Chronic Abdominal Pain In Children: A Technical Report of the American Academy of Pediatrics and the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition

Journal of Pediatric Gastroenterology and Nutrition - Tập 40 Số 3 - Trang 249-261 - 2005
Carlo Di Lorenzo1, Richard B. Colletti2, Harold P Lehmann3, John T. Boyle4, William T. Gerson2, Charles A. Stanley5, Robert C. Tasker6, Lynn S. Walker7, Pamela T Kanda
1Columbus, OH
2Burlington, Vt.
3Baltimore, M.D.
4South Birmingham, A.L.
5Hartford, CT
6Dallas, TX
7Nashville, TN

Tóm tắt

ABSTRACTChronic abdominal pain, defined as long‐lasting intermittent or constant abdominal pain, is a common pediatric problem encountered by primary care physicians, medical subspecialists and surgical specialists. Chronic abdominal pain in children is usually functional‐that is, without objective evidence of an underlying organic disorder. The Subcommittee on Chronic Abdominal Pain of the American Academy of Pediatrics and the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition has prepared this report based on a comprehensive, systematic review and rating of the medical literature. This report accompanies a clinical report based on the literature review and expert opinion.The subcommittee examined the diagnostic and therapeutic value of a medical and psychologic history, diagnostic tests, and pharmacological and behavioral therapy. The presence of alarm symptoms or signs (such as weight loss, gastrointestinal bleeding, persistent fever, chronic severe diarrhea and significant vomiting) is associated with a higher prevalence of organic disease. There was insufficient evidence to state that the nature of the abdominal pain or the presence of associated symptoms (such as anorexia, nausea, headache and joint pain) can discriminate between functional and organic disorders. Although children with chronic abdominal pain and their parents are more often anxious or depressed, the presence of anxiety, depression, behavior problems or recent negative life events does not distinguish between functional and organic abdominal pain. Most children who are brought to the primary care physician's office for chronic abdominal pain are unlikely to require diagnostic testing. Pediatric studies of therapeutic interventions were examined and found to be limited or inconclusive.

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Tài liệu tham khảo

10.1542/peds.74.6.991

10.1016/S0022-3476(96)70246-9

10.1016/S0149-2918(02)85143-8

10.1007/BF01303162

10.1016/0016-5085(95)90738-6

Martin R, 2001, Irritable bowel syndrome: toward a cost‐effective management approach, Am J Manag Care, 7, S268

CampoJV Di LorenzoC ChiappettaL et al. Adult outcomes of pediatric recurrent abdominal pain: do they just grow out of it?Pediatrics2001;108. Available at:http://www.pediatrics.org/cgi/content/full/108/1/e1.

10.1136/adc.33.168.165

Woolf SH, 1991, AHCPR Interim Manual for Clinical Practice Guideline Development

10.1136/bmj.311.7001.376

10.1002/j.1536-4801.2000.tb07169.x

WeydertJA BallTM DavisMF. Systematic review of treatments for recurrent abdominal pain.Pediatrics2003;111. Available at:http://www.pediatrics.org/cgi/content/full/111/1/e1.

Wells GA, The Newcastle‐Ottawa Scale (NOS) for Assessing the Quality of Nonrandomised Studies in Meta‐analyses

10.1136/gut.45.2008.ii60

10.1097/00005176-200004000-00012

10.1097/00005176-199700002-00008

10.1111/j.1526-4610.1992.hed3207353.x

10.1136/adc.72.5.413

Turner RM, 1978, Recurrent abdominal pain in childhood, J R Coll Gen Pract, 28, 729

10.1056/NEJM197906283002602

10.1007/BF02830749

10.1016/S0022-3476(82)80236-9

10.1016/0022-3999(84)90018-7

10.1016/S0033-3182(85)72777-6

10.1016/S0022-3476(85)80037-8

10.1002/j.1536-4801.1988.tb09654.x

10.1111/j.1651-2227.1993.tb12728.x

10.1111/j.1651-2227.1993.tb12727.x

10.1111/j.1651-2227.1994.tb12989.x

10.1002/j.1536-4801.1993.tb10858.x

10.1111/j.1469-8749.1993.tb11629.x

10.1111/j.1651-2227.1994.tb13076.x

10.1046/j.1468-2982.1995.1501022.x

10.1136/bmj.316.7139.1196

10.1046/j.1440-1754.1999.00366.x

10.1046/j.1440-1754.2000.00465.x

10.1016/S1590-8658(01)80069-4

10.1097/00042737-200104000-00017

10.1046/j.1440-1746.2001.02434.x

10.1111/j.1651-2227.2001.tb00250.x

10.1037/0022-006X.69.1.85

10.1111/j.1651-2227.1993.tb12611.x

10.1002/(SICI)1097-0096(199810)26:8<397::AID-JCU4>3.0.CO;2-D

Quak SH, 1985, Upper gastrointestinal endoscopy in children with abdominal pain, Ann Acad Med Singapore, 14, 614

10.1111/j.1651-2227.1992.tb12189.x

10.14238/pi29.11-12.1989.221-7

10.1136/adc.58.11.888

10.1037/0021-843X.102.2.248

10.1016/0022-3999(90)90051-5

Sawyer MG, 1987, Recurrent abdominal pain in childhood. Relationship to psychologic adjustment of children and families: a preliminary study, Aust Paediatr J, 23, 121

10.1093/jpepsy/14.2.231

10.1097/00004583-198803000-00008

10.1111/j.1651-2227.2001.tb02425.x

American Psychiatric Association., 1994, Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM‐IV)

10.1093/jpepsy/20.2.233

10.1093/jpepsy/9.4.427

10.1067/mpd.2001.109606

10.1023/A:1010793408132

10.1001/archpedi.1985.02140140050025

Lebenthal E, 1981, Recurrent abdominal pain and lactose absorption in children, Pediatrics, 67, 828

10.1136/adc.72.1.48

10.1037/0022-006X.57.2.294

10.1037/0022-006X.62.2.306

Stringel G, 1999, Laparoscopy in the management of children with chronic recurrent abdominal pain, JSLS, 3, 215

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Journal of Pediatric Gastroenterology and Nutrition

Tập 40 Số 3

249-261

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