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Query: UMLS:C0013395 (dyspepsia)
 4,879 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Chronic abdominal pain occurs in 17% of children aged 0-14 years with a peak of 33% at the age of 7 years. According to the Rome II criteria abdominal pain disorders can be classified as functional dyspepsia, irritable bowel syndrome, functional abdominal pain, abdominal migraine, and aerophagia. This new classification will hopefully lead to a more careful diagnosis of functional abdominal pain syndromes and to better treatment strategies. A thorough history taking and physical examination are the cornerstone of diagnostic workup in children with chronic abdominal pain. An extensive explanation and reassurance are the basis of an adequate treatment and in the majority of cases this is successful.
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PMID:[Functional childhood gastrointestinal disorders. I. Chronic abdominal pain]. 1286 62

Chronic abdominal pain in children can be dependent from motility disorders. The aim of the work was evaluation the frequency of changes in oesophageal manometry in children with chronic abdominal pain. Manometry studies were performed in 40 children with functional abdominal pain (group A, which was divided into subgroups: A1--functional dyspepsia, A2--irritable bowel syndrome, A3--nonspecific abdominal pain), in 11 children with gastritis (group B) and in 24 children as a control (group C). Disorders of lower oesophageal sphincter (LES) function were observed in 72.5% of group A and 45.5% of group B; transient lower oesophageal sphincter relaxations (TLESR) were noticed in 13.5%. Abnormalities of body function with the features of non-specific oesophageal motility disorders were observed in 62.5% in group A and 54.5% in group B during "dry" swallows and in 47.5% and 18.2% respectively during "wet" swallows. These changes were more frequent in dyspeptic children (85.7%). Statistical differences were established among values of resting LES pressure in analysed groups (group A or B versus group C; p < 0.05). In conclusion we mentioned that in oesophageal manometry abnormalities (LES and body function) were observed in children with functional abdominal pain and with gastritis. Characteristic features can not be defined in each group.
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PMID:[Motility disorders in oesophageal manometry in children with chronic abdominal pain]. 1507 18

Chronic abdominal pain (CAP) continues to be a diagnostic and therapeutic challenge. It affects about 10% of school-going children and adolescents. Few Indian studies have reported an organic cause in 30%-40% of children with recurrent abdominal pain. In developing countries, parasitic infestations such as giardiasis and ascariasis are an important cause, of recurrent abdominal pain but their frequency has decreased over time. There is a paucity of data from India on the aetiology, epidemiology and management strategies for CAP, and there is no consensus on the clinical approach to this problem. We present a practical approach to CAP in children. The first step is to elicit a detailed history and do a thorough physical examination so as to categorize CAP according to the site of pain (epigastric, periumbilical or left lower quadrant), the predominant symptom associated with pain (dyspepsia, isolated pain or altered bowel habits) and to differentiate the pain as organic or functional based on the characteristics of pain and presence or absence of alarm signs. The second step is to do appropriate investigations, restricted to simple tests when functional pain is suspected (Level I) and more investigations (Level Ia) if there are alarm signs and pain appears to be organic in nature. Invasive investigations such as gastrointestinal endoscopy (Level II) may be reserved for those with possible organic pain. Level III investigations need to be done in a small percentage of children and include EEG, workup for food allergy and porphyria. The third step is management of organic CAP according to the aetiology, while for functional CAP the pharmacological and, rarely, psychological intervention is more difficult but should be done discreetly and tailored to the needs of the child.
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PMID:Chronic abdominal pain in children. 2092 8

The perception of pain in children is easily influenced by environmental factors and psychological comorbidities that are known to play an important role in its origin and response to therapy. Chronic abdominal pain is one of the most commonly treated conditions in modern pediatric gastroenterology and is the hallmark of 'functional' disorders that include irritable bowel syndrome, functional dyspepsia, and functional abdominal pain. The development of pharmacological therapies for these disorders in adults and children has been limited by the lack of understanding of the putative, pathophysiological mechanisms that underlie them. Peripheral and central pain-signaling mechanisms are known to be involved in chronic pain originating from the gastrointestinal tract, but few therapies have been developed to target specific pathways or enhance correction of the underlying pathophysiology. The responses to therapy have been variable, potentially reflecting the heterogeneity of the disorders for which they are used. Only a few small, randomized clinical trials have evaluated the benefit of pain medications for chronic abdominal pain in children and thus, the decision on the most appropriate treatment is often based on adult studies and empirical data. This review discusses the most common, non-narcotic pharmacological treatments for chronic abdominal pain in children and includes a thorough review of the literature to support or refute their use. Because of the dearth of pediatric studies, the focus is on pharmacological and alternative therapies where there is sufficient evidence of benefit in either adults or children with chronic abdominal pain.
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PMID:The use of non-narcotic pain medication in pediatric gastroenterology. 2494 27