Chogle Ashish, Visnagra Kaajal, Janchoi Jamie, Tran Tammy, Davis Rachel, Callas Nicole, Ornelas Elisa
Division of Pediatric Gastroenterology, Hepatology and Nutrition, CHOC Children's, Orange, CA, United States.
Department of Pediatrics, University of California Irvine, Orange, CA, United States.
Front Pain Res (Lausanne). 2023 Sep 8;4:1223932. doi: 10.3389/fpain.2023.1223932. eCollection 2023.
Disorders of the Gut-Brain Interaction (DGBIs) account for 50% of pediatric gastrointestinal (GI) consultations. Children with DGBIs have worse quality of life (QoL) than those with organic GI disorders such as inflammatory bowel disease and gastroesophageal reflux disease. Pediatric DGBIs patients, especially those with chronic abdominal pain (AP), have impaired QoL and increased psychological distress in the form of anxiety and depression. Percutaneous Electrical Nerve Field Stimulation (PENFS) therapy has been shown to be effective in improving symptoms and functioning in children with DGBIs. The treatment's impact on these patients' QoL is unknown.
This prospective study evaluated changes in QoL, gastrointestinal symptoms, functional disability, somatization, global health, anxiety, and depression in patients aged 11-18 years who received PENFS therapy (IB-stim, NeurAxis, Versailles, IN) for treatment of pain related DGBIs, once a week for four consecutive weeks.
This study included 31 patients with an average age of 15.7 years (SD = 2); 80.6% were female. After PENFS therapy, patients reported significant reductions in abdominal pain, nausea severity, functional disability, somatization, and anxiety from baseline to week 4 ( < 0.05). Parents reported significant improvement in their child's QoL regarding physical function, psychosocial function, and generic core scale scores ( < 0.05). Parents also noted reduced abdominal pain, functional disability, and somatization. Average scores on the Patient-Reported Outcomes Measurement Information System (PROMIS) Global Health scale significantly improved based on both patient and parent reports ( < 0.05). Our patients' QoL was significantly lower than healthy controls at baseline and after treatment ( < 0.05).
Our research demonstrates that PENFS significantly enhances the QoL of children suffering from pain-related DGBIs, in addition to improvement in GI symptoms, daily functioning, somatization, global health, and psychological comorbidities. These findings demonstrate the effectiveness of PENFS and its potential to alleviate the suffering of countless children.
肠-脑互动障碍（DGBIs）占儿科胃肠病（GI）会诊的50%。患有DGBIs的儿童的生活质量（QoL）比患有诸如炎症性肠病和胃食管反流病等器质性胃肠疾病的儿童更差。儿科DGBIs患者，尤其是那些患有慢性腹痛（AP）的患者，生活质量受损，焦虑和抑郁等心理困扰增加。经皮电场神经刺激（PENFS）疗法已被证明对改善DGBIs儿童的症状和功能有效。该治疗对这些患者生活质量的影响尚不清楚。
这项前瞻性研究评估了11至18岁因疼痛相关DGBIs接受PENFS疗法（IB-stim，NeurAxis，凡尔赛，印第安纳州）治疗的患者的生活质量、胃肠道症状、功能残疾、躯体化、整体健康、焦虑和抑郁的变化，连续四周每周一次。
本研究纳入了31名平均年龄为15.7岁（标准差=2）的患者；80.6%为女性。PENFS治疗后，患者报告从基线到第4周腹痛、恶心严重程度、功能残疾、躯体化和焦虑显著降低（<0.05）。家长报告其孩子在身体功能、心理社会功能和通用核心量表评分方面的生活质量有显著改善（<0.05）。家长还指出孩子的腹痛、功能残疾和躯体化有所减轻。根据患者和家长报告，患者报告结局测量信息系统（PROMIS）整体健康量表的平均得分显著提高（<0.05）。我们的患者在基线和治疗后的生活质量均显著低于健康对照组（<0.05）。
我们的研究表明，PENFS除了改善胃肠道症状、日常功能、躯体化、整体健康和心理合并症外，还能显著提高患有疼痛相关DGBIs儿童的生活质量。这些发现证明了PENFS的有效性及其减轻无数儿童痛苦的潜力。
