Relation between clinical symptoms and experimental visceral hypersensitivity in pediatric patients with functional abdominal pain
Relation between clinical symptoms and experimental visceral hypersensitivity in pediatric patients with functional abdominal pain
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DOI：
10.1097/mpg.0b013e3181653a6f
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发表时间：
2008-09-01
影响因子：
2.9
通讯作者：
Walker, Lynn S.
中科院分区：
文献类型：
--
作者：
Anderson, Julia L.;Acra, Sari;Walker, Lynn S.
目的：临床症状和实验室内脏敏感性之间的关系仍然定义不清，存在争议。甚至有人认为，内脏敏感性的实验室观察结果与慢性内脏痛的临床表现无关。为了更好地理解这种关联，我们检查了儿科患者临床表现的胃肠道和心理特征与内脏敏感性的实验室测量的关系。在进行医学评估时，101名医学上无法解释的腹痛患者（年龄8-15岁）完成有效问卷，评估近期抑郁症状、功能障碍、疼痛疗效信念、胃肠道（GI），和非胃肠道症状2个月后在实验室中检查这些临床特征与内脏敏感性的关系。内脏敏感性的测量是基于增加胃肠道投诉在响应水负荷症状激发task.Results：更严重的胃肠道症状和功能障碍，在患者的临床评估前几周与胃肠道症状在实验室显着增加，在响应水负荷症状激发任务（所有P < 0.04）。认为自己有能力减轻疼痛的患者（高问题聚焦疼痛效能）的实验室内脏敏感性显著降低（P < 0.01）。临床抑郁症状和非胃肠道症状与实验室内脏sensitivity.Conclusions：临床表现更严重的胃肠道症状和残疾，以及低感知疼痛疗效是显着的预测功能性腹痛儿童实验室内脏敏感性。抑郁不能解释胃肠道症状的临床表现和内脏敏感性的实验室测量之间的关联。
Objective: The association between clinical symptoms and laboratory visceral sensitivity remains poorly defined and controversial. It has even been suggested that laboratory observations of visceral sensitivity are irrelevant to the clinical presentation of chronic visceral pain. To better understand this association, gastrointestinal and psychological features of pediatric patients' clinical presentation were examined in relation to a laboratory-based measure of visceral sensitivity.Patients and Methods: At the time of their medical evaluation, 101 patients with medically unexplained abdominal pain (ages 8-15 years) completed validated questionnaires assessing recent depressive symptoms, functional disability, pain efficacy beliefs, gastrointestinal (GI), and non-GI symptoms. These clinical features were examined in relation to visceral sensitivity assessed 2 months later in the laboratory. The measure of visceral sensitivity was based on increases in GI complaints in response to the water load symptom provocation task.Results: More severe GI symptoms and functional disability in the weeks before patients' clinical evaluation were associated with significantly greater increases in GI symptoms in the laboratory in response to the water load symptom provocation task (all P < 0.04). Patients believing that they had the ability to alleviate their pain (high problem-focused pain efficacy) had significantly lower laboratory visceral sensitivity (P < 0.01). Clinical depressive symptoms and non-GI symptoms were not associated with laboratory visceral sensitivity.Conclusions: Clinical presentations of more severe GI symptoms and disability as well as low perceived pain efficacy are significant predictors of laboratory visceral sensitivity in children with functional abdominal pain. Depression does not account for the association between clinical presentation of GI symptoms and a laboratory measure of visceral sensitivity.