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Gastroenterology Oct 2023
Topics: Humans; Pancreatic Cyst; Pancreatic Pseudocyst; Abdominal Pain; Pancreatic Neoplasms
PubMed: 36906045
DOI: 10.1053/j.gastro.2023.03.003 -
The Journal of Emergency Medicine Apr 2024
Topics: Female; Humans; Abdominal Pain; Foreign Bodies
PubMed: 38485573
DOI: 10.1016/j.jemermed.2023.11.019 -
Magnetic Resonance Imaging Clinics of... Aug 2022Evaluation of a pregnant patient presenting with acute abdominal pain can be challenging to accurately diagnose for a variety of reasons, and particularly late in... (Review)
Review
Evaluation of a pregnant patient presenting with acute abdominal pain can be challenging to accurately diagnose for a variety of reasons, and particularly late in pregnancy. Noncontrast MR remains a safe and accurate diagnostic imaging modality for the pregnant patient presenting with acute abdominal pain, following often an initially inconclusive ultrasound examination, and can be used in most settings to avoid the ionizing radiation exposure of a computed tomography scan. Pathologic processes discussed in this article include some of the more common gastrointestinal, hepatobiliary, genitourinary, and gynecologic causes of abdominal pain occurring in pregnancy, as well as traumatic injuries.
Topics: Abdomen, Acute; Abdominal Pain; Female; Humans; Magnetic Resonance Imaging; Pregnancy; Pregnancy Complications; Ultrasonography
PubMed: 35995477
DOI: 10.1016/j.mric.2022.04.010 -
European Journal of Pediatrics Jul 2022Disorders of the gut-brain interaction negatively impact quality of life and carry a substantial socioeconomic burden. Irritable bowel syndrome (IBS) and functional... (Review)
Review
UNLABELLED
Disorders of the gut-brain interaction negatively impact quality of life and carry a substantial socioeconomic burden. Irritable bowel syndrome (IBS) and functional abdominal pain-not otherwise specified (FAP-NOS) are common functional abdominal pain disorders in childhood. The pathophysiology is not fully understood, and high-quality intervention trials and international guidelines are missing. Therefore, the management of these disorders remains challenging. This review aims to provide an up-to-date overview of therapeutic possibilities for pediatric IBS or FAP-NOS and recommends management strategies. To prevent unnecessary referrals and extensive costs, it is fundamental to make a positive diagnosis of IBS or FAP-NOS in children with chronic abdominal pain with only minimal investigations. A tailor-made approach for each patient, based on the accompanying physical and psychological symptoms, is proposed to date.
CONCLUSION
Shared decision-making including non-pharmacological and pharmacological interventions should be considered and discussed with the family.
WHAT IS KNOWN
• Irritable bowel syndrome and functional abdominal pain-not otherwise specified are common in childhood. • Although the number of treatment options has grown recently, managing these disorders can be challenging and unsatisfactory, and no evidence-based international management guidelines are available.
WHAT IS NEW
• We suggest using a stepwise individualized approach to management, where after first-line management, both non-pharmacological and pharmacological interventions should be discussed.
Topics: Abdominal Pain; Child; Humans; Irritable Bowel Syndrome; Quality of Life
PubMed: 35460383
DOI: 10.1007/s00431-022-04459-y -
Annals of Emergency Medicine Dec 2023
Topics: Male; Humans; Abdominal Pain; Chronic Pain; Recurrence
PubMed: 37993233
DOI: 10.1016/j.annemergmed.2023.06.018 -
Current Opinion in Pediatrics Oct 2022The purpose of this review is to discuss up-to-date psychological treatment strategies for functional abdominal pain disorders (FAPDs) with practical implications for... (Review)
Review
PURPOSE OF REVIEW
The purpose of this review is to discuss up-to-date psychological treatment strategies for functional abdominal pain disorders (FAPDs) with practical implications for primary care providers who are the "front line" of treatment for pediatric FAPD.
RECENT FINDINGS
Positive diagnosis, pain education, and access to multidisciplinary care improve outcomes for FAPD patients. Cognitive behavioral therapy (CBT) and hypnosis continue to have the strongest evidence in psychological treatments, but educational interventions and other nonpharmacological approaches show promise as well. There are innovative programs that combine these tools into group or internet-based treatments to expand access to care. Additionally, nonpharmacological tools, including neurostimulation and virtual reality programs, are increasing in popularity.
SUMMARY
FAPD is prevalent across pediatric practices, yet there is no standard medical or dietary approach, and there are many barriers to diagnosis and treatment. It is important for patients to have positive encounters around diagnosis and education, access to multidisciplinary care, and integrated psychological support. Consistently, studies show that psychology continues to be a vital component of care. This review discusses supported uses of psychology, innovative programming for increasing access to care, and how primary care providers can incorporate lessons learned from psychology in FAPD care.
VIDEO ABSTRACT
http://links.lww.com/MOP/A67 .
Topics: Abdominal Pain; Child; Cognitive Behavioral Therapy; Humans
PubMed: 35993286
DOI: 10.1097/MOP.0000000000001161 -
Pain Management Jan 2021Abdominal pain continues to be a major challenge and unmet need in clinical practice. Normalization of bidirectional gut-brain signaling has generated much interest as a... (Review)
Review
Abdominal pain continues to be a major challenge and unmet need in clinical practice. Normalization of bidirectional gut-brain signaling has generated much interest as a therapeutic approach to treat chronic abdominal pain. Vagal nerve stimulation (VNS) is emerging as a potential non-pharmacologic strategy for the treatment of abdominal pain. In this review paper, we will summarize the etiologies of chronic pain in gastrointestinal disorders and discuss the rational for VNS as a therapeutic approach to chronic abdominal pain, with particular emphasis in the gammaCore stimulator which allows for noninvasive VNS.
Topics: Abdominal Pain; Central Nervous System Sensitization; Chronic Pain; Gastrointestinal Diseases; Humans; Vagus Nerve Stimulation
PubMed: 33111642
DOI: 10.2217/pmt-2020-0067 -
Journal of Clinical GastroenterologyFunctional abdominal cramping pain (FACP) is a common complaint, which may present either on its own or in association with a functional gastrointestinal disorder. It is...
Functional abdominal cramping pain (FACP) is a common complaint, which may present either on its own or in association with a functional gastrointestinal disorder. It is likely caused by a variety of, probably partly unknown, etiologies. Effective management of FACP can be challenging owing to the lack of usable diagnostic tools and the availability of a diverse range of treatment approaches. Practical guidance for their selection and use is limited. The objective of this article is to present a working definition of FACP based on expert consensus, and to propose practical strategies for the diagnosis and management of this condition for physicians, pharmacists, and patients. A panel of experts on functional gastrointestinal disorders was convened to participate in workshop activities aimed at defining FACP and agreeing upon a recommended sequence of diagnostic criteria and management recommendations. The key principles forming the foundation of the definition of FACP and suggested management algorithms include the primacy of cramping pain as the distinguishing symptom; the importance of recognizing and acting upon alarm signals of potential structural disease; the recognition of known causes that might be addressed through lifestyle adjustment; and the central role of antispasmodics in the treatment of FACP. The proposed algorithm is intended to assist physicians in reaching a meaningful diagnostic endpoint based on patient-reported symptoms of FACP. We also discuss how this algorithm may be adapted for use by pharmacists and patients.
Topics: Abdominal Pain; Consensus; Gastrointestinal Diseases; Humans; Parasympatholytics
PubMed: 36149666
DOI: 10.1097/MCG.0000000000001764 -
Clinical and Translational... Nov 2023The aim of this study was to explore the clinical characteristics and related factors of centrally mediated abdominal pain syndrome (CAPS).
INTRODUCTION
The aim of this study was to explore the clinical characteristics and related factors of centrally mediated abdominal pain syndrome (CAPS).
METHODS
Our study included 73 patients with CAPS and 132 age-matched and gender-matched healthy controls. The general information of the participants was collected, and the questionnaires were completed including the 7-item Generalized Anxiety Disorder Scale, 9-item Patient Health Questionnaire, Hamilton Anxiety Scale, Hamilton Depression Scale Pittsburgh Sleep Quality Index, Visual Analog Scale, and Short-Form 36. Univariate and forward stepwise regression analyses were performed to explore the influencing factors of CAPS.
RESULTS
Nonexercise (adjusted odds ration [AOR] 4.53; confidence interval [CI] 1.602-12.809), mild-to-moderate depression (AOR 7.931; CI 3.236-19.438), married status (AOR 3.656; CI 1.317-10.418), and drinking coffee (AOR 0.199; CI 0.051-0.775) were found to be related with centrally mediated abdominal syndrome. The Hamilton Anxiety Scale score (7-13) was significantly related to moderate-to-severe abdominal pain (AOR 7.043; CI 1.319-37.593). Higher Hamilton Depression Scale score was related to lower mental component scale score (β = -0.726, P < 0.01) and physical component scale score (β = -0.706, P < 0.01).
DISCUSSION
Depression, married status, and nonexercise were the independent risk factors of CAPS. Conversely, coffee intake was an independent protective factor of CAPS. Anxiety was related to the severity of abdominal pain, while depression was related to low health-related quality of life.
Topics: Humans; Quality of Life; Depression; Coffee; Anxiety; Abdominal Pain
PubMed: 37467381
DOI: 10.14309/ctg.0000000000000624 -
Endocrinologia, Diabetes Y Nutricion Jan 2024Irritable bowel syndrome (IBS) is a gastrointestinal functional disorder mainly characterised by abdominal pain, bloating and altered bowel habits. Dysbiosis might seem... (Review)
Review
Irritable bowel syndrome (IBS) is a gastrointestinal functional disorder mainly characterised by abdominal pain, bloating and altered bowel habits. Dysbiosis might seem to be involved in the pathogenesis of the disease. Probiotics represent a potential treatment, since these could favour the functional microbiota and improve symptoms. The aim was to review the effectiveness of the use of probiotics in IBS symptomatology, analysing the influence of duration and dose. 18 articles were included. At the individual level, Lactobacillus, Bifidobacterium and Bacillus could be useful in the treatment of symptoms. Bifidobacterium bifidum reported the best results (1 × 10 CFU/day for 4 weeks). The most effective combination was 2 Lactobacillus strains, one of Bifidobacterium and one of Streptococcus (4 × 10 CFU/day for 4 weeks). Future clinical trials should confirm these results and analyse the difference between individual and combined treatments.
Topics: Humans; Irritable Bowel Syndrome; Probiotics; Lactobacillus; Bifidobacterium; Abdominal Pain
PubMed: 38331656
DOI: 10.1016/j.endien.2024.01.003