• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제25권6호
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• pp.500-509
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• 2022

Purpose: We compared the health-related quality of life (HRQOL) of children and adolescents with functional abdominal pain disorders (FAPDs) and organic abdominal pain disorders (ORGDs). Methods: This was a single-center, cross-sectional, observational study. The PedsQL 4.0 generic cores scales parent proxy-report was administered to parents/caregivers of 130 and 56 pediatric patients with FAPDs and ORGDs respectively on their first visit. The self-reported pain intensity in the patients was assessed using a visual analog scale (VAS) and facial affective scale (FAS). Results: Irritable bowel syndrome was the most prevalent FAPDs, and the most prevalent ORGDs were reflux esophagitis (41.1%) and gastritis associated with Helicobacter pylori (21.4%). There was no difference in HRQOL among patients diagnosed with ORGDs and FAPDs (p>0.05). Patients with ORGDs and FAPDs had lower HRQOL Scale scores than healthy Brazilian and American children's references, with a high proportion of children at risk for impaired HRQOL (p<0.0001). There was no difference in the VAS and the FAS scores between the ORGDs and the FAPDs. FAPDs had a higher prevalence of girls' and couples' disagreement (p<0.02), although poor school performance (p<0.0007) and bullying (p<0.01) were higher in patients with ORGD. Conclusion: This study revealed that there was a difference in impaired HRQOL between patients with ORGDs and FAPDs. Thus, considering the high prevalence of chronic abdominal pain in children, a well-founded treatment plan is necessary for a multidisciplinary cognitive-behavioral Pain management program.

• 정신신체의학
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• 제26권1호
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• pp.1-8
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• 2018

연구목적 본 연구에서는 기능성 위장질환(Functional gastrointestinal disorder, 이하 FGID)이 동반된 정신질환자들의 정신사회적 특성을 알아보고자 하였다. 방 법 일 대학병원 정신건강의학과 외래를 방문한 환자를 대상으로 Rome III questionnaire - Korean version에 따라 FGID를 선별하여 144명의 자료를 분석하였다. 인구학적 요인을 조사하였으며, 정신사회적 요인을 평가하기 위해 Hospital Anxiety Depression Scale, Patient Health Questionnaire-15, Childhood Trauma Questionnaire-Korean, State-Trait Anger Expression Inventory를 사용하였다. 통계분석은 독립표본 t-검정(independent t-test)과 교차분석(chi-square test)을 사용하였다. 결 과 FGID에 따른 집단간 비교에서 학력에 따른 차이가 나타났다(${\chi}^2=10.139$, p=0.017). FGID 집단에 따른 정신질환의 차이에서는 과민성 대장증후군(Irritable bowel syndrome, 이하 IBS) 집단에서 유의한 차이가 있었다. (${\chi}^2=11.408$, p=0.022) IBS 집단은 불안(t=-3.106, p=0.002), 우울증상(t=-2.105, p=0.037), 신체증상(t=-3.565, p<0.001), 특성분노(t=-3.683, p<0.001), 분노-억제(t=-2.463, p=0.015), 분노-표출(t=-2.355, p=0.020)에서 높은 점수를 나타냈다. 기능성 소화불량(Functional dyspepsia) 집단에서는 불안(t=-4.893, p<0.001), 우울증상(t=-3.459, p<0.001), 신체증상(t=-7.906, p<0.001), 특성분노(t=-4.148, p<0.001), 상태분노(t=-2.181, p=0.031), 분노-억제(t=-2.684, p=0.008), 분노-표출(t=-3.005, p=0.003)지표가 유의하게 높았다. 비미란성 위식도 역류증(Nonerosive reflux disease) 집단에서는 불안(t=-4.286, p<0.001), 우울증상(t=-3.402, p<0.001), 신체증상(t=-7.162, p<0.001), 특성분노(t=-2.994, p=0.003), 상태분노(t=-2.259, p=0.025), 분노-억제(t=-2.772, p=0.006), 분노-표출(t=-2.958, p=0.004)에서 유의미하게 높은 수준을 나타냈다. 결 론 본 연구에서는 정신질환자에서 FGID의 유병률이 매우 높고, 다양한 정신사회적 변인들이 이에 영향을 미치는 것으로 나타났다. 따라서 이러한 정신의학적 접근은 FGID 환자를 더 잘 이해하고 치료하는데 있어서 도움이 될 것으로 생각된다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제18권4호
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• pp.224-229
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• 2015

Cyclic vomiting syndrome (CVS) is a functional disorder characterized by stereotypical episodes of intense vomiting separated by weeks to months. Although it can occur at any age, the most common age at presentation is 3-7 years. There is no gender predominance. The precise pathophysiology of CVS is not known but a strong association with migraine headaches, in the patient as well as the mother indicates that it may represent a mitochondriopathy. Studies have also suggested the role of an underlying autonomic neuropathy involving the sympathetic nervous system in its pathogenesis. CVS has known triggers in many individuals and avoiding these triggers can help prevent the onset of the episodes. It typically presents in four phases: a prodrome, vomiting phase, recovery phase and an asymptomatic phase until the next episode. Complications such as dehydration and hematemesis from Mallory Wise tear of the esophageal mucosa may occur in more severe cases. Blood and urine tests and abdominal imaging may be indicated depending upon the severity of symptoms. Brain magnetic resonance imaging and upper gastrointestinal endoscopy may also be indicated in certain circumstances. Management of an episode after it has started ('abortive treatment') includes keeping the patient in a dark and quiet room, intravenous hydration, ondansetron, sumatriptan, clonidine, and benzodiazepines. Prophylactic treatment includes cyproheptadine, propranolol and amitriptyline. No mortality has been reported as a direct result of CVS and many children outgrow it over time. A subset may develop other functional disorders like irritable bowel syndrome and migraine headaches.

• Clinical and Experimental Pediatrics
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• 제63권12호
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• pp.485-490
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• 2020

Background: Recurrent abdominal pain (RAP) is one of the frequent complaints in general practice, particularly in pediatrics and is among the common cause of referral to gastroenterology clinics. Purpose: This study is designed to investigate the effects of probiotics for the treatment of RAP and desired therapeutic outcomes. Methods: One hundred twenty-five children with the diagnosis of RAP according to Rome III criteria for irritable bowel syndrome (IBS), functional abdominal pain (FAP), functional dyspepsia (FD), and abdominal migraine (AM), were enrolled in this double-blind randomized controlled trial. Results: Sixty-five subjects received probiotics, and others received placebo treatment for 4 weeks. Lactobacillus reuteri was therapeutically effective in 32 patients compared to 8 patients, responding to the placebo treatment. Compared to baseline, all pain-related variables showed a significant reduction for the IBS and FD at the end of the 4th week. However, it did not respond well in FAP and AM groups. Pain-related outcomes such as, frequency of the pain, severity, and duration of the pain were decreased following the probiotic treatment. No therapeutic response was seen in AM group after the administration of probiotics. L. reuteri significantly led to pain relief in the overall population, and also in FAP, FD, and IBS subgroups. Conclusion: L. reuteri probiotics are likely to lead to RAP relief and can be recommended for the treatment of functional gastrointestinal disorders.

• 대한본초학회지
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• 제31권5호
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• pp.25-39
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• 2016

Objectives : Atractylodes rhizomes, which have been widely used to treat gastrointestinal disorders, consist of numerous chemical compounds. Polyacetylenes are the parts of characteristic compounds of importance required to understand the therapeutic properties of Atractylodes rhizomes. It is necessary to understand the physicochemical and pharmacological properties of polyacetylenes in the Atractylodes rhizomes.Methods : The literatures from 1970 to January 2016 were searched using Korean and international electronic databases. The chemical structures of polyacetylenes were drawn by structure-drawing software.Results : The reported polyacetylenes were classified by their chemical skeletons and original resources, and their physicochemical and pharmacological features were discussed. Polyacetylenes with skeletal moieties were reported, such as diene-diyne types (two double and two triple carbon-bonds), triene-diyne types (three double carbon bonds and two triple carbon bonds), and monoene-diyne types (one double carbon bonds and two double carbon bonds), with various functional groups. Atractylodin was most frequently reported from many Atractylodes species. Atractylodin-related polyacetylenes showed chemical instability in both high and freezing temperatures. Processing of the Atractylodes rhizomes by stir-frying with bran could affect the contents of polyacetylenes and their bioavailability in vivo. Several polyacetylenes showed structure-related anti-inflammatory activities and gastrointestinal activities.Conclusion : Polyacetylene compounds in Atractylodes rhizomes were based on three chemical backbones and showed diverse physicochemical and pharmacological features. The present study provides structural, physicochemical, and pharmacological information of polyacetylene from Atractylodes rhizomes. This information provides fundamental data for further research.

• 정신신체의학
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• 제6권1호
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• pp.3-12
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• 1998

Objective : The sensation of dysphagia, heartburn, globus hystericus, and functional dyspepsia are common symptoms of the functional upper gut disorders. This study was designed to investigate quantity of perceived stress, depression, and anxiety in the patients with functional upper gut symptoms whose esopahgeal manometry(EM) and gatroesophageal reflux (GERT) test were normal. Methods : A total of 38 patients who complained of the symptoms had been tested with 24-hour ambulatory EM and conventional GERT in our gastrointestinal clinic. Thirty patients whose tests had been normal(patients group) were assessed with Symptom Checklist-90-Revision(SCL-90-R), Beck Depression Inventory(BDI), and Spielberger Stait-Trait Anxiety Inventory(STAI) and compared with 30 patients(control group) without functional upper gut symtpoms in the hepatobiliary clinic. The two groups were also assessed by quantity of perceived stress during the last year through self-report. Results: 1) These patients tended to be predominently female, older, and possessed a lower education than control group. 79% of 38 patients who had been tested were normal. 2) Compared to the control group, the patients had significantly higher mean scores on four subscales(somatization, depression, anxiety, and positive symptom distress index). 3) The patient group had significantly more perceived stress than the control group. 4) The patients group had significantly higher levels of depression than the control gorup, but there was not any significant difference in the STAI. 5) There were significant positive correlations between the BDI score and the STAI-trait, the STAI-stait and the STAI-trait, the quantity of perceived stress and the STAI-trait. Conlusion : The patients with functional upper gut symptoms displayed more, psychological distress, sornatization, anxiety, and deperssion. Among them, patients had higer depression than control group. Functional upper gut symtoms could be more appropriately viewed as somatic symptoms of depression. These findings suggest that such patients need to have psychiatric intervention and treatment.

• 대한한의학회지
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• 제32권6호
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• pp.54-66
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• 2011

Objectives: The purpose of the present study was to investigate the antidiarrheal effects of Anjang-san in mice and rats. Methods: We measured the content of condensed tannin in Anjang-san extract, and observed the effects of Anjang-san on the small intestinal and colonic transport of mice, as well as on mice models of diarrhea induced by castor oil and $MgSO_4$, and on rat models of castor oil-induced enteropooling. Results: Anjang-san showed significant inhibitory effects on abnormally increased small intestinal transit induced by pyridostigmine and neostigmine, and inhibitory effects on large intestinal transit. Anjang-san also exhibited antidiarrheal effects on diarrhea induced by $MgSO_4$, and inhibitory effects on castor oil-induced enteropooling. Anjang-san also improved castor oil-induced diarrhea based on simple numbers without statistical significance. Conclusion: These results demonstrate that Anjang-san has significant antidiarrheal properties and attests to its possible utility in functional diarrheas, irritable bowel syndrome and other gastrointestinal disorders based upon further studies.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제19권4호
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• pp.291-292
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• 2016

• Perspectives in Nursing Science
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• 제2권1호
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• pp.1-18
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• 2005

Health care providers working with IBS patients are challenged in that the underlying pathophysiology remains poorly defined and treatments are not universally effective (American College of Gastroenterology Functional Gastrointestinal Disorders Task Force, 2002). Nurses often work with patients to identify factors provoking or alleviating symptoms and based on these observations hone strategies to manage symptoms. Understanding stress induced alterations in sleep and ANS function may provide important clues as to additional self-management strategies to test.

• 대한한의학회지
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• 제31권3호
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• pp.28-33
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• 2010

Objective: To investigate the situation of health-related main factors of Korean middle school adolescents. Methods: Data were collected via a self-reporting questionnaire from 2,254 students (650 boys and 1,604 girls), and their sleeping, exercise, dietary pattern, stress, physical problems, and taking of food supplements were analyzed. Results: Korean middle school students sleep about 7 hours per day, and they exercise less than 4 hours per week. Around 13% of the students skip breakfast nearly every day. 35% of the students were under severe stress, and 38% have reported at least one symptom of physical distresses including gastrointestinal disorders or headaches. 31% of the students took a functional supplement, especially one with vitamins as the most favored one, and ginseng and herbal drugs coming second and third. Conclusion: This result first reports a general feature of health-associated factors in middle school students. This study in the future will be basic information to develop medical supports for adolescents using traditional Korean medicine.