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Functional dyspepsia in children
Last reviewed: 23.04.2024
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Functional dyspepsia in children (synonyms: nonulcer dyspepsia, essential dyspepsia, idiopathic dyspepsia, pseudo-ulcer syndrome, epigastric distress syndrome) is a complex of disorders, including pain or discomfort in the epigastric region, early satiety, nausea, vomiting, belching, heartburn and not caused by organic GI disease. The peculiarity of the syndrome in children is the predominant localization of pain in the peripodal region (55-88%); 95% of children have pain within the triangle, the base of which is the right rib arch, and the apex - the umbilical ring.
[Epidemiology
The prevalence of functional dyspepsia in the population is 25-40% and is approximately the same in all age groups. According to the new edition of the Rome criteria (2006), this term is not applied until the child reaches the age of 4 due to the lack of structured complaints required for the diagnosis.
Symptoms of functional dyspepsia in children
According to the Roman criteria III (2006), postprandial (dyskinetic according to Roman criteria II) and pain (ulcerative according to Roman criteria II) are distinguished for functional dyspepsia. The first is characterized by the predominance of dyspepsia, the second - by abdominal pain. An indispensable condition for the diagnosis is the preservation or recurrence of symptoms for at least 3 months.
Pathognomonic for functional dyspepsia is considered to be early (arising after eating) pain, rapid satiety, a sensation of bloating and overflow in the upper half of the abdomen. Often the pain is situational in character: they arise in the morning before leaving for a pre-school or school, on the eve of examinations or other exciting events in the life of a child. In many cases, the child (parents) can not indicate a relationship of symptoms with any factors. In patients with functional dyspepsia, there are often various neurotic disorders, more often in anxious and asthenic type, eating and sleeping disorders. A combination of abdominal pain with pains of other localization, dizziness, sweating is characteristic.
Where does it hurt?
What's bothering you?
Diagnosis of functional dyspepsia in children
Since the structure of dyspepsia syndrome in children predominates peptic ulcer, early diagnosis of this disease is recognized as a priority task. Epidemiological criteria that increase the risk of peptic ulcer disease: age over 10 years (= 10 times), belonging to the male sex (3-4 times), weighed down by a factor of 6-8. Clinically, the presence of peptic ulcer is indicated by night and "hungry" pains, severe rare pains, heartburn and acidic eructations. If the child has at least one of the listed symptoms of anxiety, the EGDS is indicated as a matter of priority. Contraindications to EGDS - acute circulatory disorders, pulmonary and cardiac insufficiency, marked anatomical and topographic changes in the esophagus, mental illnesses, a serious condition of the patient, threat of bleeding.
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Treatment of functional dyspepsia in children
In the treatment of functional dyspepsia, it is important to observe consistency and consistency. Symptomatic treatment is aimed at the elimination of clinical signs, taking into account pathogenetic mechanisms, begins at the primary reception. Provides a quick, often short-lived effect. Etiotropic treatment is based, as a rule, on instrumental and laboratory data. It helps to eliminate the discovered causes of dyspepsia and provide a long-term favorable prognosis.
To improve the effectiveness of symptomatic treatment, the correct interpretation of a patient's complaints is particularly important, since many modern drugs are highly selective with respect to the mechanism of action and the point of application. It is advisable to apply criteria of functional diseases of the gastrointestinal tract, adopted at the national and international level and allowing rationalizing diagnostic and therapeutic measures.