Autonomic Abnormalities in Children With Functional Abdominal Pain: Coincidence or Etiology?

Chelimsky, Gisela; Boyle, John T.; Tusing, Lora; Chelimsky, Thomas C.

doi:10.1097/00005176-200107000-00008

Cited by 76 publications

(57 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…112 In addition, in a subset of children with functional abdominal pain, postural orthostatic tachycardia syndrome (POTS) and mild peripheral neuropathy have been noted. 113 An operational definition of POTS includes symptoms of orthostatic intolerance, such as fatigue, light-headedness, nausea, vomiting, headache, palpitations, and tremulousness, associated with increased heart rate exceeding 30 beats per minute or to a heart rate Ͼ120 beats per minute within 10 minutes of head-up tilt. 114 Thus, patients with POTS also report a variety of gastrointestinal symptoms such as nausea, bloating, early satiety, abdominal pain, and other gastrointestinal manifestations.…”

Section: Functional Abdominal Painmentioning

confidence: 99%

Pediatric Autonomic Disorders

2006

View full text Add to dashboard Cite

The scope of pediatric autonomic disorders is not well recognized. The goal of this review is to increase awareness of the expanding spectrum of pediatric autonomic disorders by providing an overview of the autonomic nervous system, including the roles of its various components and its pervasive influence, as well as its intimate relationship with sensory function. To illustrate further the breadth and complexities of autonomic dysfunction, some pediatric disorders are described, concentrating on those that present at birth or appear in early childhood.www.pediatrics.org/cgi

show abstract

Section: Functional Abdominal Painmentioning

confidence: 99%

Pediatric Autonomic Disorders

2006

View full text Add to dashboard Cite

show abstract

“…Current theories include autonomic nervous system instability, 13,14 visceral hyperalgesia, 15,16 gut dysmotility, 17 stressful life events, 18 or poor coping skills, 19 to name a few. It is known that both the gut and the nervous system are derived from the same tissues embryologically.…”

mentioning

confidence: 99%

Systematic Review of Treatments for Recurrent Abdominal Pain

Weydert

Ball²,

Davis³

2003

Pediatrics

193

100

View full text Add to dashboard Cite

ABSTRACT.Objective. To conduct a systematic review of evaluated treatments for recurrent abdominal pain (RAP) in children.Methods. Online bibliographic databases were searched for the terms "recurrent abdominal pain," "functional abdominal pain," "children," or "alternative therapies" in articles classified as randomized controlled trials. The abstracts or full text of 57 relevant articles were examined; 10 of these met inclusion criteria. Inclusion criteria required that the study involve children aged 5 to 18 years, subjects have a diagnosis of RAP, and that subjects were allocated randomly to treatment or control groups. The methodology and findings of these articles were evaluated critically, and data were extracted from each article regarding study methods, specific interventions, outcomes measured, and results.Results. Studies that evaluated famotidine, pizotifen, cognitive-behavioral therapy, biofeedback, and peppermint oil enteric-coated capsules showed a decrease in measured pain outcomes for those who received the interventions when compared with others in control groups. The studies that evaluated dietary interventions had conflicting results, in the case of fiber, or showed no efficacy, in the case of lactose avoidance.Conclusions. Evidence for efficacy of treatment of RAP in children was found for therapies that used famotidine, pizotifen, cognitive-behavioral therapy, biofeedback, and peppermint oil enteric-coated capsules. The effects of dietary fiber were less conclusive, and the use of a lactose-free diet showed no improvement. There seemed to be greater improvement when therapy (famotidine, pizotifen, peppermint oil) was targeted to the specific functional gastrointestinal disorder (dyspepsia, abdominal migraine, irritable bowel syndrome). The behavioral interventions seemed to have a general positive effect on children with nonspecific RAP. Many of these therapies have not been used widely as standard treatment for children with RAP. Although the mechanism of action for each effective therapy is not fully understood, each is believed to be safe for use in RAP. Pediatrics 2003;111:e1-e11. URL: http://www.pediatrics.org/cgi/ content/full/111/1/e1; recurrent abdominal pain, treatment, children, alternative therapies, systematic review.ABBREVIATIONS. RAP, recurrent abdominal pain; IBS, irritable bowel syndrome; RCT, randomized controlled trial; SPC, standard pediatric care; CBFI, cognitive-behavioral family intervention; BF, biofeedback; CBI, cognitive-behavioral intervention.

show abstract

“…Questiona-se se situações de estresse seriam mais freqüentes nessas crianças, ou mais valorizadas por elas, lembrando que está bem descrita a relação de DAR com a presença de sintomatologia semelhante nos familiares, bem como com o padrão de respostas aprendidas 9,10 . Uma linha de pesquisa mais recente tem buscado identificar alterações de respostas do sistema nervoso autônomo nessas crianças, associadas ou não à ansiedade e depressão, que pudessem explicar a ocorrência do sintoma, entretanto, os resultados ainda não são definitivos [14][15][16] . Assim, considera-se que o modelo proposto por Levine e Rappaport 3 , citado na introdução deste artigo, na prática clínica, é o que mais contribui para a abordagem dessas crianças e adolescentes, ao estabelecer que, mesmo diante da identificação de uma causa orgânica, deve-se considerar o conjunto de fatores que exercem influência sobre suas vidas.…”

Section: Dor Abdominal Recorrente -Darunclassified

Dores recorrentes na infância e adolescência

Puccini¹,

Bresolin²

2003

J. Pediatr. (Rio J.)

View full text Add to dashboard Cite

ResumoObjetivo: realizar revisão bibliográfica sobre dores recorrentes na infância e na adolescência, com enfoque no diagnóstico diferencial e manejo desses pacientes. Fontes de dados: levantamento bibliográfico no Medline eLilacs, abrangendo os últimos quatro e dez anos, respectivamente, além de estudos e textos clássicos que tratam sobre o tema.Síntese dos dados: estudos realizados em diferentes partes do mundo demonstram que as dores recorrentes mais freqüentes na infância e adolescência são dor abdominal, cefaléia e dor em membros. A ocorrência de causa orgânica é baixa, observada em 5% a 10% dos casos. Dentre as causas orgânicas bem definidas de dor abdominal recorrente, cefaléia e dor em membros, não se observa nenhuma etiologia predominante. Foram analisados os principais avanços quanto à fisiopatologia das dores recorrentes, nas suas diferentes localizações, apresentando-se uma orientação para abordagem diagnóstica e terapêutica das afecções mais freqüentes em pediatria.Conclusões: as dores recorrentes na infância e adolescência são muito freqüentes e determinam significativa demanda aos serviços de saúde. A anamnese, o exame físico e o seguimento do paciente constituem a base para abordagem dessas crianças e adolescentes.J Pediatr (Rio J) 2003;79(Supl.1):S65-S76: dor, dor abdominal, cefaléia, dor em membros. AbstractObjective: to perform a bibliographic review of recurrent pain in children and adolescents, focusing on differential diagnosis and management of such patients.Sources of data: search of Medline and Lilacs databases, covering the last four and ten years, respectively. Classical studies and texts related to the matter were also included.Summary of the findings: studies carried out in different parts of the world demonstrate that the most frequent kinds of recurrent pain in children and adolescents are abdominal pain, headache, and limb pain. The occurrence of organic etiology is low, observed in 5% to 10% of the cases. Among the well defined organic etiology, no predominance is observed. The main advances regarding the pathophysiology of recurrent pain in its main localizations were analyzed. Guidelines for the diagnostic and therapeutic approach of the most common infantile diseases related to recurrent pain are presented.Conclusions: recurrent pain in children and adolescents is very common and determines significant demand on healthcare services. Defined etiology is only presented by 5% to 10% of patients. Anamnesis, physical examination and follow-up are extremely important instruments for dealing with such patients. Dores recorrentes na infância e adolescênciaRecurrent pain in children and adolescents Considerações geraisVárias afecções dolorosas, de evolução aguda ou crôni-ca, podem acometer a criança, gerando sofrimento e importante demanda aos serviços de saúde. Muitos fatores modificam a expressão da dor na criança, como idade, sexo, nível cognitivo -percepção que a criança tem da dor -, experiências dolorosas prévias, aprendizado, padrões culturais, relações familiares e comportame...

show abstract

Autonomic Abnormalities in Children With Functional Abdominal Pain: Coincidence or Etiology?

Cited by 76 publications

References 23 publications

Pediatric Autonomic Disorders

Pediatric Autonomic Disorders

Systematic Review of Treatments for Recurrent Abdominal Pain

Dores recorrentes na infância e adolescência

Contact Info

Product

Resources

About