de Jesus Carine Dias Ferreira, de Assis Carvalho Mary, Machado Nilton Carlos
Pediatric Gastroenterologist, Postgraduate Student Researcher of Botucatu Medical School, Sao Paulo State University, Botucatu, Sao Paulo, Brazil.
Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Botucatu Medical School, São Paulo State University, Botucatu, Sao Paulo, Brazil.
Pediatr Gastroenterol Hepatol Nutr. 2022 Nov;25(6):500-509. doi: 10.5223/pghn.2022.25.6.500. Epub 2022 Nov 2.
We compared the health-related quality of life (HRQOL) of children and adolescents with functional abdominal pain disorders (FAPDs) and organic abdominal pain disorders (ORGDs).
This was a single-center, cross-sectional, observational study. The PedsQL 4.0 generic cores scales parent proxy-report was administered to parents/caregivers of 130 and 56 pediatric patients with FAPDs and ORGDs respectively on their first visit. The self-reported pain intensity in the patients was assessed using a visual analog scale (VAS) and facial affective scale (FAS).
Irritable bowel syndrome was the most prevalent FAPDs, and the most prevalent ORGDs were reflux esophagitis (41.1%) and gastritis associated with (21.4%). There was no difference in HRQOL among patients diagnosed with ORGDs and FAPDs (>0.05). Patients with ORGDs and FAPDs had lower HRQOL Scale scores than healthy Brazilian and American children's references, with a high proportion of children at risk for impaired HRQOL (<0.0001). There was no difference in the VAS and the FAS scores between the ORGDs and the FAPDs. FAPDs had a higher prevalence of girls' and couples' disagreement (<0.02), although poor school performance (<0.0007) and bullying (<0.01) were higher in patients with ORGD.
This study revealed that there was a difference in impaired HRQOL between patients with ORGDs and FAPDs. Thus, considering the high prevalence of chronic abdominal pain in children, a well-founded treatment plan is necessary for a multidisciplinary cognitive-behavioral Pain management program.
我们比较了功能性腹痛障碍(FAPD)和器质性腹痛障碍(ORGD)患儿及青少年的健康相关生活质量(HRQOL)。
这是一项单中心、横断面观察性研究。分别对130例FAPD患儿和56例ORGD患儿的父母/照料者在其首次就诊时采用儿童生活质量量表4.0通用核心量表家长代理报告法进行调查。采用视觉模拟量表(VAS)和面部表情量表(FAS)评估患者的自我报告疼痛强度。
肠易激综合征是最常见的FAPD,最常见的ORGD是反流性食管炎(41.1%)和胃炎(21.4%)。诊断为ORGD和FAPD的患者在HRQOL方面无差异(>0.05)。与巴西和美国健康儿童参考标准相比,ORGD和FAPD患者的HRQOL量表得分较低,HRQOL受损风险儿童比例较高(<0.0001)。ORGD和FAPD患者在VAS和FAS评分上无差异。FAPD中女孩及父母意见不一致的患病率较高(<0.02),尽管ORGD患者的学业成绩差(<0.0007)和受欺凌情况(<0.01)更为严重。
本研究表明,ORGD和FAPD患者在HRQOL受损方面存在差异。因此,考虑到儿童慢性腹痛的高患病率,多学科认知行为疼痛管理计划需要有充分依据的治疗方案。