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儿童复发性腹痛。

Recurrent abdominal pain in children.

机构信息

Department of Physiology, Faculty of Medicine, University of Kelaniya, Sri Lanka.

出版信息

Indian Pediatr. 2009 May;46(5):389-99.

Abstract

CONTEXT

Recurrent abdominal pain is one of the commonest gastrointestinal complaints in children, affecting approximately 10% of school aged children and adolescents. There is no consensus with regards to etiology, investigation and management of this common problem. This review addresses some of the issues related to epidemiology, etiology, management and prognosis of recurrent abdominal pain.

EVIDENCE ACQUISITION

We reviewed current literature on this broad subject, specially concentrating on epidemiology, etiology and, basic and advanced management strategies, from 1958 to date, using PubMed, Embase, Cochrane database and cross references.

RESULTS

The majority of the affected children have functional gastrointestinal diseases. The exact cause of pain remains obscure. New evidence suggests that emotional stress, visceral hypersensitivity and gastrointestinal motility disorders may play a vital part in its origin. Pharmacological treatments are commonly used in an effort to manage symptoms, despite the lack of data supporting their efficacy.

CONCLUSIONS

Most children with recurrent abdominal pain have functional gastrointestinal diseases and a detailed history, examination and basic stool, urine and hematological investigations are sufficient to exclude organic pathology in them. Despite the magnitude of the problem, knowledge on the effective management options is poor.

摘要

背景

腹痛反复发作是儿童最常见的胃肠道疾病之一,约影响 10%的学龄儿童和青少年。对于这个常见问题的病因、检查和处理,目前尚未达成共识。本文主要讨论了腹痛反复发作的流行病学、病因、处理和预后等相关问题。

证据获取

我们主要查阅了从 1958 年至今的相关文献,包括 PubMed、Embase、Cochrane 数据库和参考文献,特别关注了腹痛反复发作的流行病学、病因学以及基本和高级处理策略等方面。

结果

大多数受影响的儿童患有功能性胃肠道疾病。疼痛的确切原因仍不清楚。新证据表明,情绪压力、内脏敏感性和胃肠道动力障碍可能在其发病机制中起着至关重要的作用。尽管缺乏支持其疗效的数据,但仍常使用药物治疗来缓解症状。

结论

大多数腹痛反复发作的儿童都患有功能性胃肠道疾病,详细的病史、体格检查以及基本的粪便、尿液和血液检查足以排除其器质性疾病。尽管问题严重,但对于有效的治疗选择,我们的了解仍然有限。

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