\u2019s Hospital, Academic Medical Center, Amsterdam, Netherlands; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Merit M.","family":"Tabbers","sequence":"additional","affiliation":[{"name":"Department of Pediatric Gastroenterology and Nutrition, Emma\u2019s Children\u2019s Hospital, Academic Medical Center, Amsterdam, Netherlands; 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