Pediatric functional gastrointestinal (GI) and motility disorders are challenging to live with and to treat. But usually, working with a caring and accesible health care provider, they are manageable.
For parents or care givers of children with illness four questions are paramount:
- What is wrong?
- Is it dangerous?
- Will it go away?
- What can we do?
Treatment of children and adolescents with functional gastrointestinal disorders often involves a team approach. This includes not only the doctor and patient, but also family members, and other therapists such as dieticians or counselors.
The symptoms of functional GI disorders in kids and teens will range from mild to moderate to severe. Treatments will range as well. A combination of medical, dietary, and emotional or behavioral support may be most useful in helping manage symptoms and daily life challenges.
Treatment often begins with:
- Explanations from the doctor about the nature and causes of the disorder
- Dietary modifications
- Discussion of factors that might bring on or make symptoms worse
- Medications that may be used for specific symptoms
- Counseling that may help in dealing with social and school challenges caused by their disorder
Gastrointestinal motility is defined by the movements of the digestive system, and the transit of the contents within it. When nerves or muscles in any portion of the digestive tract do not function in a strong coordinated fashion, a person develops symptoms related to motility problems.
Treatment of GI motility disorders may include:
- Medical treatments
- Nutritional treatments
- Surgical options
The goals are to promote normal growth and development, and improve motility.
Children with functional GI or motility disorders are influenced by many factors. These include genetic predispositions, unique biological and psychological characteristics, family and caregivers, and external systems including school, friends, and community or social situations. Any of these can influence his or her symptom or illness experience. An integrated approach to treatment, which recognizes that the child is at the center of these interacting systems, is often an effective approach.
Within this model, the child’s experiences are linked to his or her family. When a child experiences academic difficulties, conflicts with friends, or problems encountered in community activities such as team sports or social groups, the entire family’s equilibrium can be affected.
Similarly, the child may be affected by significant or stressful experiences of other family members, including parents, siblings, grandparents or other relatives.
An integrated approach takes into account the interdependence of the child and his or her family. The family system as well as the individual child are included in the treatment plan. Within this framework, the physician will spend time with both the child and the family, not only providing education about the disorder but also seeking to understand factors that may compound the child’s disorder.
Mild symptoms can often be treated with:
- A confident diagnosis and education about the condition
- Simple lifestyle modifications
Moderate to severe symptoms may require additional interventions such as:
- Behavioral support
Depending on the disorder and level of severity, treatment may combine:
- Medical support from a physician
- Dietary support from a dietician
- Psychological support from a therapist
- Surgical treatment, in the case of certain motility disorders
Together, they will help the child and family develop new and more effective ways of managing symptoms.
Adapted from IFFGD Publication: The Global Approach To Pediatric Functional Gastrointestinal Disorders #825 by Arlene Caplan, PhD and Andrée Rasquin, MD.