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Effects of probiotic supplementation on abdominal pain severity in pediatric patients with irritable bowel syndrome:a systematic review and meta-analysis of randomized clinical trials

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World Journal of Pediatrics 2022年第5期18卷 320-332页

作者： Somayeh Fatahi Amirhossein Hosseini Mohammad Hassan Sohouli Aliakbar Sayyari Katayoun Khatami Zahra Fazeli Farsani Hamzeh Amiri Naghi Dara Ivan G.O.de Souza Heitor O.Santos Pediatric Gastroenterology Hepatologyand Nutrition Research Center.Research Institute for Children's HealthShahid Beheshti University of Medical SciencesTehranIran Student Research Committee Faculty of Public Health BranchIran University of Medical Sciences.Tehran.Iran Student Research Committee.Department of Clinical Nutrition and Dietetics Faculty of Nutrition and Food TechnologyShahid Beheshti University of Medical Sciences.TehranIran School of Health Sciences.Universidade Salvador(UNIFACS) SalvadorBahia.Brazil School of Medicine Federal University of Uberlandia(UFU)UberlandiaMinas GeraisBrazil

Background Probiotic supplementation has been used to alleviate abdominal pain in children and adolescents with irritable bowel syndrome(IBS),but the evidence is not ***,a systematic review and meta-analysis of randomized clinical trials(RCTs)were performed to investigate the effects of probiotic supplementation on abdominal pain in pediatric patients with *** PubMed/MEDLINE,Web of Science,Scopus,Cochrane Library,and Embase were the available databases searched to find relevant randomized clinical trials up to April *** effect size was expressed as weighted mean differenee(WMD)and 95% confidence interval(CI).Results Seven RCTs with 441 participants were included,from which the meta-analysis demonstrated that probiotic supplementation has a significant effect on reducing abdominal pain in pediatric patients with IBS(WMD=-2.36:95%CI-4.12 to-0.60;P=0.009).Although our study involved children and adolescents(≤18 years),the effects of probiotic supplementation seem to be more potent in patients under 10 years old(WMD=-2.55;95%CI-2.84 to -2.27)compared to patients aged 10-18 years(WMD=-1.70;95%CI-2.18 to -1.22).The length of supplementation longer than four weeks was more effective(WMD=-2.43;95%CI-2.76 to -2.09).Conclusion Probiotic supplementation can reduce abdominal pain in pediatric patients with IBS.

关键词： abdominal pain Adolescents-Irritable bowel syndrome Meta-analysis Probiotic

Measuring episodic abdominal pain and disability in suspected sphincter of Oddi dysfunction

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World Journal of Gastroenterology 2010年第35期16卷 4416-4421页

作者： Valerie Durkalski Walter Stewart Paulette MacDougall Patrick Mauldin Joseph Romagnuolo Olga Brawman-Minzter Peter Cotton Division of Biostatistics and Epidemiology Medical University of South Carolina Center for Health Research Geisinger Health System Digestive Diseases Center Medical University of South Carolina Department of Pharmacy Medical University of South Carolina Department of Psychiatry Medical University of South Carolina

AIM:To evaluate the reliability of an instrument that measures disability arising from episodic abdominal pain in patients with suspected sphincter of Oddi dysfunction(SOD).METHODS:Although several treatments have been utilized to reduce pain and associated disability,measurement tools have not been developed to reliably track *** pilot studies were conducted to assess test-retest reliability of a newly developed instrument,the recurrent abdominal pain intensity and disability(RAPID) *** RAPID score is a 90-d summation of days where productivity for various daily activities is reduced as a result of abdominal pain episodes,and is modeled after the migraine disability assessment instrument used to measure headache-related *** was administered by telephone on 2 consecutive occasions in 2 consenting populations with suspected SOD:a pre-sphincterotomy population(Pilot Ⅰ,n = 55) and a post-sphincterotomy population(Pilot Ⅱ,n = 70).RESULTS:The average RAPID scores for Pilots Ⅰ and Ⅱ were:82 d(median:81.5 d,SD:64 d) and 48 d(median:0 d,SD:91 d),*** concordance between the 2 assessments for both populations was very good:0.81 for the pre-sphincterotomy population and 0.95 for the post-sphincterotomy ***:The described pilot studies suggest that RAPID is a reliable instrument for measuring disability resulting from abdominal pain in suspected SOD patients.

关键词： Sphincter of Oddi abdominal pain Disability measurement Reproducibility of results pain measurement Episodic pain

Electroacupuncture for abdominal pain relief in patients with acute pancreatitis:A three-arm randomized controlled trial

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Journal of Integrative Medicine 2023年第6期21卷 537-542页

作者： Dong Kee Jang Jun Kyu Lee Chan Yung Jung Kyung Ho Kim Ha Ra Kang Yeon Sun Lee Jong Hwa Yoon Kwang Ro Joo Min Kyu Chae Yong Hyeon Baek Byung-Kwan Seo Sang Hyub Lee Chiyeon Lim Department of Internal Medicine Seoul Metropolitan Government Boramae Medical CenterSeoul National University College of MedicineSeoul 07061Republic of Korea Department of Internal Medicine Dongguk University Ilsan HospitalDongguk University College of MedicineGoyang 10326Republic of Korea Department of Acupuncture and Moxibustion Dongguk University Ilsan Oriental HospitalCollege of Korean MedicineDongguk UniversityGoyang 10326Republic of Korea Department of Korean Medicine Dongguk UniversityGoyang 10326Republic of Korea Department of Acupuncture and Moxibustion College of Korean MedicineDongguk UniversityGyeongju 38067Republic of Korea Department of Gastroenterology Kyung Hee University Hospital at GangdongSeoul 05278Republic of Korea Department of Acupuncture and Moxibustion Kyung Hee University Korean Medicine Hospital at GangdongSeoul 05278Republic of Korea Department of Internal Medicine and Liver Research Institute Seoul National University HospitalSeoul National University College of MedicineSeoul 03080Republic of Korea Department of Biostatistics College of MedicineDongguk UniversityGoyang 10326Republic of Korea

Background: Electroacupuncture(EA) may reduce the severity of acute pancreatitis(AP) and provide additional pain relief in patients with chronic pancreatitis. However, the ability of EA to relieve pain in patients with AP has not been well ***: This study was undertaken to compare the pain-relieving effects of EA and conventional treatment in patients with ***, setting, participants and interventions: This study was conducted using a randomized, controlled,three-arm, parallel-group and multi-center design. Patients diagnosed with AP were randomly and equally assigned to EA1, EA2 or control groups. All participants received conventional standard-of-care therapy for AP. Local EA alone was administered in EA1, and local plus distal EA was given in *** EA included two abdominal acupoints, while distal EA included twelve peripheral acupoints. EA groups underwent one session of EA daily for 4 days(days 1–4), or until pain was resolved or *** outcome measures: The primary outcome measure was the change in the visual analogue scale(VAS;0–100) pain score between baseline and day ***: Eighty-nine participants were randomized into EA1, EA2 and control groups, and 88(EA1, 30;EA2, 29;control, 29) were included in the full-analysis set. VAS score change(median [interquartile range]) on day 5 was(12.3 ± 22.5) in the EA1 group,(10.3 ± 21.5) in the EA2 group, and(8.9 ± 15.2) in the control group. There were not significant differences in the change in VAS score among treatments(P = 0.983). However, time to food intake was significantly shorter in the EA group(EA1 + EA2) than in the control group(median 2.0 days vs 3.0 days), with a hazard ratio of 0.581(P = 0.022;95% CI,0.366–0.924). No significant adverse events ***: EA treatment did not significantly reduce pain after 4 days of treatment in patients with AP-associated abdominal pain but significantly reduced time to first food intake.

关键词： Acute pancreatitis Electroacupuncture pain management abdominal pain Randomized controlled trial

Paroxysmal drastic abdominal pain with tardive cutaneous lesions presenting in Henoch-Schnlein purpura

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World Journal of Gastroenterology 2012年第16期18卷 1991-1995页

作者： Xiao-Liang Chen Hong Tian Jian-Zhong Li Jin Tao Hua Tang Yang Li Bin Wu Department of Gastroenterology The-Third Affiiiated Hospital of Sun Yat-Sen University Guangzhou 510630 Guangdong Province China Department of Nephrology The Third Affiliated Hospital of Sun Yat-Sen University Guangzhou 510630 Guangdong Province China Department of Pathology The First Affiliated Hospital of Sun Yat-Sen University Guangzhou 510080 Guangdong Province China

Henoch-Schnlein purpura(HSP) is a small-vessel vasculitis mediated by IgA-immune complex *** is characterized by the clinical tetrad of non-thrombocytopenic palpable purpura,abdominal pain,arthritis and renal *** diagnosis of HSP is difficult,especially when abdominal symptoms precede cutaneous *** report a rare case of paroxysmal drastic abdominal pain with gastrointestinal bleeding presented in *** diagnosis was verified by renal damage and the occurrence of purpura.

关键词： Henoch-Schnlein purpura abdominal pain Gastrointestinal bleeding

abdominal separation in an adult male patient with acute abdominal pain

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World Journal of Gastroenterology 2010年第26期16卷 3343-3346页

作者： Liu, Bao-Lin Chen, Yang Liu, Shi-Qing Zhang, Xiao-Bo Cui, Dong-Xu Dai, Xian-Wei China Med Univ Shengjing Hosp Dept Surg Oncol & Organ Transplatat Div Shenyang 110004 Liaoning Prov Peoples R China

We report a male patient with prolonged post-prandial abdominal distension and a sudden onset of epigastric pain initially diagnosed as acute abdomen. The patient had no history of surgery. Physical examination revealed peritonitis and abdominal computed tomography scan showed upper abdominal mesentery intorsion. The patient then underwent surgical intervention. It was found that the descending mesocolon dorsal root was connected to the ascending colon and formed a membrane encapsulating the small intestine. The membrane also formed an orifice in the ileal pars caeca, from which a 30 cm herniated ileum formed a "C"-shaped loop which was strangulated by the orifice. An abdominal separation was diagnosed after surgery. We liberated the membranous peritoneum which incarcerated the intestinal canal from the root ofileocecal junction to Treitz ligament, and reduced the small intestinal malrotation. The patient had an uneventful recovery after opera-tion with his abdominal distention disappeared during the follow-up. abdominal separation is a rare situation, which may be related with embryo development. Surgery is a choice of treatment for it.

关键词： abdominal separation abdominal pain Internal hernia Malrotation Acute abdomen

Non-pharmacological management of abdominal pain-related functional gastrointestinal disorders in children

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World Journal of Pediatrics 2016年第4期12卷 389-398页

作者： Siba Prosad Paul Dharamveer Basude Torbay Hospital Vowden HallLowes BridgeTorquayTQ27AAUK Bristol Royal Hospital for Children Upper Maudlin StreetBristolBS28BJUK

Background:abdominal pain-related functional gastrointestinal disorder(AP-FGID)comprises of 4 main conditions:functional dyspepsia,irritable bowel syndrome,abdominal migraine and functional abdominal ***-FGIDs are diagnosed clinically based on the Rome IV criteria for FGIDs of *** is limited evidence for pharmacological *** sources:This review article discusses non-pharmacological management of AP-FGID based on the current literature including systematic reviews,randomized controlled trials,cohort and case control *** aim to provide a comprehensive overview on the available evidence for the pediatricians and pediatric gastroenterologists involved in managing children with ***:Managing AP-FGIDs can be *** should follow a stepwise approach with focused history,identification of“red flag”signs and symptoms,physical examination and investigations done following initial *** needs explaining that there is nothing seriously wrong with the child’s *** explanation and reassurance can achieve symptom control in large number of ***-pharmacological interventions are delivered through lifestyle and dietary changes and bio-psychosocial *** interventions vary depending on the type of ***-psychosocial therapies such as hypnotherapy,cognitive behavioral therapy and yoga aim at stress ***:There is increasing evidence for use of non-pharmacological interventions in children with AP-FGID.

关键词： abdominal pain behavioral intervention diet gastrointestinal diseases hypnosis RomeⅣcriteria

Are bowel symptoms and psychosocial features different in irritable bowel syndrome patients with abdominal discomfort compared to abdominal pain?

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World Journal of Gastroenterology 2022年第33期28卷 4861-4874页

作者： Xiu-Cai Fang Wen-Juan Fan Douglas D Drossman Shao-Mei Han Mei-Yun Ke Department of Gastroenterology Peking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100730China Department of Gastroenterology Tongji HospitalTongji Medical CollegeHuazhong University of Science&TechnologyWuhan 430030Hubei ProvinceChina Center of Functional GI and Motility Disorders University of North CarolinaChapel HillNC 27517United States Center for Education and Practice of Biopsychosocial Care Drossman GastroenterologyDurhamNC 27713United States Rome Foundation Rome FoundationRaleighNC 27614United States Department of Epidemiology and Statistics Institute of Basic Medical SciencesChinese Academy of Medical Sciences&School of Basic MedicinePeking Union Medical CollegeBeijing 100005China

BACKGROUND The Rome IV criteria eliminated abdominal discomfort for irritable bowel syndrome(IBS), which was previously included in Rome III. There are questions as to whether IBS patients with abdominal discomfort(seen in Rome III but not Rome IV) are different from those with abdominal pain(Rome IV).AIM To compare bowel symptoms and psychosocial features in IBS patients diagnosed with Rome III criteria with abdominal discomfort, abdominal pain, and pain &*** We studied IBS patients meeting Rome III criteria. We administered the IBS symptom questionnaire, psychological status, and IBS quality of life. Patients were classified according to the predominant abdominal symptom associated with defecation into an only pain group, only discomfort group, and pain & discomfort group. We compared bowel symptoms, extraintestinal symptoms, IBS quality of life, psychological status and healthcare-seeking behaviors, and efficacy among the three groups. Finally, we tested risk factors for symptom reporting in IBS *** Of the 367 Rome III IBS patients enrolled, 33.8%(124 cases) failed to meet Rome IV criteria for an IBS diagnosis. There were no meaningful differences between the pain group(n = 233) and the discomfort group(n = 83) for the following:(1) Frequency of defecatory abdominal pain or discomfort;(2) Bowel habits;(3) Coexisting extragastrointestinal pain;(4) Comorbid anxiety and depression;and(5) IBS quality of life scores except more patients in the discomfort group reported mild symptom than the pain group(22.9% vs 9.0%). There is a significant tendency for patients to report their defecatory and non-defecatory abdominal symptom as pain alone, or discomfort alone, or pain & discomfort(all P abdominal discomfort have similar bowel symptoms and psychosocial features to those with abdominal pain. IBS symptoms manifesting abdominal pain or discomfort may primarily be due to different sensation and reporting expe

关键词： Irritable bowel syndrome abdominal pain abdominal discomfort Diagnosis Psychosocial distress Quality of life

Eosinophilic gastroenteritis with abdominal pain and ascites:A case report

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World Journal of Clinical Cases 2021年第17期9卷 4238-4243页

作者： Xiao-Qing Tian Xiang Chen Sheng-Liang Chen Department of Gastroenterology Renji HospitalSchool of MedicineShanghai Jiao Tong UniversityShanghai 200001China

BACKGROUND Eosinophilic gastroenteritis(EGE)is a rare disease that presents many unspecific gastroenterological *** disease includes three types depending on the depth of eosinophil infiltration in the gastrointestinal *** serosal type is the most rare,presenting as *** SUMMARY A 34-year-old man presented with abdominal pain,diarrhea without bloody stool,or *** test results revealed a peripheral blood eosinophil count(4.85×10^(9)/L),which was remarkedly *** tomography scan demonstrated extensive intestinal wall edema thickening in the duodenum,jejunum,ascending colon and transverse colon;multiple exudative effusion surrounding the intestinal tract,and ascites in the abdominal cavity.A series of examinations excluded eosinophil elevation in secondary *** multipoint biopsy detected eosinophilic infiltration in the mucous layer of the transverse colon,with≥50 eosinophils/high power *** symptoms vanished after a few days of steroid therapy and ascites disappeared within 2 *** EGE should be considered in patients with abdominal pain,ascites,and *** point biopsies are essential for diagnosis.

关键词： Eosinophilic gastroenteritis abdominal pain Ascites Endoscopy Prednisone Case report

Postpolypectomy syndrome without abdominal pain led to sepsis/septic shock and gastrointestinal bleeding:A case report

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World Journal of Gastrointestinal Surgery 2023年第10期15卷 2343-2350页

作者： Fang-Zhi Chen Lin Ouyang Xiao-Li Zhong Jin-Xiu Li Yan-Yan Zhou Department of Gastroenterology The Second Affiliated HospitalHengyang Medical SchoolUniversity of South ChinaHengyang 421001Hunan ProvinceChina Department of Critical Care Medicine The Second Xiangya HospitalCentral South UniversityChangsha 410011Hunan ProvinceChina

BACKGROUND Postpolypectomy syndrome(PPS)is a rare postoperative complication of colonic *** presents with abdominal pain and fever accompanied by coagulopathy and elevated inflammatory *** prognosis is usually good,and it only requires outpatient treatment or observation in a general ***-ever,it can be *** SUMMARY The patient was a 58-year-old man who underwent two colonic polypectomies,each resulting in life-threatening sepsis,septic shock,and *** of the notable manifestations was a rapid drop in blood pressure,an increase in heart rate,loss of consciousness,and heavy sweating,accompanied by shortness of breath and decreased oxygen in the finger *** on the criteria of organ dysfunction due to infection,we diagnosed him with *** patient also experienced severe gastrointestinal bleeding after the second ***,he did not complain of any abdominal pain throughout the course of the *** had significantly elevated concentrations of inflammatory markers and *** for the absence of abdominal pain,his fever,significant coagulopathy,and elevated inflammatory marker concentrations were all consistent with *** computed tomography and superior mesenteric artery computed tomography angiography showed no free air or vascular ***,the diagnosis of colon perforation was not *** final blood culture results indicated Moraxella *** patient was transferred to the intensive care unit and quickly improved after fluid resuscitation,antibiotic treatment,oxygen therapy,and blood *** PPS may induce dysregulation of the systemic inflammatory response,which can lead to sepsis or septic shock,even in the absence of abdominal pain.

关键词： Postpolypectomy syndrome abdominal pain Sepsis Gastrointestinal bleeding Case report