***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND Antidepressants are effective in adults with pain-related functional gastrointestinal disorders . We investigated the effectiveness of citalopram in the treatment of childhood functional abdominal pain ( FAP ) . METHODS Children with FAP , based on the Rome III criteria ( n = 115 , aged 6 - 18 years ) , were r and omized to receive either citalopram 20 mg/day or placebo for 4 weeks . Treatment response was defined as ≥ 2 point reduction in the 6-point Faces pain rating scale or ' no pain ' . Depression , anxiety , somatization , and physician-rated global severity and improvement were also evaluated . Patients were followed up for 8 weeks after medication period . KEY RESULTS Eighty-six patients completed the medication ( 43 in each group ) . Response rate in the citalopram and placebo groups based on per- protocol ( intention-to-treat ) analysis was 55.8 % ( 40.6 % ) and 39.5 % ( 30.3 % ) at week 4 ( p = 0.097 [ 0.169 ] ) and 72.0 % ( 52.5 % ) and 53.4 % ( 41.0 % ) at week 12 ( p = 0.059 [ 0.148 ] ) , respectively . In per- protocol analysis , more reduction was observed in pain ( F = 3.84 , p = 0.024 ) and global severity scores ( F = 4.12 , p = 0.021 ) in the citalopram group compared with the placebo group over the study period . Such differences were not present in the intention-to-treat analysis . No difference was found between the two groups regarding change in depression , anxiety , or somatization score over the study . CONCLUSIONS & INFERENCES Overall , we found a trend toward the effectiveness  of citalopram in the treatment of children with FAP . Trials with longer treatment duration in larger sample s of patients are required in this regard Background : Irritable bowel syndrome ( IBS ) is a common gastrointestinal disorder in children . Recently , probiotics have been suggested as a treatment option for gastrointestinal disorders . The most effective species and the most appropriate doses are still unknown . Objective : The aim of this study was to assess the effects of Lactobacillus GG ( LGG ) for treating IBS in pediatric patients . Methods : In a controlled , double blind , r and omized trial , patients with IBS diagnosed by Rome III criteria from August 2012 to September 2012 at Dr. Sheikh Hospital , Mashhad University of Medical Sciences , Iran , were assigned to one of two groups , i.e. , intervention and control groups . For four weeks , the intervention group received a probiotic in capsule form that contained LGG at a concentration of 1 × 1010 cfu/ml bacteria . For the same period , the control group received a placebo capsule that had the same shape and color but only contained inulin , which also was present in the LGG capsules . The primary outcome was any change in the severity of the patients ’ pain , and we used a five-point Likert scale to evaluate the severity of their pain . Secondary outcomes were ghanges of the functional scale , stool patterns , and associated problems . Results : Fifty-two patients participated in the study , and 26 patients were assigned r and omly to each of the two groups . The severity of the patients ’ pain decreased significantly in the intervention group after one , two , three , and four weeks of treatment , as indicated by P-values of 0.01 , 0.00 , 0.00 , and 0.00 , respectively . Also , there was significant improvement in the functional scale after two weeks of treatment ( P-value ≤ 0.00 ) . Conclusion : Lactobacillus GG at a concentration of 1 × 1010 cfu/ml for a period of four weeks can lessen the severity of the patients ’ pain and improve the functional scale in patients with irritable bowel syndrome . Probiotics can have therapeutic effects for IBS patients BACKGROUND Adolescents with irritable bowel syndrome ( IBS ) frequently experience interference with everyday activities . Mind-body approaches such as yoga have been recommended as interventions for patients with IBS . Despite promising results among adult sample s , there have been limited studies exploring the efficacy of yoga with pediatric patients . OBJECTIVE To conduct a preliminary r and omized study of yoga as treatment for adolescents with IBS . METHODS Twenty-five adolescents aged 11 to 18 years with IBS were r and omly assigned to either a yoga or wait list control group . Before the intervention , both groups completed question naires assessing gastrointestinal symptoms , pain , functional disability , coping , anxiety and depression . The yoga intervention consisted of a 1 h instructional session , demonstration and practice , followed by four weeks of daily home practice guided by a video . After four weeks , adolescents repeated the baseline question naires . The wait list control group then received the yoga intervention and four weeks later completed an additional set of question naires . RESULTS Adolescents in the yoga group reported lower levels of functional disability , less use of emotion-focused avoidance and lower anxiety following the intervention than adolescents in the control group . When the pre- and postintervention data for the two groups were combined , adolescents had significantly lower scores for gastrointestinal symptoms and emotion-focused avoidance following the yoga intervention . Adolescents found the yoga to be helpful and indicated they would continue to use it to manage their IBS . CONCLUSIONS Yoga holds promise as an intervention for adolescents with IBS OBJECTIVE : This study was design ed to develop and to test a home-based , guided imagery treatment protocol , using audio and video recordings , that is easy for health care professionals and patients to use , is inexpensive , and is applicable to a wide range of health care setting s. METHODS : Thirty-four children , 6 to 15 years of age , with a physician diagnosis of functional abdominal pain were assigned r and omly to receive 2 months of st and ard medical care with or without home-based , guided imagery treatment . Children who received only  st and ard medical care initially received guided imagery treatment after 2 months . Children were monitored for 6 months after completion of guided imagery treatment . RESULTS : All treatment material s were reported to be self-explanatory , enjoyable , and easy to underst and and to use . The compliance rate was 98.5 % . In an intention-to-treat analysis , 63.1 % of children in the guided imagery treatment group were treatment responders , compared with 26.7 % in the st and ard medical care – only group ( P = .03 ; number needed to treat : 3 ) . Per- protocol analysis showed similar results ( 73.3 % vs 28.6 % responders ) . When the children in the st and ard medical care group also received guided imagery treatment , 61.5 % became treatment responders . Treatment effects were maintained for 6 months ( 62.5 % responders ) . CONCLUSION : Guided imagery treatment plus medical care was superior to st and ard medical care only for the treatment of abdominal pain , and treatment effects were sustained over a long period OBJECTIVE : This r and omized controlled trial investigated the effectiveness of a 6-session protocol ized cognitive behavior therapy ( CBT ) compared with 6 visits to a pediatrician ( intensive medical care ; IMC ) for the treatment of pediatric functional abdominal pain ( FAP ) . METHODS : One hundred four children aged 7 to 18 were r and omized to CBT or IMC . CBT was delivered primarily by trained master ’s degree students in psychology ; IMC was delivered by pediatricians or pediatric gastroenterologists . Assessment s were performed pretreatment , posttreatment , and at 6- and 12-month follow-up . Primary outcomes were level of abdominal pain ( AP ) as reported on question naires and diaries . Secondary outcomes were other gastrointestinal complaints , functional disability , other somatic complaints , anxiety , depression , and quality of life . RESULTS : Both CBT and IMC result ed in a significant decrease in AP ( P < .001 ) , but no significant difference was found between the treatments in their effectiveness ( P > .05 for all end points ) . According to the question naire-derived data , 1 year after treatment , 60 % of children that received CBT had significantly improved or recovered , versus 56.4 % of children receiving IMC , which did not significantly differ ( P = .47 ) . These percentages were 65.8 % versus 62.8 % according to the diary-derived data , which also did not significantly differ ( P = .14 ) . Additionally , nearly all secondary outcomes improved after treatment . CONCLUSIONS : CBT was equally effective as IMC in reducing AP in children with FAP . More research into the specific working mechanisms of CBT for pediatric FAP is needed This study describes the results of a controlled clinical trial involving 44 7- to 14-year-old children with recurrent abdominal pain who were r and omly allocated to either cognitive-behavioral family intervention ( CBFI ) or st and ard pediatric care ( SPC ) .  Both treatment conditions result ed in significant improvements on measures of pain intensity and pain behavior . However , the children receiving CBFI had a higher rate of complete elimination of pain , lower levels of relapse at 6- and 12-month follow-up , and lower levels of interference with their activities as a result of pain and parents reported a higher level of satisfaction with the treatment than children receiving SPC . After controlling for pretreatment levels of pain , children 's active self-coping and mothers ' caregiving strategies were significant independent predictors of pain behavior at posttreatment AIM The management of functional abdominal pain ( FAP ) in children and adolescents is challenging for health care professionals , and there are only limited or inconclusive studies of pharmacologic or behavioral therapy in childhood FAP . The objective of this r and omized placebo-controlled clinical trial was to determine the potential efficacy and safety of cyproheptadine in the treatment of pediatric FAP . METHODS Between January 2006 and March 2007 , 29 clinical ly referred children and adolescents with FAP ( aged 4.5 to 12 years ) completed a 2-week , double-blinded r and omized placebo-controlled trial of cyprohetadine . Primary outcome measure was the self-reported change of frequency and duration of abdominal pain by using a 6-point scale , and the parents ' impression or assessment of the children 's improvement . RESULTS By week 1 and 2 of the intervention , the intensity and frequency of abdominal pain among the patients treated with cyproheptadine , were rated as complete resolved and very much improved or improved for 3 ( 20 % ) , 10 ( 66.6 % ) , respectively . However , in the placebo-receiver children , these scales had no change in 7 ( 50 % ) , rated as improved or very much improved in 5 ( 35.7 % ) , and become worse in 2 ( 14.3 % ) . The patients ' self-reported and the parents ' impression in the cyproheptadine group were significantly better than it in the placebo group ( P=0.003 ) . CONCLUSION Among children with functional abdominal pain , cyproheptadine is enough effective to improve the intensity and frequency of abdominal pain in a short-term period Objectives : We evaluated the efficacy of cognitive-behavioral family intervention in the treatment of crises of pain in children with nonorganic recurrent abdominal pain ( RAP ) and the thresholds of pain for 17 body surface areas in these children . Methods : A r and omized clinical trial was undertaken with 32 children between the ages of 5.1 and 13.9 years with nonorganic RAP . A group of 15 patients , aged 9.9 ± 2.2 years ( 11 girls ) , received st and ard pediatric care and cognitive-behavioral family intervention for treatment of pain crises . The control group of 17 children , aged 8.4 ± 2.0 years ( 11 girls ) , received only st and ard pediatric care . These procedures were undertaken by general pediatricians over 4 monthly sessions . An analog visual scale was used to measure the frequency and intensity of the pain crises per month and a mechanical pressure algometer for the measurement of pain threshold . Results : The median frequency of pain crises per month reported by patients at the 3 monthly cognitive-behavioral family intervention sessions was 15 , 5 , 2 and 2 , respectively . In contrast , the median frequency for pain crises per month reported by the control group was 12 , 8 , 10 and 8 , respectively . The difference between the intervention group and the controls was statistically significant for frequency of pain at the second , third and fourth visits . There was no statistical difference for intensity of pain or for measured pain thresholds between the control and the intervention group . Conclusions : The cognitive-behavioral family intervention reduced the frequency of pain crises of children with nonorganic RAP . This successful intervention was carried out by the intervention of general pediatricians ABSTRACT Cognitive – behavioral therapy ( CBT ) interventions show promise for decreasing chronic pain in youth . However , the availability of CBT is limited by many factors including distance to major treatment centers and expense . This study evaluates a more accessible treatment approach for chronic pediatric pain using an Internet‐delivered family CBT intervention .  Participants included 48 children , aged 11–17 years , with chronic headache , abdominal , or musculoskeletal pain and associated functional disability , and their parents . Children were r and omly assigned to a wait‐list control group or an Internet treatment group . Primary treatment outcomes were pain intensity ratings ( 0–10 NRS ) and activity limitations on the Child Activity Limitations Interview , both completed via an online daily diary 
    Output:
    
We found probiotic diets , cognitive-behavioural therapy ( CBT ) and hypnotherapy were reported to reduce pain in the short-term and there is some evidence of medium term effectiveness .
There was insufficient evidence of effectiveness for all other dietary interventions and psychosocial therapies .
These data suggest that probiotics , CBT , and hypnotherapy could be considered as part of holistic management of children with RAP .
The lack of evidence of effectiveness for any drug suggests that there is little justification for their use outside of well-conducted clinical trials .