Department of Pediatric Gastroenterology, Hepatology, and Nutrition, Bursa City Hospital, Bursa, Turkey.
Department of Pediatric Rheumatology, Bursa City Hospital, Bursa, Turkey.
Postgrad Med. 2023 May;135(4):386-393. doi: 10.1080/00325481.2023.2176637. Epub 2023 Feb 6.
Musculoskeletal pain has a considerable frequency in pediatric outpatients. Benign joint hypermobility (BJHS) and juvenile fibromyalgia syndrome (JFMS) are non-inflammatory causes of musculoskeletal pain. In these syndromes, pain is often accompanied by various symptoms such as fatigue, sleep difficulties, mood disorders, cognitive dysfunction, dizziness, headaches, abdominal pain, irritable bowel syndrome, and restless legs syndrome. Functional dyspepsia, functional vomiting, functional abdominal pain, functional constipation, and irritable bowel syndrome all together are termed functional gastrointestinal (GI) disorders. We aimed to evaluate the functional gastrointestinal disorders association of BJHS and JFMS.
Patients aged 10-18 years who were diagnosed with functional GI disorder in the pediatric gastroenterology department were included in the study. The findings of BJHS and JFMS were evaluated by the pediatric rheumatology department. Scales for anxiety, somatization, and depression were administered by a child psychiatrist. COMPASS 31 scoring was used in autonomic dysfunction.
The prevalence of JFMS and BJHS was 64% and 32%, respectively in children with a functional GI disorder. Retrosternal chest pain, dysphagia, early satiation, nausea, vomiting, and regurgitation were common in JFMS (p = 0.007; p = 0.005; p = 0.018; p = 0.002, p = 0.013; p = 0.014, respectively). Gastrointestinal symptoms did not differ with BJHS. One hundred six (88.3%) and 99 (82.5%) had orthostatic intolerance and reflex syncope, respectively. One hundred three (85.6%) had anxiety symptoms, 101 (84.2%) had somatization symptoms, and 102 (85%) had depression symptoms.
Functional GI disorders, JFMS, and BJHS are complex intertwined disorders influenced by emotional distress. Therefore, a multidisciplinary approach is necessary for the diagnosis and treatment process.
肌肉骨骼疼痛在儿科门诊患者中较为常见。良性关节过度活动症（BJHS）和青少年纤维肌痛综合征（JFMS）是非炎症性肌肉骨骼疼痛的原因。在这些综合征中，疼痛常伴有疲劳、睡眠困难、情绪障碍、认知功能障碍、头晕、头痛、腹痛、肠易激综合征和不安腿综合征等各种症状。功能性消化不良、功能性呕吐、功能性腹痛、功能性便秘和肠易激综合征统称为功能性胃肠道（GI）疾病。我们旨在评估 BJHS 和 JFMS 与功能性胃肠道疾病的关联。
本研究纳入了儿科胃肠病学部门诊断为功能性胃肠道疾病的 10-18 岁患者。儿科风湿病科评估了 BJHS 和 JFMS 的发现。儿童精神病学家通过焦虑、躯体化和抑郁量表进行评估。自主神经功能障碍采用 COMPASS 31 评分。
在患有功能性胃肠道疾病的儿童中，JFMS 和 BJHS 的患病率分别为 64%和 32%。胸骨后胸痛、吞咽困难、早饱、恶心、呕吐和反流在 JFMS 中较为常见（p=0.007；p=0.005；p=0.018；p=0.002；p=0.013；p=0.014）。BJHS 与胃肠道症状无差异。106 例（88.3%）和 99 例（82.5%）存在直立不耐受和反射性晕厥。103 例（85.6%）有焦虑症状，101 例（84.2%）有躯体化症状，102 例（85%）有抑郁症状。
功能性胃肠道疾病、JFMS 和 BJHS 是受情绪困扰影响的复杂交织疾病。因此，诊断和治疗过程需要多学科方法。
