Rutten Juliette M T M, Benninga Marc A, Vlieger Arine M
*Department of Pediatric Gastroenterology and Nutrition, Emma Children's Hospital AMC, Amsterdam †Department of Pediatrics, St Antonius Hospital Nieuwegein, The Netherlands.
J Pediatr Gastroenterol Nutr. 2014 Oct;59(4):493-9. doi: 10.1097/MPG.0000000000000452.
It has been suggested that different subcategories of childhood abdominal pain-related functional gastrointestinal disorders (AP-FGIDs) are not separate clinical entities, but represent variable expressions of the same FGID. The aim of the present study was to compare clinical and psychological characteristics of children with irritable bowel syndrome (IBS), functional abdominal pain (FAP), and functional abdominal pain syndrome (FAPS).
A total of 259 children, ages 8 to 18 years, fulfilling Rome III criteria for IBS or FAPS were included in a randomized controlled trial evaluating the effect of hypnotherapy. At inclusion, questionnaires assessed demographics, clinical features, abdominal pain frequency and intensity, depression and anxiety, somatization, health-related quality of life, pain beliefs, and coping strategies.
No differences were found between children with IBS and those with FAPS with respect to the main outcomes: frequency and intensity of abdominal pain, symptoms of depression and anxiety, somatization, health-related quality of life, pain beliefs, and coping strategies. A significantly higher percentage of patients with IBS had a positive family history for AP-FGIDs (56.8% vs 37.8%; P = 0.00). Characteristics of patients with IBS subtypes did not differ. Patients with FAP or FAPS differed only with respect to problem-focused coping strategy (2.21 ± 0.61 vs 2.52 ± 0.49; P = 0.00).
Pediatric patients with IBS and those with FAPS have similar psychosocial profiles. These results may explain why treatment response of psychological therapies in these AP-FGIDs is similar. These results may indicate that pediatric IBS and FAPS are different expressions of 1 underlying functional disorder, but similarities in psychosocial characteristics do not exclude the possibility that these disorders are different entities, because these similarities can exist between disorders of various causes. Therefore, future research is required on the role of other (physiological) factors in pediatric IBS and FAPS.
有人提出，儿童腹痛相关功能性胃肠疾病（AP - FGIDs）的不同亚类并非独立的临床实体，而是同一功能性胃肠疾病的不同表现形式。本研究的目的是比较肠易激综合征（IBS）、功能性腹痛（FAP）和功能性腹痛综合征（FAPS）患儿的临床和心理特征。
共有259名年龄在8至18岁、符合IBS或FAPS罗马III标准的儿童被纳入一项评估催眠疗法效果的随机对照试验。纳入时，通过问卷评估人口统计学、临床特征、腹痛频率和强度、抑郁和焦虑、躯体化、健康相关生活质量、疼痛信念和应对策略。
在主要结局方面，IBS患儿和FAPS患儿之间未发现差异：腹痛频率和强度、抑郁和焦虑症状、躯体化、健康相关生活质量、疼痛信念和应对策略。IBS患儿有AP - FGIDs家族史的比例显著更高（56.8%对37.8%；P = 0.00）。IBS各亚型患儿的特征无差异。FAP或FAPS患儿仅在以问题为中心的应对策略方面存在差异（2.21±0.61对2.52±0.49；P = 0.00）。
儿科IBS患者和FAPS患者具有相似的心理社会特征。这些结果可能解释了为什么心理治疗在这些AP - FGIDs中的治疗反应相似。这些结果可能表明儿科IBS和FAPS是一种潜在功能性障碍的不同表现形式，但心理社会特征的相似性并不排除这些障碍是不同实体的可能性，因为各种原因导致的疾病之间可能存在这些相似性。因此，需要进一步研究其他（生理）因素在儿科IBS和FAPS中的作用。
