In a landmark advancement for pediatric healthcare, the first international treatment guidelines for functional abdominal pain disorders in children have been published, offering a globally unified, evidence-based framework for managing conditions such as irritable bowel syndrome, functional abdominal pain-not otherwise specified, and abdominal migraines.
Dr. Ashish Chogle, chief of pediatric gastroenterology at CHOC, part of Rady Children’s Health, and director of the GI Integrative Health and Culinary Medicine Program, was selected by the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) to represent the society as lead author from North America, a recognition of his leadership in the field.
Dr. Chogle played a pivotal role in launching and shaping the three-year global effort, developed in partnership with the European Society for Pediatric Gastroenterology and the Cochrane Group, an international organization that helps evaluate medical evidence.
The guidelines were recently published in the Journal of Pediatric Gastroenterology and Nutrition.
“These collaborative guidelines are not only a clinical milestone — they are the foundation for transforming how we care for children living with chronic GI conditions,” said Dr. Chogle, one of 18 international subject experts involved in the effort and among three co-first authors. “They empower physicians with evidence-based tools while recognizing the need for individualized, holistic care.”
A national and global model for pediatric integrative GI care
CHOC has positioned itself as a national model in pediatric integrative health, said Dr. Coleen Cunningham, senior vice president and pediatrician in chief at CHOC and professor and chair, Department of Pediatrics, at UC Irvine.
“To be co-first author on such important guidelines is really impressive,” Dr. Cunningham said.
Through collaborative partnerships with institutions like Children’s Hospital of Philadelphia and UCI’s Samueli Integrative Health Institute, CHOC is leading the charge toward a future where children with chronic GI conditions receive comprehensive, evidence-based and whole-child care.
“It feels incredible to finally see these guidelines published after three long years of hard work and an intense review process,” Dr. Chogle said. “This was truly a team effort. The guidelines are packed with evidence yet remain practical for quick reference during patient interactions. These are the first solid guidelines resulting from analyzing evidence, and they also highlight the fact that psychotherapies shouldn’t be an afterthought.
“I hope they spark even more research in this important area.”
Transforming pediatric GI care: Blending innovation, tradition and whole-child healing
At CHOC, the recommendations published in the Journal of Pediatric Gastroenterology and Nutrition are already in practice through the GI Integrative Health and Culinary Medicine Program, the only center of its kind in Southern California and among the six largest in the country.
Launched in 2024 following generous support from Sherry and John Phelan, the program blends conventional and complementary therapies, including:
- Mind-body interventions such as gut-directed hypnotherapy, cognitive behavioral therapy and biofeedback
- Traditional Indian and Chinese medicine, including Ayurvedic herbs, acupuncture cupping and aromatherapy
- Personalized nutrition therapy, anchored by a culinary medicine program
- Pelvic floor rehabilitation
- Advanced technologies such as vagus nerve stimulation and virtual reality-based immersive treatments
Recognizing the high prevalence of sleep-related challenges in this population, collaborations are being established with CHOC and UCI sleep programs to support children in achieving restorative sleep as part of their overall treatment plan.
To date, CHOC’s GI Integrative Health and Culinary Medicine Program has served more than 2,000 patients. In addition, more than 325 patients have been seen by the psychology team since the program launched last year.
“The Phelans’ visionary investment has laid the foundation for this new model of care — one that is already transforming lives and will continue to do so for generations to come,” Dr. Chogle said. “Restoring a child’s joy, resilience and quality of life — this is the measurable impact we strive for every day.”
Food as medicine: Transforming lives one bite at a time
A new culinary demonstration kitchen in the Bill Holmes Tower will serve as the heart of CHOC’s culinary medicine program. The kitchen officially launches on Aug. 19.
The space provides hands-on culinary training that empowers children and families through nutritional education.
To generate excitement, program leaders recently offered nutritious drinks and snacks at CHOC’s farmers market on the second-floor outdoor patio, along with recipes and insights into the medicinal benefits of each ingredient.
The program is also collaborating with CHOC’s child life team and Seacrest Studios to produce interactive workshops that make culinary medicine engaging and fun. The first culinary medicine event at Seacrest Studios is scheduled for July 21.
Driving the future: Real-world data to refine and redefine pediatric GI care
In a move that reflects CHOC’s leadership in innovation, the GI Integrative Medicine team is also systematically collecting real-world data from patients treated under this holistic model. This data will be used to:
- Evaluate multimodal treatment effectiveness across diverse patient populations
- Study long-term outcomes such as resilience, sleep and quality of life
- Identify predictors of treatment response using AI-powered analytics
- Generate actionable insights that will influence current clinical practice and inform future updates to international guidelines
“We are building a continuous learning health system,” added Dr. Chogle. “By combining clinical excellence with real-world research, we are not just applying the best evidence — we are generating it.”
Meet the team powering CHOC’s integrative revolution in pediatric gastroenterology
CHOC’s GI Integrative Health and Culinary Medicine Program now operates two full clinic days per week, supported by an expanded, multidisciplinary team. In addition to Dr. Chogle, the clinical team includes Dr. Janice Khoo and nurse practitioners Tammy Tran and Alda Taube, each bringing specialized expertise in pediatric gastroenterology and integrative care.
Care coordination is managed by pediatric registered nurses Emily Phillip and Stephanie Ahlstrand, while Michael Perry and Nicole Palmer ensure seamless access through scheduling support. Social worker Krishna Diyarza supports patients and families by addressing social determinants of health, connecting them to resources and ensuring psychosocial care.
Key team members also include Nicole Trisler, a pediatric registered nurse with over 12 years of experience at CHOC. She leads program development and serves as a passionate advocate for the use of food as medicine, merging clinical innovation with nutritional education to empower children and families.
Joining her is Kristin Feiler, a registered dietitian with specialized training in integrative medicine. Kristin provides individualized nutritional counseling and serves as co-lead of the culinary medicine program, helping children translate dietary guidance into everyday habits.
The team also benefits from the expertise of Dr. Elicia Wartman, a GI psychologist who specializes in gut-directed therapy. She offers compassionate, personalized care while actively screening for mental health concerns such as anxiety, depression, eating disorders including ARFID, and sleep disturbances.
To expand therapeutic options, the program partners with Dr. Ruth McCarty, who delivers CHOC’s first outpatient traditional Chinese medicine services. Her care includes acupuncture, cupping, massage and aromatherapy, all integrated into a holistic treatment model.
In collaboration with CHOC Rehabilitation Services, the program will help launch the Center for Comprehensive Pediatric Pelvic Rehabilitation in August 2025. Led by physical therapists Fabiola Levya and Devon Voss, the center will offer specialized care for children with constipation, incontinence, pelvic floor dysfunction, and neurogenic bowel. Services include muscle training, biofeedback, core strengthening, and pre-/post-operative rehab.
Refer a patient to CHOC’s GI Nutrition Clinic
