Recurrent abdominal pain in children

Zeiter, Donna K.; Hyams, Jeffrey S.

doi:10.1016/s0031-3955(03)00108-1

Cited by 24 publications

(13 citation statements)

References 39 publications

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“…Several recent studies of therapies for childhood RAP have used the number of pain episodes as a primary outcome, 29,30 with the exception of 1 study that used missed activities as a result of pain as a primary outcome. 18 Despite continued research on RAP and improved diagnostic criteria, [31][32][33][34][35] the treatment of pediatric patients with RAP continues to challenge physicians, 36,37 and there is still a lack of consistency in methods used by researchers. Therefore, we developed and tested an MM-RAP.…”

Section: Discussionmentioning

confidence: 99%

Development of a Multidimensional Measure for Recurrent Abdominal Pain in Children: Population-Based Studies in Three Settings

et al. 2005

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ABSTRACT. Objective. Recurrent abdominal pain (RAP) is a common problem in children and adolescents. Evaluation and treatment of children with RAP continue to challenge physicians because of the lack of a psychometrically sound measure for RAP. A major obstacle to progress in research on RAP has been the lack of a biological marker for RAP and the lack of a reliable and valid clinical measure for RAP. The objectives of this study were (1) to develop and test a multidimensional measure for RAP (MM-RAP) in children to serve as a primary outcome measure for clinical trials, (2) to evaluate the reliability of the measure and compare its responses across different populations, and (3) to examine the reliabilities of the measure scales in relation to the demographic variables of the studied population.Methods. We conducted 3 cross-sectional studies. Two studies were clinic-based studies that enrolled children with RAP from 1 pediatric gastroenterology clinic and 6 primary care clinics. The third study was a community-based study in which children from 1 elementary and 2 middle schools were screened for frequent episodes of abdominal pain. The 3 studies were conducted in Houston, Texas. Inclusion criteria for the clinic-based studies were (1) age of 4 to 18 years; (2) abdominal pain that had persisted for 3 or more months; (3) abdominal pain that was moderate to severe and interfered with some or all regular activities; (4) abdominal pain that may or may not be accompanied by upper-gastrointestinal symptoms; and (5) children were accompanied by a parent or guardian who was capable of giving informed consent, and children over the age of 10 years were capable of giving informed assent. The community-based study used standardized questionnaires that were offered to 1080 children/parents from the 3 participating schools; 700 completed and returned the questionnaires (65% response rate). The questionnaire was designed to elicit data concerning the history of abdominal pain or discomfort. A total of 160 children met Apley's criteria and were classified as having RAP. Inclusion criteria were identical to those criteria for the clinic-based studies. Participating children in the 3 studies received a standardized questionnaire that asked about socioeconomic variables, abdominal pain (intensity; frequency; duration; nature of abdominal pain, if present, and possible relationships with school activities; and other upper gastrointestinal symptoms). We used 4 scales for the MM-RAP: pain intensity scale (3 items), nonpain symptoms scale (12 items), disability scale (3 items), and satisfaction scale (2 items). Age 7 was used as a cutoff point for the analysis as the 7-year-olds have been shown to exhibit more sophisticated knowledge of illness than younger children.Results. A total of 295 children who were aged 4 to 18 years participated in the study: 155 children from the pediatric gastroenterology clinics, 82 from the primary care clinics, and 58 from the schools. The interitem consistency (Cronbach's coefficient ␣) for the pain i...

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Section: Discussionmentioning

confidence: 99%

Development of a Multidimensional Measure for Recurrent Abdominal Pain in Children: Population-Based Studies in Three Settings

et al. 2005

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“…Em cerca de 95% dos casos de DAR, não há uma etiologia bem definida, e a importância de fatores emocionais na gênese do sintoma tem sido reconhecida por diferentes autores [9][10][11] . Uma primeira classificação da DAR propunha uma divisão, segundo sua etiologia, em orgânica e não orgânica.…”

Section: Dor Abdominal Recorrente -Darunclassified

“…Na década de 1990, foi sugerida a terminologia Síndrome da Dor Abdominal Recorrente (SDAR) para o conjunto de crianças sem doença orgânica, as quais constituiriam a maioria dos casos de DAR 11 . Recentemente, foi proposto um sistema de classificação de distúrbios gastrintestinais associados à DAR, conhecido como ROMA II, entretanto, esta classificação não contempla todos os casos de DAR, à medida que é restrita às afecções do trato gastrintestinal 9 .…”

Section: Dor Abdominal Recorrente -Darunclassified

“…A ocorrência do sintoma em crianças que haviam sido submetidas a eventos críticos, como hospitalização de familiares, hospitalização da pró-pria criança e fracasso escolar, não tem persistido como uma associação consistente e definitiva. 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] .…”

Section: Dor Abdominal Recorrente -Darunclassified

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Dores recorrentes na infância e adolescência

Puccini¹,

Bresolin²

2003

J. Pediatr. (Rio J.)

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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...

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“…Odinofaji ve disfaji özofagus tutulumlar›nda, epigastrik a¤r› da gastroduodenal tutulumlarda görülür. Crohn hastalar›n-da kar›n a¤r›s› genellikle çocu¤u uykudan uyand›racak kadar fliddetli ve süregendir (17).…”

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Kronik enflamatuar barsak hastalıkları

Çokuğraş¹

2011

tpa

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Recurrent abdominal pain in children

Cited by 24 publications

References 39 publications

Development of a Multidimensional Measure for Recurrent Abdominal Pain in Children: Population-Based Studies in Three Settings

Development of a Multidimensional Measure for Recurrent Abdominal Pain in Children: Population-Based Studies in Three Settings

Dores recorrentes na infância e adolescência

Kronik enflamatuar barsak hastalıkları

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