儿童反复出现的腹痛 - 评估和管理
1Division of Pediatric Gastroenterology and Hepatology, Department of Pediatrics, Christian Medical College, Vellore, Tamil Nadu, India. jayendra.seetharaman@gmail.com.
Indian journal of pediatrics
|March 28, 2025
概括
复发性腹痛 (RAP) 通常源于功能障碍,但必须排除IBD和感染等有机原因. 诊断包括病史,检查和有针对性的调查,以指导儿童和成人适当的治疗.
科学领域:
- 儿科胃肠病学 儿科胃肠病学
- 内部医学 内部医学
- 临床诊断 临床诊断 临床诊断
背景情况:
- 复发性腹痛 (RAP) 影响了许多儿童和成人,功能性腹痛障碍 (FAPD) 占病例的95%.
- 主要的有机原因包括胃病,炎症性肠病 (IBD) 和感染,需要仔细的差异诊断.
研究的目的:
- 概述复发性腹痛的诊断方法,区分功能性和有机性病因.
- 突出关键的调查和管理策略,针对RAP的各种原因.
主要方法:
- 综合性病史,重点关注疼痛特征,相关症状和压力因素.
- 身体检查以确定暗示有机疾病的警报症状.
- 使用实验室测试 (CBC,便/尿液检查,炎症标志物),便calprotectin (FCP),超声波腹部 (USG) 和内镜进行诊断.
主要成果:
- 便calprotectin (FCP) 有效地区分了炎症性肠病 (IBD) 和易怒肠综合征 (IBS).
- 腹部超声波 (USG) 有助于检测胆结石,胰腺炎和肠道异常.
- 内镜对于诊断诸如胃潰瘍,IBD和腹结核病等疾病至关重要.
结论:
- 准确诊断RAP需要一个系统的方法,区分功能和有机原因.
- 对有机病因来说,具体的管理至关重要,而FAPD则从咨询和向治疗中获益.
- 耐药病例可能需要诸如认知行为疗法或催眠疗法之类的干预措施.
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