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Pediatric Abdominal Pain

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1. Home-Based Hypnotherapy Self-exercises vs Individual Hypnotherapy With a Therapist for Treatment of Pediatric Irritable Bowel Syndrome, Functional Abdominal Pain, or Functional Abdominal Pain Syndrome: A Randomized Clinical Trial (Abstract)

Home-Based Hypnotherapy Self-exercises vs Individual Hypnotherapy With a Therapist for Treatment of Pediatric Irritable Bowel Syndrome, Functional Abdominal Pain, or Functional Abdominal Pain Syndrome: A Randomized Clinical Trial Individual gut-directed hypnotherapy (HT) is effective in pediatric irritable bowel syndrome (IBS) and functional abdominal pain or functional abdominal pain syndrome (FAP[S]). It is, however, unavailable to many children.To compare the effectiveness of HT by means (...) ratio) to home-based HT with a CD (CD group) or iHT performed by qualified therapists (iHT group). No children withdrew from the study because of adverse effects.The CD group was instructed to perform exercises 5 times per week or more for 3 months. The iHT group consisted of 6 sessions during 3 months.Primary outcomes were treatment success directly after treatment and after 1-year follow-up. Treatment success was defined as a 50% or greater reduction in pain frequency and intensity scores

2017 EvidenceUpdates

2. CRACKCast E095 – Large Intestine

? What are the risk factors for developing each type? In general you can get a volvulus anywhere. Patients can present with a bowel obstruction pattern. Can get: Electrolyte disturbances secondary to third spacing / respiratory compromise from massive abdominal distention If left untreated bowel can get ischemic, gangrenous and perforate. Pearl: Sigmoid volvulus account for 60% of all intestinal volvulus. So if you’re a betting person that’s the most common. Gastric – Not large intestine…we know 2 (...) ! IBS Diverticular disease Volvulus Large bowel obstruction IBD Intussusception Colonic ischemia Radiation proctocolitis 1) List features that are typical for IBS. This is a chronic, non-life threatening disorder – causing abdo pain and weird bowel habits. 10-15% prevalence, and it is thought to impair one’s QOL more than diabetes or renal failure!!! Its defined as a “functional, somatic syndrome” because there are no physical or lab features that clinch the diagnosis! No known cause. Testing shows

2017 CandiEM

3. Increased Gut Permeability in First-degree Relatives of Children with Irritable Bowel Syndrome or Functional Abdominal Pain. (Abstract)

or colonic permeability. After administration of ibuprofen, gastroduodenal and small bowel permeability tended to be greater in IBS or FAP siblings (P = .08) and gastroduodenal permeability tended to be greater in IBS or FAP parents (P = .086).Siblings and parents of children with IBS or FAP have increased baseline small intestinal permeability compared with control children and their parents. These results indicate that there are familial influences on gastrointestinal permeability in patients with IBS (...) Increased Gut Permeability in First-degree Relatives of Children with Irritable Bowel Syndrome or Functional Abdominal Pain. Increased gut permeability might contribute to the pathogenesis of irritable bowel syndrome or functional abdominal pain (IBS or FAP). We investigated whether siblings and parents of children with IBS or FAP have increased gut permeability.We performed permeability tests (using sucrose, lactulose, mannitol, and sucralose) on 29 siblings and 43 parents of children with IBS

2019 Clinical Gastroenterology and Hepatology

4. Abdominal Wall Pain or Irritable Bowel Syndrome: Validation of a Pediatric Questionnaire. (Abstract)

Abdominal Wall Pain or Irritable Bowel Syndrome: Validation of a Pediatric Questionnaire. A questionnaire study demonstrated that some adult patients who were diagnosed with Irritable Bowel Syndrome (IBS) were in fact having an abdominal wall pain syndrome such as anterior cutaneous nerve entrapment syndrome (ACNES). The aim of the present study was to investigate whether a pediatric version of this questionnaire was useful in diagnosing abdominal wall pain syndromes in children with chronic (...) abdominal pain (CAP).An 18-item questionnaire was tested in three groups of children with CAP: I. children who underwent surgery for ACNES (n = 42); II. Children who were found to have ACNES after an outpatient analysis (n = 57), and III. Children diagnosed with IBS (n = 53). Qualities including internal consistency (Cronbach's α), cut-off points and a ROC-curve were calculated using standard statistical analysis.Questionnaire response rates in the three populations of CAP children ranged from 69-92

2019 Journal of Pediatric Gastroenterology and Nutrition

5. Laser Acupuncture at Large Intestine 4 Compared with Oral Glucose Administration for Pain Prevention in Healthy Term Neonates Undergoing Routine Heel Lance: Study Protocol for an Observer-Blinded, Randomised Controlled Clinical Trial. Full Text available with Trip Pro

Laser Acupuncture at Large Intestine 4 Compared with Oral Glucose Administration for Pain Prevention in Healthy Term Neonates Undergoing Routine Heel Lance: Study Protocol for an Observer-Blinded, Randomised Controlled Clinical Trial. Nonpharmacological strategies have actually become more important in neonatal pain management during routinely applied minor painful procedures. However, commonly used nonpharmacological strategies are inferior to orally administered sweet solutions. Therefore, we (...) will compare laser acupuncture, as a recent nonpharmacological method, with the standard care of oral glucose solution for pain prevention.Ninety-five healthy term neonates will be allocated into one of two groups. Before routine heel lance for metabolic screening, one group will receive laser acupuncture at acupuncture point Large Intestine 4 (LI 4) bilaterally for 60 seconds per point (acupuncture group) and the other will receive the standard care with orally administered glucose solution (glucose group

2018 Evidence-based Complementary and Alternative Medicine (eCAM) Controlled trial quality: predicted high

6. Comparison of gut-directed hypnotherapy and unspecific hypnotherapy as self-help format in children and adolescents with functional abdominal pain or irritable bowel syndrome: a randomized pilot study. (Abstract)

Comparison of gut-directed hypnotherapy and unspecific hypnotherapy as self-help format in children and adolescents with functional abdominal pain or irritable bowel syndrome: a randomized pilot study. Psychosocial treatments for chronic abdominal pain in childhood or adolescence are effective, but time consuming and hardly available. In the present study, gut-directed hypnotherapy (GDHT) and unspecific hypnotherapy (UHT) were compared to evaluate the feasibility and efficacy (...) adherence and a similar decrease in days with pain and pain duration. Pain intensity decreased only in the UHT condition. Eleven participants (two GDHT, nine UHT) achieved clinical remission (>80% improvement) and 13 participants (seven GDHT, six UHT) improved significantly (30-80%).Results suggest a high efficacy of standardized home-based hypnotherapy for children/adolescents with abdominal pain. Children/adolescents with high pain severity are at risk of dropping out. The UHT condition showed slight

2018 European journal of gastroenterology & hepatology Controlled trial quality: uncertain

7. Predicting inflammatory bowel disease in children with abdominal pain and diarrhoea: calgranulin-C versus calprotectin stool tests. Full Text available with Trip Pro

Predicting inflammatory bowel disease in children with abdominal pain and diarrhoea: calgranulin-C versus calprotectin stool tests. Calgranulin-C (S100A12) is a new faecal marker of inflammation that is potentially more specific for inflammatory bowel disease (IBD) than calprotectin, since it is only released by activated granulocytes. We compared calgranulin-C and calprotectin to see which of the two tests best predicted IBD in children with chronic abdominal pain and diarrhoea.Delayed-type (...) cross-sectional diagnostic study.Previously undiagnosed patients aged 6-17 years, who were seen in paediatric clinics in the Netherlands and Belgium, sent in a stool sample for analysis. Patients with a high likelihood of IBD underwent upper and lower endoscopy (ie, preferred reference test), while those with a low likelihood were followed for 6 months for latent IBD to become visible (ie, alternative reference test). We used Bayesian modelling to correct for differential verification bias.Primary

2018 Archives of Disease in Childhood

8. Recurrent abdominal pain and upper gastrointestinal endoscopy findings in children and adolescents presenting at the Lagos University Teaching Hospital. Full Text available with Trip Pro

Recurrent abdominal pain and upper gastrointestinal endoscopy findings in children and adolescents presenting at the Lagos University Teaching Hospital. Recurrent abdominal pain (RAP) is a common reason for referral to the paediatric gastroenterology unit and the attending physician needs to be able to rule out an organic cause when evaluating any child with this condition. The aim of this study was to describe the endoscopic findings in children who presented to the paediatric gastroenterology (...) unit of the Lagos University Teaching Hospital (LUTH) with RAP.This was a prospective descriptive study which was conducted from January 2015 to July 2018 at the Paediatric Gastroenterology unit of the department of Paediatrics and the endoscopy unit of the LUTH, Lagos, Nigeria. All children and adolescents ≤ 19 years old with recurrent abdominal pain who were referred for upper GI endoscopy during the study period, were recruited. Baseline sociodemographic data, dyspepsia and alarm symptoms

2019 PLoS ONE

9. Assessment of abdominal pain in children

Assessment of abdominal pain in children Assessment of abdominal pain in children - Differential diagnosis of symptoms | BMJ Best Practice   Search  Assessment of abdominal pain in children Last reviewed: February 2019 Last updated: June 2018 Summary Paediatric abdominal pain is often a diagnostic dilemma. It is a common problem and, although the vast majority of these episodes are benign and self-limiting, persistent abdominal pain may signify an underlying pathology requiring urgent (...) intervention. Timely assessment and intervention are critical in preventing untoward sequelae in children presenting with abdominal pain. Because of the spectrum of aetiologies that manifest as abdominal pain, the differential remains broad and diagnosis can be challenging. In most cases, a thorough history and physical examination can narrow the broad differential. However, depending on the age of the child, additional investigations may be required to delineate diseases that present with similar symptoms

2018 BMJ Best Practice

10. Acute abdominal pain in infants (1-12 months old) - approach to the patient

Acute abdominal pain in infants (1-12 months old) - approach to the patient

2017 DynaMed Plus

11. Acute abdominal pain in children aged 6-11 years - approach to the patient

Acute abdominal pain in children aged 6-11 years - approach to the patient

2017 DynaMed Plus

12. Acute abdominal pain in children aged 1-5 years - approach to the patient

Acute abdominal pain in children aged 1-5 years - approach to the patient

2017 DynaMed Plus

14. Vitamin D Status and Bone Mineral Density in Children with Inflammatory Bowel Disease Compared to Those with Functional Abdominal Pain Full Text available with Trip Pro

Vitamin D Status and Bone Mineral Density in Children with Inflammatory Bowel Disease Compared to Those with Functional Abdominal Pain Low vitamin D has been implicated in reduced bone mineral density (BMD) in children with inflammatory bowel disease (IBD). Our study aimed to evaluate differences in serum 25-hydroxyvitamin D (25[OH]D) and total body less head (TBLH) BMD z-scores in children with Crohn's disease (CD), ulcerative colitis (UC), and those with abdominal pain-related functional (...) gastrointestinal disorder (AP-FGID) as the control group. We also examined the correlation between serum 25(OH)D and TBLH BMD z-score, and factors that affect each of these parameters. A total of 105 children were included and divided into 3 groups: AP-FGID (n = 45), CD (n = 43), and UC (n = 17). Among the 3 study groups, TBLH BMD z-scores were found to be significantly different (0.5 ± 0.8 in CD vs. 0.1 ± 0.8 in UC vs. -0.1 ± 1.1 in FGID; P = 0.037), despite similar levels of serum 25(OH)D. Within each study

2017 Journal of Korean medical science

15. American Society for Gastrointestinal Endoscopy guideline on the role of endoscopy in the management of acute colonic pseudo-obstruction and colonic volvulus

for Gastrointestinal Endoscopy 0016-5107/$36.00 https://doi.org/10.1016/j.gie.2019.09.007 228 GASTROINTESTINAL ENDOSCOPY Volume 91, No. 2 : 2020 www.giejournal.orgis ACPO, occurs as a result of alterations in GI motility and can be characterized by a clinical picture suggestive of mechanical obstruction with no demonstrable cause of obstruction noted on imaging. 4 Given that patients with both colon volvulus and ACPO may present with abdominal pain and distention, demo- graphic factors and abdominal cross (...) from functional causes of obstruction. 38 Water-soluble contrast enema of the rectum and distal colon is another diagnosticoption, although CT has largely replaced contrast enema studies. It is worth noting that mechanical obstruc- tion rarely occurs in a patient admitted for unrelated ill- nesses (eg, pneumonia, elective non-GI surgery). Conservative therapy In patients with uncomplicated ACPO (absence of ischemia, peritonitis, cecal diameter>12 cm, and/or signif- icant abdominal pain

2020 American Society for Gastrointestinal Endoscopy

16. Aneurysmal dilation of bowel mimicking an abscess in pediatric primary gastrointestinal lymphoma Full Text available with Trip Pro

Aneurysmal dilation of bowel mimicking an abscess in pediatric primary gastrointestinal lymphoma Primary gastrointestinal lymphoma, though rare, is the most common gastrointestinal malignancy in children. Signs and symptoms are nonspecific, and include abdominal pain, nausea, emesis, and a palpable abdominal mass. Imaging is therefore typically required to differentiate gastrointestinal lymphoma from other abdominal conditions. We present a pediatric case of primary gastrointestinal lymphoma (...) involving the distal bowel that was initially misdiagnosed as an intra-abdominal abscess. This case highlights the imaging findings of primary gastrointestinal lymphoma, potential pitfalls in imaging diagnosis, and the role of accurate imaging diagnosis in expediting patient management to reduce associated morbidity and mortality.

2018 Radiology Case Reports

17. The Role of Distress and Pain Catastrophizing on the Health-related Quality of Life of Children With Inflammatory Bowel Disease. (Abstract)

The Role of Distress and Pain Catastrophizing on the Health-related Quality of Life of Children With Inflammatory Bowel Disease. Inflammatory bowel disease (IBD) can be particularly challenging during the pediatric age with a relevant impact on patient's health-related quality of life (HRQoL). Disease activity accounts for only a small part of the variability in HRQoL, and psychological factors can play a significant role. We aimed to evaluate the impact of patient's distress and pain (...) catastrophizing on children and adolescents with IBD.We prospectively recruited children aged 8 to 18 with IBD and recorded demographic and disease characteristics. Patients answered questionnaires on HRQoL (IMPACT III), distress (distress thermometer [DT]), and pain catastrophizing (Pain Catastrophizing Scale-Children [PCS-C]). Univariate and multivariate regression models analysis were used to evaluate correlations between patients' characteristics, disease activity, distress, pain catastrophizing

2019 Journal of Pediatric Gastroenterology and Nutrition

18. Patient Health Communication Mediating Effects Between Gastrointestinal Symptoms and Gastrointestinal Worry in Pediatric Inflammatory Bowel Disease. Full Text available with Trip Pro

Gastrointestinal Symptoms, Gastrointestinal Worry, and Communication Scales, and Pediatric Quality of Life Inventory 4.0 Generic Core Scales were completed in a 9-site study by 252 pediatric patients with IBD. Gastrointestinal Symptoms Scales measuring stomach pain, constipation, or diarrhea and patient communication were tested for bivariate and multivariate linear associations with Gastrointestinal Worry Scales specific to patient worry about stomach pain or bowel movements. Mediational analyses were (...) , gastrointestinal symptoms (stomach pain, constipation, or diarrhea), and patient communication significantly accounted for 46, 43, and 54 percent of the variance in gastrointestinal worry (all Ps < 0.001), respectively, reflecting large effect sizes.Patient health communication explains in part the effects of gastrointestinal symptoms on gastrointestinal worry in pediatric patients with IBD. Supporting patient disease-specific communication to their health care providers and significant others may improve

2017 Inflammatory Bowel Diseases

19. Hepatic Issues and Complications Associated With Inflammatory Bowel Disease: A Clinical Report From the NASPGHAN Inflammatory Bowel Disease and Hepatology Committees

. Razumilava N, Gores GJ, Lindor KD. Cancer surveillance in patients with primary sclerosing cholangitis. Hepatology 2011;54: 1842–52. 41. Mieli-Vergani G, Vergani D. Paediatric autoimmune liver disease. Arch Dis Child 2013;98:1012–7. 42. Hyams JS. Extraintestinal manifestations of in?ammatory bowel dis- ease in children. J Pediatr Gastroenterol Nutr 1994;19:7–21. 43. Jose FA, Garnett EA, Vittinghoff E, et al. Development of extrain- testinal manifestations in pediatric patients with in?ammatory bowel (...) (39). Because of higher risk of colorectal carcinoma in PSC, adult recommendations are for these patients to undergo surveil- lance colonoscopy every 1 to 2 years (40). Although similar recommendations do not exist for pediatric patients with PSC, most pediatric IBD clinicians will follow this surveillance protocol. Similarly from a hepatic standpoint, adult patients typically undergo annual MRCP imaging, CA 19–9, and AFP levels that are not routinely performed on children due to the low risk

2017 North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition

20. PredictSure-IBD for inflammatory bowel disease prognosis

in a stepped approach. This depends on the efficacy of the treatment, tolerability of the side effects and the severity of the disease. Severe, active Crohn's disease is defined as very poor general health and 1 or more of: weight loss, fever, severe pain in the abdomen, frequent bouts (3 or more per day) of diarrhoea. If this does not respond to steroids and immunosuppressive drugs, the biological TNF inhibitors infliximab or adalimumab can be offered. Surgery can also be considered. Infliximab (...) is an option for adults, children and young people aged 6 and over, but adalimumab is an option for adults only. Both drugs can be used with an immunosuppressive drug. NICE guidance also recommends vedolizumab after TNF inhibitors have not responded. Severe ulcerative colitis is defined as 6 or more bowel movements a day with visible blood, high temperature and heart rate and anaemia. It is treated first with intravenous corticosteroids or intravenous ciclosporin for people who cannot tolerate, or decline

2019 National Institute for Health and Clinical Excellence - Advice

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