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A new study is calling for a multidisciplinary approach to tackle the rising number of children with functional gastrointestinal disorders (FGIDs) in Bahrain, as well as to find out how better to treat mental health symptoms that may arise as a result of the condition.
FGIDs are a group of conditions that arise from abnormal digestive system functioning without identifiable structural abnormalities.
Chronic symptoms, such as abdominal pain, diarrhoea, constipation or discomfort characterise these disorders.
The review was published on March 18 in the World Journal of Clinical Paediatrics by leading doctors in Bahrain from the University Medical Centre at King Abdullah Medical City, Salmaniya Medical Complex, the Royal College of Surgeons in Ireland (RCSI) – Bahrain, as well as by other medical professionals in Egypt.
Overview
It covered 328 studies sourced from PubMed, Scopus and Google Scholar, covering research published over the past 20 years to examine psychiatric impacts of FGIDs in children, focusing on anxiety, depression and their association with other neurodevelopment disorders of childhood.
It also evaluated the role of family dynamics and coping strategies in exacerbating symptoms and contributing to psychiatric symptoms.
The findings revealed a strong bidirectional relationship with FGIDs and psychiatric symptoms, which can increase children’s vulnerability to anxiety and depression.
Psychosocial factors – such as chronic stress, early-life trauma, maladaptive family dynamics, and ineffective coping strategies – intensify the cycle of gastrointestinal and emotional distress.
Anxiety was the most frequently reported, present in 62 per cent of children with FGIDs, where heightened stress and visceral hypersensitivity (your experience of pain or discomfort in your visceral organs) exacerbated symptoms.
Depression, affecting 38pc of cases, was associated with altered pain perception, fatigue and appetite changes. Attention deficit hyperactivity disorder (ADHD), identified in 24pc of children, was linked to impulsivity, emotional dysregulation and irregular eating patterns, worsening GI distress.
Emotional dysregulation, reported in 58pc of studies, frequently resulted in psychological symptoms, that manifested as physical symptoms such as abdominal pain, creating a cycle of symptom exacerbation and stress.
King Abdullah Medical City’s University Medical Centre senior paediatric consultant professor Mohammed Elbatagi, who was among those that took part in the study, told the GDN that paediatric FGIDs remain under-reported in Bahrain, despite increasing evidence of their prevalence worldwide, affecting children’s quality of life and mental well-being.
“The combination of modern dietary habits, academic pressure and changing lifestyles contributes to the rise in these disorders among children,” he said, adding that many Bahraini parents struggle to understand the connection between their child’s stomach pain or constipation and underlying psychological stress.
“Bahrain’s shift from a traditional diet rich in fibre to more processed and fast foods has exacerbated the problem. Many children consume low-fibre, high-fat meals, which contribute to constipation and irritable bowel symptoms.
“In addition, excessive consumption of carbonated drinks and highly spiced foods can aggravate reflux and stomach discomfort. Encouraging a return to more traditional Bahraini foods, such as whole grains, fresh vegetables and natural probiotics like yoghurt, could be a key step in preventing FGIDs.”
He also claimed that the fast-paced lifestyle and rising academic expectations in Bahrain have placed significant pressure on schoolchildren.
“Children as young as six face high expectations, leading to chronic stress that manifests as abdominal pain, nausea or altered bowel habits,” he said.
School-related stress was a significant trigger in 41pc of studies used in the systematic review, with academic pressure and social challenges exacerbating anxiety and complaints.
“In many Bahraini households, traditional parenting styles that emphasise discipline and high academic achievement can increase stress levels. Over protective or anxious parenting can also exacerbate symptoms, as children often internalise their parents’ worries.
“Educating parents on stress management techniques and the importance of emotional reassurance can go a long way in breaking the cycle of FGIDs.”
Despite the kingdom’s advancements in healthcare, Dr Elbatagi said that paediatric FGIDs remain a neglected area, and that more should be done to create a multidisciplinary approach to integrate paediatricians, psychologists and dieticians in managing FGIDs.
“Many parents take their children for repeated medical consultations, only to receive symptomatic treatment without addressing the root cause.”
Prominent Bahraini psychologist Dr Mariam Alammadi told the GDN that a combination of strategies can reduce the impact of FGIDs.
Remedy
“Parents can find easy exercises on YouTube Kids, and I recommend doing them for 10 minutes in the morning and at night,” she said.
“In addition, educating themselves on how to support their children, manage stress at home and recognise early signs of mental health struggles can make a significant difference.”
“Exercise can also help reduce anxiety and depression, boost mood and overall health. Activities such as swimming walking or playing sports can help children manage both physical and mental symptoms.”
She also highlighted that Cognitive Behavioural Therapy (CBT) can help tremendously by teaching them how to identify and change negative thought patterns.
“CBT has been shown to be effective for both mental health issues and in managing the stress caused by chronic health conditions such as FGIDs,” she said, adding that a structured daily routine, including regular sleep can help improve mental health.
“A balanced diet that supports gut health may also improve mental health. Including foods rich in fibre, probiotics (yoghurt), and omega-3 fatty acids (fish) can promote a healthy gut microbiome, potentially improving both gastrointestinal symptoms and mental well-being.”
FGIDs are common in children, with a prevalence ranging from 9.9pc to 29pc and even higher in clinical settings, reaching up to 87pc. They are more frequently seen in females and can vary significantly in severity.
julia@gdnmedia.bh
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