Faculty Opinions recommendation of Rome II versus Rome III classification of functional gastrointestinal disorders in pediatric chronic abdominal pain.

Author(s):  
Annamaria Staiano
2017 ◽  
Vol 53 (1) ◽  
pp. 5-10
Author(s):  
Stanisław Pieczarkowski ◽  
Kinga Kowalska-Duplaga ◽  
Andrzej Wędrychowicz ◽  
Krzysztof Fyderek ◽  
Przemko Kwinta ◽  
...  

<i>Introduction:</i> Chronic abdominal pain in children is a very frequent and sometimes challenging diagnostic issue. Differential diagnosis in that cases is difficult and often connected with numerous, time-consuming, expensive, and frequently stressful diagnostic studies. The aim of the study was to establish whether fecal calprotectin concentration (FCC) and TNF-alpha may be useful in children with chronic abdominal pain to differentiate between inflammatory bowel disease (IBD), other inflammatory gastrointestinal disorders, and functional gastrointestinal disorders. Methods. The study included patients (median age 13 years), who were assigned to functional gastrointestinal disorders group (n=33); inflammatory gastrointestinal disorders other than IBD (n=71), children with IBD (n=37) and 22 healthy children served as a control group. The concertation of FCC and TNF-alpha in stool samples was measured using ELISA. <i>Results:</i> In healthy children and in children with functional disorders FCCs were below 100 μg/g. In patients with IBD FCCs and TNF-alpha were markedly elevated as compare to children with functional gastrointestinal disorders, however using ROC discrimination of IBD patients was significantly better using FCC than TNF-alpha. <i>Conclusion:</i> FCC is better test for differentiation between IBD, other inflammatory gastrointestinal disorders, and functional gastrointestinal disorders as compare to TNF-alpha concentration in stool. FCC as screening test in patients with chronic abdominal pain should allow to diminish unnecessary diagnostic in cases of functional gastrointestinal disorders.


2013 ◽  
Vol 25 (8) ◽  
pp. 686-e511 ◽  
Author(s):  
M. Bouchoucha ◽  
M. Fysekidis ◽  
G. Devroede ◽  
J. -J. Raynaud ◽  
B. Bejou ◽  
...  

2020 ◽  
Vol 42 (5-6) ◽  
pp. 115-118
Author(s):  
Dušica Simić ◽  
Ana Vlajković ◽  
Ivana Budić ◽  
Miodrag Milenović ◽  
Marija Stević

Abdominal migraine (AM) is a syndrome usually diagnosed in childhood. The AM syndrome comprises episodic attacks of severe, recurrent, and chronic abdominal pain localized in the periumbilical area, followed by symptoms like headache, anorexia, nausea, vomiting, or pallor. Between the abdominal migraine episodes the child felt good and continued to develop well. The pathophysiological process is presumed to be similar to that of other functional gastrointestinal disorders (FGIDs) and cephalic migraine. It is vital to assess anamnesis, dietary and social history, detailed physical examination, and symptom-based guidelines. Evaluation of the patient for the presence of any potential alarming symptoms or signs, to exclude an organic disease, is essential. The major problem is the lack of knowledge regarding its unclear pathophysiology. Nonpharmacological and pharmacological treatment alternatives vary. Although thorough diagnostic criteria under Rome IV classification of FGIDs and International Classification of Headache Disorders are available, AM persists to be an underdiagnosed entity. A definite diagnosis of abdominal migraine allows appropriate management and avoids unnecessary investigations and incorrect treatments.


2019 ◽  
Vol 317 (5) ◽  
pp. G640-G650
Author(s):  
Michael Camilleri

The overall objectives of this review are to summarize actionable biomarkers for organic etiology of lower functional gastrointestinal disorders (FGIDs) that lead to individualized treatment for their FGIDs and to assess the pipeline for novel approaches to the management of constipation, diarrhea, and chronic abdominal pain in lower FGIDs. The new approaches to therapy include ion exchangers/transporters for functional constipation (sodium-glucose cotransporter 1, Na+/H+ exchanger 3, and solute carrier family 26 member 3 inhibitors), bile acid modulators for constipation such as ileal bile acid transporter inhibitors and fibroblast growth factor 19 analog for functional constipation, and bile acid sequestrants or farnesoid X receptor agonists for functional diarrhea. Treatment for chronic abdominal pain remains an unmet need in patients with lower FGIDs, and promising novel approaches include delayed-release linaclotide, nonclassical opioid visceral analgesics, and selective cannabinoid receptor agonists. The role of probiotics, fecal microbial transplantation, and possible future microbiome therapies is discussed.


2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Stanisław Pieczarkowski ◽  
Kinga Kowalska-Duplaga ◽  
Przemko Kwinta ◽  
Przemysław Tomasik ◽  
Andrzej Wędrychowicz ◽  
...  

Objectives. The aim of the study was to establish whether fecal calprotectin concentration (FCC) may be useful in children with chronic abdominal pain to differentiate between inflammatory bowel disease (IBD), other inflammatory gastrointestinal disorders, and functional gastrointestinal disorders. Methods. The study included 163 patients (median age 13 years), who were assigned to four study groups: group 0 (control), 22 healthy children; group 1, 33 children with functional gastrointestinal disorders; group 2, 71 children with inflammatory gastrointestinal disorders other than IBD; group 3, 37 children with IBD. FCC was measured using ELISA assay. Results. In group 0 and group 1 FCCs were below 100 μg/g. Low FCCs were found in 91% of patients in group 2. In patients with IBD FCCs were markedly elevated with median value of 1191.5 μg/g. However, in children with inflammatory gastrointestinal disorders other than IBD and in children with IBD mean FCCs were significantly higher compared with the control group. Significant differences in FCCs were also found between group 1 and group 2, between group 1 and group 3, and between group 2 and group 3. Conclusion. FCC is the best parameter allowing for differentiation between IBD, other inflammatory gastrointestinal disorders, and functional gastrointestinal disorders. High FCC is associated with a high probability of IBD and/or other inflammatory gastrointestinal disorders, and it allows excluding functional gastrointestinal disorders.


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