Recurrent Abdominal Pain in Children

描述：（由申请人提供）10%至17%的儿童之间的 4岁和16岁符合复发性腹痛（RAP）的标准a 占所有儿科门诊就诊人数的至少5% 并且经常导致严重的残疾（例如，缺课）。从30-60 %的RAP儿童会继续经历与成年人相似的疼痛 导致RAP和肠易激综合征（IBS）可能是 在不同的发育阶段出现相同的症状。与IBS相似，20-68 报告腹痛的儿童中， 排便模式（便秘和/或腹泻）。尽管RAP的原因（如 以及IBS）是未知的，导致症状的因素， 包括寻求医疗保健，可能包括生理和 心理社会学生理异常、心理异常、 RAP中的化妆和父母的反应/行为在很大程度上未被探索 （未定义）。为了研究这些因素的贡献及其 潜在的相互作用，我们建议比较三组儿童： 被转诊到三级医疗机构的RAP患者（RAP-GI）;患有RAP但 不要寻求儿科医生以外的医疗照顾（RAP-Ped）; 没有RAP症状的患者（对照组）。我们的具体目标是描述和 比较这些儿童（7-10岁）：1）胃肠道症状（腹痛和 肠型）和功能性残疾（疼痛干扰活动， 缺课）使用回顾性和前瞻性症状措施; 2） 自主神经系统功能（心脏的光谱和非光谱分析 心率变异性和尿儿茶酚胺）; 3）儿童和父母的疼痛应对 技能，父母的建模和疾病行为的强化;以及4） 心理困扰（焦虑、抑郁和躯体化）。孩子会 从休斯顿的儿科诊所招募这一拟议 跨学科研究将是第一个在儿童同时检查 RAP相关的生理和心理社会因素，及其功能 结果，并将这些与RAP儿童的样本进行比较， 寻求三级医疗照顾。因为很多有RAP的孩子 当他们成年时被确定患有IBS，这项研究可能提供 深入了解这种疾病的发展过程这些数据可 用于制定供卫生保健提供者使用的指南， 早期与儿童谁有这种常见的投诉，以防止健康 寻求护理的行为及其伴随的经济和情感成本。

DESCRIPTION: (provided by applicant) Ten to 17 percent of children between the ages of 4 and 16 years meet the criteria for recurrent abdominal pain (RAP) a condition that accounts for at least 5 percent of all pediatric office visits and often leads to significant disability (e.g., school absence). From 30-60 percent of children with RAP will go on to experience similar pain as adults leading to the suggestion that RAP and irritable bowel syndrome (IBS) may be the same syndrome at different developmental stages. Similar to IBS, 20-68 percent of children reporting abdominal pain also experience alterations in bowel patterns (constipation and/or diarrhea). Although the cause(s) of RAP (as well as IBS) are unknown, factors contributing to the symptom experience, including health care seeking, are likely to include both physiological and psychosocial. The relationships among physiologic abnormalities, psychological makeup, and parental responses/behaviors in RAP are largely unexplored (undefined). To study the contributions of these sets of factors and their potential interplay, we propose to compare three groups of children: those with RAP who are referred to tertiary medical attention (RAP-GI); who have RAP but do not seek medical attention beyond their pediatrician (RAP-Ped); and those who do not have RAP symptoms (Controls). Our Specific Aims are to describe and compare among these children (ages 7-10): 1) GI symptoms (abdominal pain and bowel patterns) and functional disability (pain interfering with activity, school absences) using retrospective and prospective symptom measures; 2) autonomic nervous system function (spectral and non-spectral analysis of heart rate variability and urine catecholamines); 3) child and parent pain coping skills, parent modeling and reinforcement of illness behavior; and 4) psychological distress (anxiety, depression, and somatization). Children will be recruited from pediatric practices in Houston. This proposed interdisciplinary study will be the first in children to examine concurrently both physiologic and psychosocial factors related to RAP, and its functional consequences, and to compare these to a sample of children with RAP who do not seek tertiary medical attention. Because so many children with RAP are identified as having IBS when they reach adulthood, this study may provide insight into the developmental progression of this disorder. These data could be used to develop guidelines for use by health care providers to intervene early with children who have this common complaint in order to prevent health care seeking behavior with its attendant financial and emotional cost.