Functional gastrointestinal disorders (FGIDs) in children present with chronic symptoms like abdominal pain, diarrhea, and constipation without identifiable structural abnormalities. These disorders are closely linked to gut-brain axis dysfunction, altered gut microbiota, and psychosocial stress, leading to psychiatric comorbidities such as anxiety, depression, and behavioral issues. Understanding this bidirectional relationship is crucial for developing effective, holistic management strategies that address physical and mental health.

To examine the psychiatric impacts of FGIDs in children, focusing on anxiety and depression and their association with other neurodevelopmental disorders of childhood, such as attention-deficit/hyperactivity disorder, emphasizing the role of the gut-brain axis, emotional dysregulation, and psychosocial stress. Key mechanisms explored include neurotransmitter dysregulation, microbiota imbalance, central sensitization, heightening stress reactivity, emotional dysregulation, and symptom perception. The review also evaluates the role of family dynamics and coping strategies in exacerbating FGID symptoms and contributing to psychiatric conditions.

A narrative review was conducted using 328 studies sourced from PubMed, Scopus, and Google Scholar, covering research published over the past 20 years. Inclusion criteria focused on studies examining FGID diagnosis, gut-brain mechanisms, psychiatric comorbidities, and psychosocial factors in pediatric populations. FGIDs commonly affecting children, including functional constipation, abdominal pain, irritable bowel syndrome, gastroesophageal reflux, and cyclic vomiting syndrome, were analyzed concerning their psychological impacts.

The review highlights a strong connection between FGIDs and psychiatric symptoms, mediated by gut-brain axis dysfunction, dysregulated microbiota, and central sensitization. These physiological disruptions increase children’s vulnerability to anxiety and depression, while psychosocial factors - such as chronic stress, early-life trauma, maladaptive family dynamics, and ineffective coping strategies - intensify the cycle of gastrointestinal and emotional distress.

Effective management of FGIDs requires a biopsychosocial approach integrating medical, psychological, and dietary interventions. Parental education, early intervention, and multidisciplinary care coordination are critical in mitigating long-term psychological impacts and improving both gastrointestinal and mental health outcomes in children with FGIDs.

• Functional gastrointestinal disorders
• Psychiatric comorbidities
• Gut-brain axis
• Pediatric mental health
• Psychosocial stress

• COVID-19-induced ‎gastrointestinal disorders
• Coeliac disease
• Cystic fibrosis
• Fecal calprotectin
• Functional gastrointestinal ‎disorders
• Infectious gastroenteritis
• Inflammatory bowel disease
• Pediatric gastrointestinal diseases

• Humans
• Child
• Dietary Supplements
• Probiotics/therapeutic use
• Prebiotics
• Gastrointestinal Diseases/drug therapy
• Complementary Therapies

• abdominal pain
• functional constipation
• irritable bowel syndrome

• Male
• Female
• Child
• Humans
• Irritable Bowel Syndrome/complications
• Irritable Bowel Syndrome/diagnosis
• Quality of Life
• Down Syndrome/complications
• Cross-Sectional Studies
• Constipation/complications
• Constipation/diagnosis
• Brain Diseases
• Brain
• Surveys and Questionnaires

• Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), NIH

• Abdominal pain
• Constipation
• Down syndrome
• Dyspepsia
• Nausea

• Abdominal pain
• Gastrointestinal illness
• Health-related quality of life
• Optimism
• Pain self-efficacy
• Psychogastroenterology

• Functional
• Gastrointestinal
• Motility
• Pediatric
• Peristalsis

• Child
• Gastrointestinal Diseases/diagnosis
• Gastrointestinal Diseases/therapy
• Humans

• abdominal migraine
• functional abdominal pain
• functional dyspepsia
• functional gastrointestinal disorders
• gastroenterology
• irritable bowel syndrome

Introduction: Irritable bowel syndrome (IBS) is included as one of the functional gastrointestinal (GI) related disorders presenting with pain in abdomen of chronic duration in the absence of any identifiable organic cause. Bloating, distension of abdomen, and defecation in disordered manner are other features commonly associated with IBS. It is a complex disorder with mixed physiological, psychological, and social interactions. The present study was carried out with the aim to determine the frequency of IBS in patients presenting with abdominal pain in a population of a developing country.

Materials and methods: A descriptive cross-sectional study was undertaken at the outpatient department of a large tertiary care hospital. Patients of either gender aged between 20 and 50 years presenting with abdominal pain were included. The diagnosis of IBS was established using Rome III criteria. Prevalence of IBS was calculated and confounding factors such as age, gender, marital status, duration of abdominal pain, and economic status were stratified to see their effect on outcome variable by applying chi-square test and taking p-value of <0.05 as significant.

Results: A total of 186 patients were included in this study. Some 100 (53.76%) were male and 86 (46.24%) were female. Mean age of the patients was 33.67 ± 7.08 years. Some 58.6% were married and 41.4% were single. Some 61.83% had mild abdominal pain and 38.17% had moderate pain. Out of the total 186 patients, the frequency of IBS was found to be 35.48%. There was no significant effect of confounding variables such as age, gender, duration of abdominal pain, marital status, and economic status on IBS.

Conclusion: In our study the frequency of IBS in patients with abdominal pain is high with no significant effect of gender, marital status, economic status, and duration of abdominal pain on IBS.

• abdominal pain
• bowel disorder
• irritable bowel syndrome

• cyclic vomiting
• emesis
• migraine
• pediatric emergency
• pharmacologic intervention

• epidemiology
• functional gastrointestinal disorders
• pediatrics
• prevalence
• risk-factors

• Chronic medical condition
• Pain
• Pediatric illness
• Sleep

• Comorbidity
• Developmental Disabilities/complications
• Developmental Disabilities/epidemiology
• Humans
• Pain/epidemiology
• Pain/psychology
• Pain Management
• Pediatrics
• Sleep Wake Disorders/epidemiology
• Sleep Wake Disorders/psychology
• Sleep Wake Disorders/therapy

• Abdominal Pain/diagnosis
• Abdominal Pain/therapy
• Child
• Child, Preschool
• Chronic Disease
• Family Characteristics
• Female
• Humans
• Male
• Parents/education

The aim of this case report was to evaluate the psychiatric co-morbidity and efficacy of mirtazapine treatment in young subjects with chronic or cyclic vomiting syndromes. This is a case series of 8 young subjects (age range of 6-16 years, 11.12 ± 3.52 years) who were referred or consulted to child psychiatry department. They were referred or consulted by pediatric gastroenterology or surgery departments for the presence of non-remitting and medically unexplained vomiting. They were investigated for co-morbid psychiatric disorders using a structured psychiatric interview. An open trial of mirtazapine was conducted for the treatment and/or prevention of vomiting. Primary outcome measure was Clinical Global Impression-Improvement scale. Subjects were diagnosed with chronic (n = 5) or cyclic (n = 3) vomiting syndromes. Duration of vomiting ranged from 6 months to 10 years (3.5 ± 3.2 years). All subjects received multiple psychiatric diagnoses with anxiety disorders being the most frequent. Maximum mirtazapine dosage was 7.5-30 mg/day (16.00 ± 6.16 mg/day). Three subjects showed complete remission and 5 subjects showed much to very much improvement in vomiting. Most frequent side effects were increased appetite, weight gain and sedation. Young subjects with chronic or cyclic vomiting may frequently suffer anxiety and/or depressive symptoms or disorders. Mirtazapine could be an effective treatment option for the treatment of vomiting and co-morbid anxiety or depressive disorders in these subjects. More systematic research are needed on this topic.

• Anxiety
• Child
• Familial cyclic vomiting syndrome
• Gastrointestinal diseases
• Mirtazapine