Functional gastrointestinal disorders (FGIDs) are common among children and cause tremendous distress for patients and families. Family physicians should know how to diagnose and manage some of the more common childhood FGIDs. These include infant regurgitation, infant colic, infant dyschezia, cyclic vomiting syndrome, functional nausea and vomiting, functional diarrhea and constipation, abdominal migraine, and nonspecific functional abdominal pain. Diagnosis requires a thorough history and physical examination to rule out red flag signs and symptoms for structural or organic etiologies. Rome IV criteria can help establish a specific diagnosis so that clinicians can select a therapeutic approach and share prognosis with the patient and family. In general, FGID management requires a biopsychosocial approach. This includes symptom management with drugs, where applicable, and establishing a therapeutic relationship with the child and family to relieve distress and dysfunction that may be caused by or cause the FGID. Behavioral therapies such as direct behavioral therapy for younger children and cognitive behavioral therapy for older children are helpful for most FGIDs. More recent approaches include use of probiotics and drugs. Probiotics, for example, can help alleviate symptoms of infant colic in exclusively breastfed infants.
