Chopra Jagrati, Patel Neal, Basude Dharamveer, Gil-Zaragozano Elena, Paul Siba Prosad
4th Year Medical Student, University of Bristol.
Consultant Paediatric Gastroenterologist, Bristol Royal Hospital for Children.
Br J Nurs. 2017 Jun 8;26(11):624-631. doi: 10.12968/bjon.2017.26.11.624.
Recurrent abdominal pain is a common presentation in children and mostly non-organic in origin. Nearly one-fifth of the childhood population are known to suffer from it worldwide, although only 50% of these may seek consultation with a health professional. Non-organic recurrent abdominal pain encompasses four main conditions broadly labelled as abdominal pain-related functional gastrointestinal disorders (FGIDs). These are diagnosed following exclusion of organic pathologies and by symptom concordance with defined parameters, published as the Rome IV criteria for FGIDs. Appropriate evaluation includes assessment for 'red flag' manifestations to rule out organic causes. Appropriate review of social and family circumstances is vital to identify triggers and protective factors. Management is based on explanation, reassurance and therapeutic interventions that need to be decided on an individual basis. Treatment focuses primarily on dietary and biopsychosocial interventions, with a minimal role for pharmacological agents. A case study is included to highlight some of the challenges that may arise while managing abdominal pain-related FGIDs. Nurses play a vital role in early identification, providing support and education to children and their families. There is increasing evidence for the effectiveness of nurse-led services in managing these disorders, as well as providing continuity of care.
复发性腹痛是儿童常见的症状,其病因大多为非器质性。据了解,全球近五分之一的儿童患有此病,不过其中只有50%的人可能会寻求医疗专业人员的咨询。非器质性复发性腹痛包括四种主要情况,大致归类为与腹痛相关的功能性胃肠疾病(FGIDs)。这些疾病是在排除器质性病变后,根据与既定参数的症状一致性进行诊断的,这些参数已作为FGIDs的罗马IV标准发布。适当的评估包括对“警示”表现进行评估,以排除器质性病因。对社会和家庭情况进行适当审查对于确定触发因素和保护因素至关重要。管理基于解释、安慰和治疗干预措施,这些措施需要根据个体情况来决定。治疗主要侧重于饮食和生物心理社会干预,药物治疗的作用最小。本文包含一个案例研究,以突出在管理与腹痛相关的FGIDs时可能出现的一些挑战。护士在早期识别、为儿童及其家庭提供支持和教育方面发挥着至关重要的作用。越来越多的证据表明,由护士主导的服务在管理这些疾病以及提供持续护理方面是有效的。