Herbal Approaches to Pediatric Functional Abdominal Pain

doi:10.3390/children9081266

Review

. 2022 Aug 22;9(8):1266.

doi: 10.3390/children9081266.

Herbal Approaches to Pediatric Functional Abdominal Pain

Rebecca N Cherry¹, Samra S Blanchard², Ashish Chogle³, Neha R Santucci^{4

5}, Khyati Mehta⁶, Alexandra C Russell⁷

Affiliations

¹ Deep Well Health Care, Elkins Park, PA 19027, USA.
² Division of Pediatric Gastroenterology, University of Maryland School of Medicine, Baltimore, MD 21201, USA.
³ Department of Pediatric Gastroenterology, CHOC Children's, Orange, CA 92868, USA.
⁴ Division of Pediatric Gastroenterology, Hepatology and Nutrition, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA.
⁵ Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA.
⁶ Division of Pediatric Gastroenterology, Hepatology and Nutrition, Loma Linda University Medical Center, Loma Linda, CA 92354, USA.
⁷ Division of Pediatric Gastroenterology, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN 37232, USA.

PMID: 36010156
PMCID: PMC9406842
DOI: 10.3390/children9081266

Review

Herbal Approaches to Pediatric Functional Abdominal Pain

Rebecca N Cherry et al. Children (Basel). 2022.

. 2022 Aug 22;9(8):1266.

doi: 10.3390/children9081266.

Authors

Rebecca N Cherry¹, Samra S Blanchard², Ashish Chogle³, Neha R Santucci^{4

5}, Khyati Mehta⁶, Alexandra C Russell⁷

Affiliations

¹ Deep Well Health Care, Elkins Park, PA 19027, USA.
² Division of Pediatric Gastroenterology, University of Maryland School of Medicine, Baltimore, MD 21201, USA.
³ Department of Pediatric Gastroenterology, CHOC Children's, Orange, CA 92868, USA.
⁴ Division of Pediatric Gastroenterology, Hepatology and Nutrition, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA.
⁵ Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA.
⁶ Division of Pediatric Gastroenterology, Hepatology and Nutrition, Loma Linda University Medical Center, Loma Linda, CA 92354, USA.
⁷ Division of Pediatric Gastroenterology, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN 37232, USA.

PMID: 36010156
PMCID: PMC9406842
DOI: 10.3390/children9081266

Abstract

Chronic abdominal pain is one of the most common problems seen by both pediatricians and pediatric gastroenterologists. Abdominal-pain-related functional gastrointestinal disorders (AP-FGIDs) are diagnosed in children with chronic and recurrent abdominal pain meeting clinical criteria set forth in the Rome IV criteria. AP-FGIDs affect approximately 20% of children worldwide and include functional dyspepsia (FD), irritable bowel syndrome (IBS), functional abdominal pain (FAP), and abdominal migraine. IBS accounts for 45% of pediatric AP-FGIDs. The pathophysiology of functional abdominal pain involves an interplay of factors including early life events, genetics, psychosocial influences, and physiologic factors of visceral sensitivity, motility disturbance, altered mucosal immune function, and altered central nervous system processing. Treatment approaches are varied and can include dietary, pharmacologic, and complementary medicine interventions, as well as psychosocial support, depending on the many aspects of the disorder and the needs of the individual patient. There is a strong interest in complementary and integrative medicine approaches to pediatric pain from both patients, providers, and families. In this article, we discuss popular herbal treatments typically used in the field of complementary medicine to treat pediatric AP-FGIDs: peppermint oil, Iberogast^®, cannabis, fennel, and licorice. While high-quality data are rather limited, studies generally show that these remedies are at least as effective as placebo, and are well tolerated with minimal side effects. We will need more placebo-controlled, double-blind, and unbiased prospective studies to document and quantify efficacy.

Keywords: abdominal pain.

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Conflict of interest statement

The authors declare no conflict of interest.

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References

1. Rasquin A., Di Lorenzo C., Forbes D., Guiraldes E., Hyams J.S., Staiano A., Walker L.S. Childhood functional disorders, child/adolescent. In: Drossman D., Chang L., Chey W., editors. Rome IV, Functional Disorders, Disorders of Gut-Brain Interaction. The Rome Foundation; Raleigh, NC, USA: 2016. pp. 1297–1371.
1. Korterink J.J., Rutten J.M., Venmans L., Benninga M.A., Tabbers M.M. Pharmacologic Treatment in Pediatric Functional Abdominal Pain Disorders: A Systematic Review. J. Pediatr. 2015;166:424–431.e6. doi: 10.1016/j.jpeds.2014.09.067. - DOI - PubMed
1. Zeiter D.K. Abdominal Pain in Children: From the Eternal City to the Examination Room. Pediatr. Clin. N. Am. 2017;64:525–541. doi: 10.1016/j.pcl.2017.01.012. - DOI - PubMed
1. Wahera V., Lemberg D., Leach S., Day S. Complementary and alternative medicine in children attending gastroenterology clinics: Usage patterns and reasons for use. J. Paediatr. Child Health. 2011;47:904–910. doi: 10.1111/j.1440-1754.2011.02100.x. - DOI - PubMed
1. Kline R.M., Kline J.J., Di Palma J., Barbero G.J. Enteric-coated, pH-dependent peppermint oil capsules for the treatment of irritable bowel syndrome in children. J. Pediatr. 2001;138:125–128. doi: 10.1067/mpd.2001.109606. - DOI - PubMed

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[1] Rasquin A., Di Lorenzo C., Forbes D., Guiraldes E., Hyams J.S., Staiano A., Walker L.S. Childhood functional disorders, child/adolescent. In: Drossman D., Chang L., Chey W., editors. Rome IV, Functional Disorders, Disorders of Gut-Brain Interaction. The Rome Foundation; Raleigh, NC, USA: 2016. pp. 1297–1371.

[2] Rasquin A., Di Lorenzo C., Forbes D., Guiraldes E., Hyams J.S., Staiano A., Walker L.S. Childhood functional disorders, child/adolescent. In: Drossman D., Chang L., Chey W., editors. Rome IV, Functional Disorders, Disorders of Gut-Brain Interaction. The Rome Foundation; Raleigh, NC, USA: 2016. pp. 1297–1371.

[3] Korterink J.J., Rutten J.M., Venmans L., Benninga M.A., Tabbers M.M. Pharmacologic Treatment in Pediatric Functional Abdominal Pain Disorders: A Systematic Review. J. Pediatr. 2015;166:424–431.e6. doi: 10.1016/j.jpeds.2014.09.067. - DOI - PubMed

[4] Korterink J.J., Rutten J.M., Venmans L., Benninga M.A., Tabbers M.M. Pharmacologic Treatment in Pediatric Functional Abdominal Pain Disorders: A Systematic Review. J. Pediatr. 2015;166:424–431.e6. doi: 10.1016/j.jpeds.2014.09.067. - DOI - PubMed

[5] Zeiter D.K. Abdominal Pain in Children: From the Eternal City to the Examination Room. Pediatr. Clin. N. Am. 2017;64:525–541. doi: 10.1016/j.pcl.2017.01.012. - DOI - PubMed

[6] Zeiter D.K. Abdominal Pain in Children: From the Eternal City to the Examination Room. Pediatr. Clin. N. Am. 2017;64:525–541. doi: 10.1016/j.pcl.2017.01.012. - DOI - PubMed

[7] Wahera V., Lemberg D., Leach S., Day S. Complementary and alternative medicine in children attending gastroenterology clinics: Usage patterns and reasons for use. J. Paediatr. Child Health. 2011;47:904–910. doi: 10.1111/j.1440-1754.2011.02100.x. - DOI - PubMed

[8] Wahera V., Lemberg D., Leach S., Day S. Complementary and alternative medicine in children attending gastroenterology clinics: Usage patterns and reasons for use. J. Paediatr. Child Health. 2011;47:904–910. doi: 10.1111/j.1440-1754.2011.02100.x. - DOI - PubMed

[9] Kline R.M., Kline J.J., Di Palma J., Barbero G.J. Enteric-coated, pH-dependent peppermint oil capsules for the treatment of irritable bowel syndrome in children. J. Pediatr. 2001;138:125–128. doi: 10.1067/mpd.2001.109606. - DOI - PubMed

[10] Kline R.M., Kline J.J., Di Palma J., Barbero G.J. Enteric-coated, pH-dependent peppermint oil capsules for the treatment of irritable bowel syndrome in children. J. Pediatr. 2001;138:125–128. doi: 10.1067/mpd.2001.109606. - DOI - PubMed

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Herbal Approaches to Pediatric Functional Abdominal Pain

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Herbal Approaches to Pediatric Functional Abdominal Pain

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