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功能性腹痛

簡介

功能性腹痛指偶爾或持續發生的腹痛，於2個月內每月出現多於4次。這種腹痛與進食及胃部或腸道功能關係不大，亦不能以生理狀況解釋成因。

功能性腹痛常見於大於4歲的兒童，女童較男童常出現腹痛。受功能性腹痛困擾的兒童經常需要求醫，導致缺席課堂，長期身心疲倦有機會影響精神狀況或引起焦慮。
Causes
成因
  1. 腸腦軸受到干擾
  2. 內臟過度敏感
  3. 腸道微菌叢失調
  4. 胃排空或腸蠕動異常
  5. 遺傳易感性
Risk factors
風險因素
  1. 抑鬱及焦慮
  2. 壓力
  3. 慢性炎症
風險因素
  1. 抑鬱及焦慮
  2. 壓力
  3. 慢性炎症
Risk factors
Symptoms
症狀
  1. 肚臍周圍突然或逐漸出現腹痛
  2. 腹瀉或便秘
  3. 消化不良
  4. 進食少量食物後容易有飽腹感
  5. 感到噁心或嘔吐
  1. Romano, C., Ferrau’, V., Cavataio, F., Iacono, G., Spina, M., Lionetti, E., Comisi, F., Famiani, A., & Comito, D. (2014). lactobacillus reuteri in children with functional abdominal pain (FAP). Journal of Paediatrics and Child Health, 50(10). https://doi.org/10.1111/j.1440-1754.2010.01797.x
    • 56 children (aged 6-16) with FAP
    • 2 x 10⁸ CFU/ day of L. reuteri Protectis or placebo for 4 weeks followed by a 4-week follow-up without supplementation
    • Result: significant pain reduction intensity from week 0 to week 8 in the L. reuteri Protectis (n=26)
  2. Weizman, Z., Abu-Abed, J., & Binsztok, M. (2016). Lactobacillus reuteri DSM 17938 for the management of functional abdominal pain in childhood: A randomized, double-blind, placebo-controlled trial. The Journal of Pediatrics, 174. https://doi.org/10.1016/j.jpeds.2016.04.003
    • 93 children (average age 11-12) with at least one episode of abdominal pain per week
    • 10⁸ CFU/ day L. reuteri Protectis or placebo for 4 weeks followed by a 4 week follow-up without supplementation
    • Result: Insignificant reduction in pain intensity week 0 to week 8 in the L. reuteri Protectis (n=47)
    • Result: insignificant reduction of number of pain episodes from week 0 to week 8 in the L. reuteri Protectis (n=47)
  3. Jadrešin, O., Hojsak, I., Mišak, Z., Kekez, A. J., Trbojević, T., Ivković, L., & Kolaček, S. (2017). Lactobacillus reuteri DSM 17938 in the treatment of functional abdominal pain in children: RCT Study. Journal of Pediatric Gastroenterology & Nutrition, 64(6), 925–929. https://doi.org/10.1097/mpg.0000000000001478
    • 55 children aged 4-18 with FAP or IBS
    • 10⁸ CFU/ day L. reuteri Protectis or placebo for 12 weeks followed by a 4-week follow-up without supplementation
    • Result: 80% pain-free days in the L. reuteri group (n= 26)
    • Result: Significant reduction in severity of pain during the follow-up month (n=26)
紓緩方法
  1. 三餐盡量定時進食，如兒童因進食時感腹痛，或會拒絕進食，影響發育或導致便祕
  2. 多吸收膳食纖維，同時有助腹瀉或便秘
  3. 放鬆心情如多做深呼吸練習，或靠對話、遊戲等分散腹痛的注意力
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