Abdominal Wall Pain or Irritable Bowel Syndrome

Siawash, Murid; Assen, Tijmen van; Ten, Walther Tjon a; Janssen, Loes; Heurn, Ernst van; Roumen, R.; Scheltinga, Marc

doi:10.1097/mpg.0000000000002366

Cited by 7 publications

(4 citation statements)

References 26 publications

(32 reference statements)

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“…The anterior cutaneous nerve entrapment syndrome (ACNES) is a cause of abdominal pain, difficult to distinguish from IBS 22 . A 17‐item questionnaire showed good diagnostic test properties and may aid in distinguishing ACNES from IBS 22 …”

Section: Methodsmentioning

confidence: 99%

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How to manage irritable bowel syndrome in children

Levy¹,

Geyter²,

Chaib³

et al. 2021

Acta Paediatrica

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Aim This paper discusses the risk factors and management of paediatric irritable bowel syndrome (IBS), with a focus on the role of the gastrointestinal microbiome. Methods English articles of interest published in PubMed and Google Scholar were searched using subject heading and keywords of interest. Results Only few randomised controlled trials on the management of IBS in children have been published. The vast majority of these intervention trials target to change the composition of the gastrointestinal microbiome. Most studies are underpowered. Major heterogeneities in study designs such as differences in inclusion criteria, including patients with different pain‐related functional gastrointestinal disorders and differences in primary outcomes, make it impossible to formulate recommendations. Overall, few adverse events are reported what could indicate safety or point to suboptimal conduction of clinical trials and safety reporting. However, it can also not be excluded that some interventions such as the administration of selected probiotic products may result in benefit. Conclusion There is insufficient evidence to recommend any therapeutic intervention in paediatric IBS, including manipulation of the gastrointestinal tract microbiome, despite the evidence that dysbiosis seems an associated pathophysiologic factor. More designed prospective trials are needed since IBS is not a rare condition during childhood.

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Section: Methodsmentioning

confidence: 99%

“…22 A 17item questionnaire showed good diagnostic test properties and may aid in distinguishing ACNES from IBS. 22…”

Section: Other Aetiologies Causing Ibs-like Symptomsmentioning

confidence: 99%

How to manage irritable bowel syndrome in children

Levy¹,

Geyter²,

Chaib³

et al. 2021

Acta Paediatrica

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“…Anterior cutaneous nerve entrapment syndrome (ACNES) is a pain syndrome characterized by localized abdominal pain resulting from the entrapment of the terminal branches of the intercostal nerves penetrating the muscle sheet of the rectus abdominis. In cases of unilateral chronic or recurrent abdominal pain without an organic explanation, consideration of this diagnosis is warranted, based on specific criteria [ 3 ]. Although ACNES was initially described in 1926 by Carnett and Bates [ 4 ], it is only in the last decade that this syndrome has been increasingly recognized in children.…”

Section: Introductionmentioning

confidence: 99%

How Do We Treat Children with Anterior Cutaneous Nerve Entrapment Syndrome and Is the Biopsychosocial Model Also Being Applied? A Scoping Review

Top,

de Leeuw,

Bramer

et al. 2024

Pain Research and Management

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Background. Evidence-based guidelines for managing anterior cutaneous nerve entrapment syndrome (ACNES) in children are absent. The primary aim of this review was to scrutinize the evidence supporting currently used treatment interventions. In accordance with the World Health Organization (WHO) guidelines for managing chronic pain in children, these patients and their families and caregivers should be treated within the context of the biopsychosocial model; pain should not be treated purely as a biomedical problem. Therefore, our second aim was to evaluate whether these interventions are applied within the context of the biopsychosocial model, utilizing an inter- or multidisciplinary approach. Materials and Methods. A scoping review of the literature was conducted to explore treatment strategies for ACNES in children. To ensure a comprehensive overview of published literature on this topic, the search was not restricted based on study type. Two reviewers independently assessed titles and abstracts. After excluding records unrelated to children, full texts were screened for inclusion. Any discrepancies in judgement were resolved through discussion with a third reviewer. Results. Out of 35 relevant titles, 22 were included in this review. Only 4 articles provided information on long-term outcomes. The overall quality of the review was deemed low. The majority of reports did not address treatment or education within the psychological and social domains. A structural qualitative analysis was not feasible due to the substantial heterogeneity of the data. Conclusion. The evidence supporting current treatment strategies in children with ACNES is of low quality. More research is needed to establish an evidence-based treatment algorithm for patients with this challenging pain problem. In line with the WHO recommendation, greater emphasis should be placed on a biopsychosocial approach. The ultimate goal should be the development of a generic treatment algorithm outlining an approach to ACNES applicable to all professionals involved.

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“…Uno de los diagnósticos diferenciales más frecuentes es el síndrome de intestino irritable, para lo cual recientemente se ha publicado un cuestionario pediátrico validado de 17 ítems, con una sensibilidad del 85% y especificidad del 89% 18 . Otros diagnósticos diferenciales se muestran en la tabla 1 7,[19][20][21][22][23] .…”

Section: Introductionunclassified

Síndrome de ACNES, explorando la pared abdominal como noxa del dolor abdominal

Arcos

et al. 2022

Andes pediatr

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El dolor de pared abdominal, y concretamente el síndrome de ACNES (Anterior Cutaneous Nerve Entrapment Syndrome), forma parte del diagnóstico diferencial del dolor abdominal crónico. Este síndrome es poco conocido y por consiguiente infradiagnosticado. Objetivos: Describir las características clínicas y evolutivas de pacientes diagnosticados de ACNES y llamar la atención sobre esta patología. Pacientes y Método: Estudio descriptivo retrospectivo realizado en un centro de referencia, entre octubre 2016 y julio de 2021, en pacientes menores 17 años, diagnosticados de ACNES, que cumpliesen al menos dos de cuatro hallazgos siguientes: signo de Carnett, Pinch test, disestesias en el punto de máximo dolor, mejoría tras infiltración de anestésico local, habiéndose descartado patología abdominal visceral o funcional. Se recogieron variables epidemiológicas, síntomas, exploración física, pruebas complementarias, tratamiento y evolución. Se usaron estadísticas descriptivas. Resultados: 20 pacientes diagnosticados de ACNES, 75% mujeres, mediana de edad 12,85 años. Se objetivó signo de Carnett en 95%, signo de Pinch test en 65% y disestesias en 90% de los pacientes. 65% refirió síntomas pseudoviscerales. 7 pacientes presentaron sobrepeso u obesidad. La localización más frecuente (50%) fue la fosa ilíaca derecha, a nivel T10-T11. Un paciente refirió mejoría espontánea; 7 mejoraron con analgesia oral; 9 fueron derivados a la Unidad del Dolor, de los cuales acudieron 5, los que mejoraron con infiltración anestésica con bupivacaína-triamcinolona; los 4 restantes perdieron seguimiento. Conclusión: El ACNES debe ser considerado en pacientes con dolor abdominal crónico. La combinación de hallazgos típicos en la historia y el examen físico permiten su diagnóstico, evitando pruebas complementarias innecesarias. El tratamiento debe ser escalonado, comenzando por analgesia oral, seguido de infiltración anestésica y, por último, neurectomía anterior.

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Abdominal Wall Pain or Irritable Bowel Syndrome

Cited by 7 publications

References 26 publications

How to manage irritable bowel syndrome in children

How to manage irritable bowel syndrome in children

How Do We Treat Children with Anterior Cutaneous Nerve Entrapment Syndrome and Is the Biopsychosocial Model Also Being Applied? A Scoping Review

Síndrome de ACNES, explorando la pared abdominal como noxa del dolor abdominal

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