Clinical and Experimental Pediatrics

The Korean Pediatric Society (대한소아청소년과학회)
권호 표지

Characteristics of functional gastrointestinal disorders in children with chronic abdominal pain

소아의 만성 복통에서 기능성 위장관 질환의 양상

  • Uhm, Ji Hyun (Department of Pediatrics, College of Medicine, Eulji University)
  • 엄지현 (을지의과대학교 노원을지병원 소아과)
  • Received : 2007.04.03
  • Accepted : 2007.06.28
  • Published : 2007.07.15
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose : The aim of this study was to document the causes of chronic abdominal pain in children referred to a hospital setting and evaluate the frequency and characteristics of functional gastrointestinal disorder (FGID) classified by Rome III criteria. Methods : One hundred thirty two patients with chronic abdominal pain were evaluated. Examinations were performed in order to find organic causes in patients when organic disease was suspected. Results : Among the 132 patients, 20 patients (15.2%) had organic diseases and 112 patients (84.8%) were diagnosed as having FGIDs. Functional dyspepsia was the most common cause of FGIDs, followed by irritable bowel syndrome. Overlap of some FGIDs was observed in seven patients (5.3%). Conclusion : FGIDs are the main causes of chronic abdominal pain in children and functional dyspepsia was the most prevalent disorder.

목 적 : 만성 복통으로 병원에 내원한 환아들에서 그 원인을 밝히고 Rome III 기준에 의해 진단된 기능성 위장관 질환의 종류 및 양상을 알아보고자 하였다. 방 법 : 2004년 3월부터 2007년 2월까지 노원 을지병원 소아과에 만성 복통을 주소로 내원한 132명을 대상으로 하였다. 결 과 : 대상 환자 중 기질적 질환으로 진단된 경우가 20명(15.2%), 기능성 위장관 질환이었던 경우는 112명(84.8%)이었다. 기능성 위장관 질환은 기질적 질환에 비해 통계적으로 유의하지 않았으나 여자에서 더 흔하게 나타났다. 기능성 위장관 질환 중에는 기능성 소화불량증(32.6%)과 과민성 장증후군(27.3%)이 가장 많았으며 2가지 종류 이상의 기능성 위장관 질환으로 진단된 환아는 7명(5.3%) 이었다. 배꼽 주위 통증, 최근의 스트레스, 기능성 위장관 질환의 가족력, 아침 시간의 통증 등은 기능성 위장관 질환을 갖고 있는 환아 들에서 더 많이 호소하였고 야간 통증, 구토, 두통은 기질적 질환을 갖고 있는 환아 들에서 더 많이 호소하였으나 모두 통계적으로 유의한 차이는 없었다. 결 론 : 소아의 만성 복통의 대부분의 원인은 기능성 위장관 질환이며 특히 기능성 소화 불량증과 과민성 장증후군이 가장 많았다. 불필요한 검사를 하지 않고 효과적인 진단과 치료를 위해 신뢰성 있는 진단 기준을 사용하는 것이 필요하다.

Keywords

References

  1. Taminiau J, Benninga M. Pediatric clinical research will benefit from Rome III. J Pediatr Gastroenterol Nutr 2005;41 Suppl 1:30-1 https://doi.org/10.1097/01.scs.0000180295.12354.f7
  2. Hyams JS, Burke G, Davis PM, Rzepski B, Andrulonis PA. Abdominal pain and irritable bowel syndrome in adolescents: a community-based study. J Pediatr 1996;129:220-6 https://doi.org/10.1016/S0022-3476(96)70246-9
  3. Rasquin-Weber A, Hyman PE, Cucchiara S, Fleisher DR, Hyams JS, Milla PJ, et al. Childhood functional gastrointestinal disorders. Gut 1999;45 Suppl 2:60-8
  4. Rasquin A, Di Lorenzo C, Forbes D, Guiraldes E, Hyams JS, Staiano A, et al. Childhood functional gastrointestinal disorders: child/adolescent. Gastroenterology 2006;130:1527-37 https://doi.org/10.1053/j.gastro.2005.08.063
  5. Chung KS. Diagnosis and treatment of chronic recurrent abdominal pain in children. J Korean Pediatr Soc 1996;39:1351-7
  6. Apley J, Naish N. Recurrent abdominal pains: a field survey of 1,000 school children. Arch Dis Child 1958;33:165-70 https://doi.org/10.1136/adc.33.168.165
  7. Faull C, Nicol AR. Abdominal pain in six-year-olds: an epidemiological study in a new town. J Child Psychol Psychiatry 1986;27:251-60 https://doi.org/10.1111/j.1469-7610.1986.tb02287.x
  8. Oster J. Recurrent abdominal pain, headache and limb pains in children and adolescents. Pediatrics 1972;50:429-36
  9. Zuckerman B, Stevenson J, Bailey V. Stomachaches and headaches in a community sample of preschool children. Pediatrics 1987;79:677-82
  10. Hyams JS. Irritable bowel syndrome, functional dyspepsia, and functional abdominal pain syndrome. Adolesc Med Clin 2004;15:1-15 https://doi.org/10.1016/j.admecli.2003.11.003
  11. Boey CC, Goh KL. Recurrent abdominal pain and consulting behaviour among children in a rural community in Malaysia. Dig Liver Dis 2001;33:140-4 https://doi.org/10.1016/S1590-8658(01)80069-4
  12. Walker LS, Lipani TA, Greene JW, Caines K, Stutts J, Polk DB, et al. Recurrent abdominal pain: symptom subtypes based on the Rome II criteria for pediatric functional gastrointestinal disorders. J Pediatr Gastroenterol Nutr 2004;38:187-91 https://doi.org/10.1097/00005176-200402000-00016
  13. Caplan A, Walker L, Rasquin A. Validation of the pediatric Rome II criteria for functional gastrointestinal disorders using the questionnaire on pediatric gastrointestinal symptoms. J Pediatr Gastroenterol Nutr 2005;41:305-16 https://doi.org/10.1097/01.mpg.0000172749.71726.13
  14. Schurman JV, Friesen CA, Danda CE, Andre L, Welchert E, Lavenbarg T, et al. Diagnosing functional abdominal pain with the Rome II criteria: parent, child, and clinician agreement. J Pediatr Gastroenterol Nutr 2005;41:291-5 https://doi.org/10.1097/01.mpg.0000178438.64675.c4
  15. Miele E, Simeone D, Marino A, Greco L, Auricchio R, Novek SJ, et al. Functional gastrointestinal disorders in children: an Italian prospective survey. Pediatrics 2004;114:73-8 https://doi.org/10.1542/peds.114.1.73
  16. Hyams JS, Davis P, Sylvester FA, Zeiter DK, Justinich CJ, Lerer T. Dyspepsia in children and adolescents: a prospective study. J Pediatr Gastroenterol Nutr 2000;30:413-8 https://doi.org/10.1097/00005176-200004000-00012
  17. Hyams JS, Treem WR, Justinich CJ, Davis P, Shoup M, Burke G. Characterization of symptoms in children with recurrent abdominal pain: resemblance to irritable bowel syndrome. J Pediatr Gastroenterol Nutr 1995;20:209-14 https://doi.org/10.1097/00005176-199502000-00012
  18. American Academy of Pediatrics Subcommittee on Chronic Abdominal Pain in Children: A Technical Report of the American Academy of Pediatrics and the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition. J Pediatr Gastroenterol Nutr 2005;40:249-61 https://doi.org/10.1097/01.MPG.0000154661.39488.AC
  19. Croffie JM, Fitzgerald JF, Chong SK. Recurrent abdominal pain in children-a retrospective study of outcome in a group referred to a pediatric gastroenterology practice. Clin Pediatr 2000;39:267-74 https://doi.org/10.1177/000992280003900502
  20. El-Matary W, Spray C, Sandhu B. Irritable bowel syndrome: the commonest cause of recurrent abdominal pain in children. Eur J Pediatr 2004;163:584-8
  21. Pellicano R, Savi L, De Martino P, Morgando A, Astegiano M, Pinessi L, et al. Helicobacter pylori and headache: a minireview. Minerva Med 2007;98:37-41
  22. Tunca A, Turkay C, Tekin O, Kargili A, Erbayrak M. Is Helicobacter pylori infection a risk factor for migraine? A case-control study. Acta Neurol Belg 2004;104:161-4
  23. Gasbarrini A, De Luca A, Fiore G, Franceschi F, Ojetti V V, Torre ES, et al. Primary Headache and Helicobacter Pylori. Int J Angiol 1998;7:310-2 https://doi.org/10.1007/s005479900121