Breaking the cycle: Psychological and social dimensions of pediatric functional gastrointestinal disorders

Table 2 The psychological mechanisms underlying various functional gastrointestinal disorders

FGID	Psychological mechanisms
Infant colic	Psychosocial stress: High parental stress and anxiety may contribute to infant colic through alterations in caregiving responses and infant stress reactivity
	Parent-infant interaction: Stressful caregiving environments and ineffective soothing strategies may exacerbate colic symptoms
	Family dynamics: Parental conflict or lack of support can increase stress levels, impacting infant behavior and gastrointestinal symptoms
Functional constipation	Psychosocial stress: Stress from social or academic pressures can affect bowel habits and lead to constipation
	Emotional regulation: Difficulty managing emotions may result in withholding behavior, contributing to constipation
	Family dynamics: Overcontrolling or punitive parenting styles regarding toilet training may increase constipation risk
	Coping mechanisms: Ineffective coping strategies or anxiety about bowel movements can exacerbate symptoms
GER	Psychosocial stress: Stress can affect gastrointestinal motility and increase acid reflux symptoms
	Emotional regulation: Stress or anxiety may exacerbate ger symptoms by increasing gastric acid production or sensitivity
	Family dynamics: High-stress family environments may influence feeding practices and exacerbate reflux symptoms
Diarrhea	Psychosocial stress: Stress and anxiety can affect gut motility and contribute to episodes of diarrhea
	Emotional regulation: Difficulty managing stress can lead to gastrointestinal disturbances, including diarrhea
	Family dynamics: Family stressors or dysfunctional family environments may impact bowel habits and exacerbate diarrhea
IBS	Psychosocial stress: Stress and anxiety play a significant role in IBS, influencing symptoms through the brain-gut axis
	Emotional regulation: Difficulty managing emotions can lead to altered gut motility and heightened sensitivity
	Family dynamics: Dysfunctional family environments or high levels of family stress may exacerbate IBS symptoms.
	Coping mechanisms: Ineffective coping strategies may lead to somatization of stress
Cyclic vomiting syndrome	Psychosocial stress: Stressful events or emotional distress can trigger episodes of cyclic vomiting
	Emotional regulation: Poor emotional regulation may contribute to the severity and frequency of vomiting episodes
	Family dynamics: Stressful family environments or parental anxiety can impact the frequency and intensity of episodes
Dysfunctional abdominal pain	Psychosocial stress: Emotional stress and psychosocial factors can contribute to chronic abdominal pain through the brain-gut axis
	Emotional regulation: Ineffective emotional regulation can lead to persistent pain perception
	Family dynamics: Family stress and conflicts may exacerbate symptoms by affecting the child’s emotional state
	Coping mechanisms: Poor coping strategies and somatization of stress may perpetuate pain symptoms
Abdominal migraine	Psychosocial stress: Stress can trigger episodes of abdominal migraine by affecting the brain-gut axis and stress-response systems
	Emotional regulation: Poor emotional regulation can lead to somatization of stress and exacerbate symptoms
	Family dynamics: Parental stress or emotional instability can impact the child’s susceptibility to abdominal migraines
	Early life stressors: Trauma or adverse experiences can alter stress-response systems, contributing to abdominal migraine
	Coping mechanisms: Ineffective coping strategies may exacerbate the frequency and severity of episodes

This table provides an overview of the psychological mechanisms associated with each FGID, focusing on factors such as psychosocial stress, emotional regulation, family dynamics, and coping mechanisms. IBS: Irritable bowel syndrome; FGID: Functional gastrointestinal disorder; GER: Gastroesophageal reflux.