martes, 27 de marzo de 2012

Dolor abdominal en pediatría


Dolor abdominal recurrente en la infancia
Recurrent abdominal pain in childhood.
Bufler P, Gross M, Uhlig HH.
Abteilung für Pädiatrische Gastroenterologie und Hepatologie, Dr. von Haunersches Kinderspital, Ludwig-Maximilians-Universität München, Lindwurmstrasse 4, 80337 München, Germany. philip.bufler@med.uni-muenchen.de
Dtsch Arztebl Int. 2011 Apr;108(17):295-304. Epub 2011 Apr 29.
Abstract
BACKGROUND: Chronic, recurrent abdominal pain is common among children and adolescents. It interferes with everyday life, causes absence from school, and leads to frequent medical consultations, often involving burdensome diagnostic testing and protracted attempts at treatment. METHOD: Selective review of the literature. RESULTS: Organic causes should be ruled out with a thorough medical history and physical examination and a small number of laboratory tests. The pediatric Rome III criteria include valid diagnostic criteria for functional abdominal pain in childhood. The available data imply that this condition is best treated with cognitive behavioral therapy, rather than with medications or dietary measures. CONCLUSION: A systematic approach to chronic recurrent abdominal pain in children and adolescents is key to ruling out organic diseases while avoiding unnecessary tests and treatments
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3103980/pdf/Dtsch_Arztebl_Int-108-0295.pdf 
Dolor abdominal funcional y síndrome de intestino irritable en niños y adolescentes
Functional abdominal pain and irritable bowel syndrome in children and adolescents.
Chiou E, Nurko S.
Center for Motility & Functional Gastrointestinal Disorders, Children's, Hospital Boston, 300 Longwood Ave, Boston, MA 02115, USA.
Therapy. 2011 May 1;8(3):315-331.
Abstract
Functional abdominal pain (FAP) and irritable bowel syndrome (IBS) are both associated with recurrent abdominal pain and are among the most commonly diagnosed medical problems in pediatrics. The majority of patients with mild complaints improve with reassurance and time. For a distinct subset of patients with more severe and disabling illness, finding effective treatment for these disorders remains a challenge. Based on the biopsychosocial model of functional disease, the Rome III criteria have helped frame FAP and IBS in terms of being a positive diagnosis and not a diagnosis of exclusion. However, the lack of a single, proven intervention highlights the complex interplay of pathologic mechanisms likely involved in the development of childhood FAP and IBS and the need for a multidisciplinary, integrated approach. This article discusses the epidemiology, proposed mechanisms, clinical approach and therapeutic options for the management of FAP and IBS in children and adolescents.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3127202/pdf/nihms304140.pdf

Dolor abdominal recurrente en niños y adolescents: una encuesta entre pediatras 
Recurrent abdominal pain in children and adolescents - a survey among paediatricians.
Schlarb AA, Gulewitsch MD, Bock Genannt Kasten I, Enck P, Hautzinger M.
Department of Clinical and Developmental Psychology, University of Tübingen, Germany.
Psychosoc Med. 2011 Mar 28;8:Doc02.
Abstract
Objective: Little is known about prevalence and usual treatment of childhood and adolescent recurrent abdominal pain (RAP) in outpatient paediatricians' practice. This study's primary objective was to acquire insights into the usual paediatricians' treatment and their estimation of prevalence, age and gender of RAP patients. Further objectives were to assess to which extent family members of patients report similar symptoms, how paediatricians rate the strain of parents of affected children and adolescents and how paediatricians estimate the demand for psychological support.Methods: Provided by a medical register, 437 outpatient paediatricians received a questionnaire to assess their perception of several psychosomatic problems and disorders including recurrent abdominal pain. Results: According to paediatricians' estimation, 15% of all visits are caused by patients with RAP. In 22% of these cases of RAP, at least one family member has similar problems. In about 15% of all RAP cases, parents ask for professional psychological support concerning their children's issues, whereas 40% of paediatricians wish for psychological support considering this group of patients.Conclusions: Estimated frequencies and paediatricians' demands show the need for evidence-based psychological interventions in RAP to support usual medical treatment
http://www.egms.de/static/pdf/journals/psm/2011-8/psm000071.pdf
 
Atentamente
Dr. Enrique Hernández-Cortez
Anestesiología y Medicina del Dolor

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