What is new in abdominal pain-related disorders of the gut-brain interaction in children.

PURPOSE OF REVIEW: This review aims to summarize recent advances in the diagnosis, epidemiology, pathophysiology, and management of pediatric abdominal pain-related disorders of gut-brain interaction (AP-DGBI), including irritable bowel syndrome (IBS) and functional abdominal pain - not otherwise specified (FAP-NOS). Emphasis is placed on emerging diagnostic tools, updated international guidelines, and novel therapeutic approaches. RECENT FINDINGS: Novel diagnostic scoring systems may improve clinical evaluation. Growing evidence also supports the role of sleep, biopsychosocial model, and family dynamics in disease severity and persistence, suggesting additional targets in treatment. The recent 2025 ESPGHAN/NASPGHAN guidelines provide evidence-based recommendations for the management of AP-DGBI. Evidence for pharmacologic and nonpharmacologic therapies is promising, although data remains limited. SUMMARY: Pediatric AP-DGBI are common and significantly impair quality of life. Advances in diagnostic approaches, our understanding of prevalence and pathophysiology, and growing evidence for both pharmacologic and nonpharmacologic therapies for AP-DGBI may improve future management. Larger high-quality pediatric trials are needed. A multidisciplinary, patient-centered approach using the biopsychosocial model remains at the forefront of optimizing outcomes.