功能性腹痛

简介

功能性腹痛指偶尔或持续发生的腹痛，于2个月内每月出现多于4次。这种腹痛与进食及胃部或肠道功能关系不大，亦不能以生理状况解释成因。

功能性腹痛常见于大于4岁的儿童，女童较男童常出现腹痛。受功能性腹痛困扰的儿童经常需要求医，导致缺席课堂，长期身心疲倦有机会影响精神状况或引起焦虑。

成因

肠脑轴受到干扰
内脏过度敏感
肠道微菌丛失调
胃排空或肠蠕动异常
遗传易感性

风险因素

抑郁及焦虑
压力
慢性炎症

风险因素

抑郁及焦虑
压力
慢性炎症

症状

肚脐周围突然或逐渐出现腹痛
腹泻或便秘
消化不良
进食少量食物后容易有饱腹感
感到恶心或呕吐

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)
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)
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)

纾缓方法

三餐尽量定时进食，如儿童因进食时感腹痛，或会拒绝进食，影响发育或导致便秘
多吸收膳食纤维，同时有助腹泻或便秘
放松心情如多做深呼吸练习，或靠对话、游戏等分散腹痛的注意力

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