Abdominal pain is one of the most common complaints found in children.
Abdominal pain that lasted more acute disorders often associated with organic matter, whereas abdominal pain that lasted more chronic or recurrent is a non-organic disorders.
Although not rare in such circumstances to the contrary; recurrent abdominal pain as a clinical manifestation of an organic disorder, and acute abdominal pain is an early episode of the series of recurrent abdominal pain is a disorder that fungsional.
Approach to diagnosis of abdominal pain in children is still a problem because the diagnostic criteria used have not uniform, especially for abdominal pain of non-organic. Criteria for diagnosis of abdominal pain that is widely used today is the criteria Appley and Rome II criteria. Diagnostic criteria are needed to provide proper governance.
Classification
Various classification abdominal pain in children has been filed. Although there are differences, but basically the authors always stressed the importance of abdominal pain to distinguish organic and non-organic.
In the children also used the term recurrent abdominal pain is defined as abdominal pain that lasted at least 3 times for at least 3 months within the last 1 year and interfere with daily activities.
Some clinical symptoms included in the alarm symptoms group and used as a guide organic abdominal pain. A group of experts in Europe and the United States consider these criteria are too general, so that proposed a diagnostic criteria for gastrointestinal disorders of non-organic (functional), the Rome Criteria.
At the Rome criteria, functional gastrointestinal disorders in the form of abdominal pain are grouped into 5 categories, namely
(1) functional dyspepsia,
(2) iritabel bowel syndrome,
(3) functional abdominal pain,
(4) abdominal migraine,
(5) erofagia.
Aetiology
Functional abdominal pain is the commonest cause of recurrent abdominal pain in children.
Although still controversial, gastrointestinal motility disorders and hipersentivitas viscera are two circumstances that allegedly contribute to the occurrence of functional abdominal pain.
Previous data reported that organic disorder is found in approximately 10% of cases, but with technological advances, especially in diagnostic procedures, the percentage of organic disorders increased to 30%.
Based on epidemiological research reports, abdominal pain in children under the age of 4 years and above 15 years is more often associated with organic abnormalities, whereas the age range is more often associated with functional abnormalities.
Of the many organic disorders that can cause abdominal pain complaints in children, abnormalities in the gastrointestinal system and urogenital system is a common cause. As clinicians, doctors need to know the specificity of clinical symptoms of each organ abnormalities. Some organic disorders is frequently reported as a cause of abdominal pain in children include lactose intolerance, gastritis, urinary tract infections, gastro reflux, Giardia lamblia infection, and Helicobacter pylori infection.
Pathogenesis
Pathogenesis of functional abdominal pain is not known with certainty. Are the symptoms caused clinically shown also by a variety of disorders or just a variation of clinical symptoms of the same cause. Gastrointestinal motility and hypersensitivity is suspected to play a role viscera of abdominal pain incidence of non-organic in children.
Motility disorders seen in children who manometri examination. On examination manometri seen increased intensity of muscle contractions in the small intestine and large intestine, and the time stopped in the gut that are slow (delayed intestinal transit time).
The concept of involvement of the viscera hypersensitivity gained from research that shows the change of the threshold receptors on gastrointestinal wall, a change in the modulation of sensory impulses mengkonduksi, and the threshold of conscious changes in the central nervous system in patients with irritable bowel syndrome. Imunomodulasi role in inflammation and pathogenesis of functional abdominal pain should also be considered since the discovery of nonspecific inflammatory processes in gastrointestinal biopsy tissue.
Originally posted 2009-11-04 09:29:15. Republished by Blog Post Promoter
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