Person Hannibal, Keefer Laurie
Department of Pediatrics, Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, One Gustave Place, Box 1656, New York, NY, 10029, USA.
Department of Medicine, Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Curr Gastroenterol Rep. 2019 Mar 12;21(4):12. doi: 10.1007/s11894-019-0683-8.
The purpose of this review is to discuss current knowledge of brain-gut therapies (BGT) in pediatric functional gastrointestinal disorders (FGID) and inflammatory bowel disease (IBD), including their evidence base, the common psychopathology that they address, and the integration of this knowledge into medical settings.
Cognitive behavioral therapy (CBT), hypnotherapy (HT), mindfulness-based therapy (MBT), and exposure-based therapy (EBT) have the most data supporting their use in children, particularly in FGID, more so than in IBD. This difference is most likely because of the increased role of psychological factors in FGID, though these same factors can be seen comorbidly in IBD. Integrative BGT treatment strategies with the collaboration of clinicians across disciplines may provide the most benefit to patients. This review details our current understanding of the evidence for BGT in pediatric FGID and IBD and how they may best be used in treatment strategies.
本综述旨在探讨小儿功能性胃肠疾病(FGID)和炎症性肠病(IBD)中脑肠疗法(BGT)的现有知识,包括其证据基础、所针对的常见精神病理学问题,以及将这些知识整合到医疗环境中的情况。
认知行为疗法(CBT)、催眠疗法(HT)、正念疗法(MBT)和暴露疗法(EBT)有最多的数据支持其在儿童中的应用,尤其是在FGID中,在IBD中的应用支持数据相对较少。这种差异很可能是因为心理因素在FGID中的作用更大,尽管这些相同的因素在IBD中也可能合并出现。跨学科临床医生合作的综合BGT治疗策略可能对患者最有益。本综述详细阐述了我们目前对小儿FGID和IBD中BGT证据的理解,以及它们在治疗策略中如何能得到最佳应用。