Functional abdominal pain syndrome
Functional abdominal pain syndrome
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DOI：
10.1053/j.gastro.2005.11.062
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发表时间：
2006-04-01
期刊：
影响因子：
29.4
通讯作者：
Naliboff, Bruce D.
中科院分区：
文献类型：
--
作者：
Clouse, Ray E.;Mayer, Emeran A.;Naliboff, Bruce D.
功能性腹痛综合征（FAPS）不同于其他功能性肠病；它不太常见，症状基本上与食物摄入和排便无关，并且与精神疾病的合并症较高。病因和病理生理尚不完全清楚。由于FAPS可能代表了一组异质性疾病，周围神经性疼痛机制，内源性疼痛调节系统的改变，或两者都可能涉及任何一个患者。FAPS的诊断是在阳性症状标准和长期症状史的基础上做出的；如果没有警报症状，则不需要进行广泛的诊断评估。管理是基于治疗的医患关系和经验性治疗算法，使用各种类型的集中作用药物，包括抗抑郁药和抗惊厥药。药物的选择、剂量和组合受精神疾病的影响。心理治疗方案包括心理治疗、放松技术和催眠。难治性FAPS患者可能受益于多学科的疼痛临床方法。
Functional abdominal pain syndrome (FAPS) differs from the other functional bowel disorders; it is less common, symptoms largely are unrelated to food intake and defecation, and it has higher comorbidity with psychiatric disorders. The etiology and pathophysiology are incompletely understood. Because FAPS likely represents a heterogenous group of disorders, peripheral neuropathic pain mechanisms, alterations in endogenous pain modulation systems, or both may be involved in any one patient. The diagnosis of FAPS is made on the basis of positive symptom criteria and a longstanding history of symptoms; in the absence of alarm symptoms, an extensive diagnostic evaluation is not required. Management is based on a therapeutic physician-patient relationship and empirical treatment algorithms using various classes of centrally acting drugs, including antidepressants and anticonvulsants. The choice, dose, and combination of drugs are influenced by psychiatric comorbidities. Psychological treatment options include psychotherapy, relaxation techniques, and hypnosis. Refractory FAPS patients may benefit from a multidisciplinary pain clinic approach.