El síndrome de intestino irritable como causa de dolor abdominal crónico

Trini Fragoso Arbelo; Rebeca Milán Pavón

El síndrome de intestino irritable como causa de dolor abdominal crónico

Trini Fragoso Arbelo, Rebeca Milán Pavón

Texto completo:

HTML

Resumen

Introducción: los trastornos funcionales gastrointestinales son motivo de consulta frecuente en Gastroenterología, y presentan un serio problema social y en la dinámica familiar. El síndrome de intestino irritable en la población pediátrica es poco diagnosticado, y el dolor abdominal crónico es motivo de consulta frecuente en la infancia y adolescencia.
Objetivo: analizar los aspectos más actuales en su diagnóstico y tratamiento, y su relación con el dolor abdominal crónico.
Métodos: se revisaron las bases documentales de PubMed, Scielo y Latindex y el Registro Especializado del Grupo Cochrane de datos relacionados con el síndrome de intestino irritable hasta diciembre de 2017, así como las guías de tratamiento postuladas por distintas organizaciones médicas, basadas en los criterios de Roma y de la Medicina Basada en la Evidencia.
Desarrollo: se realizó una revisión del tema referido a la infancia, y se incluyeron concepto y patogénesis más aceptadas, así como los criterios de Roma establecidos para el diagnóstico. Se hizo énfasis en la etiología, diagnóstico clínico y pruebas diagnósticas. Se analizaron algunos aspectos del tratamiento.
Conclusiones: el síndrome de intestino irritable es relativamente frecuente como causa de dolor abdominal crónico funcional, y el interrogatorio dirigido según los criterios de Roma es útil para su diagnóstico. La mayoría de los pacientes con síndrome de intestino irritable en la infancia deben ser atendidos en la atención primaria.

Referencias

Di Lorenzo C, Colletti RB, Lehmann HP, Boyle JT, Gerson WT, Hyams JS, et al. AAP Subcommittee; NASPGHAN Committee on Chronic Abdominal Pain. Chronic Abdominal Pain In Children: a Technical Report of the American Academy of Pediatrics and the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition. J. Pediatr. Gastroenterol. Nutr. (JPGN) 2005; 40(3): 249-61.

Spiller RC. Postinfectious irritable bowel syndrome. Gastroenterology. 2003; 124: 1662-71.

McFerron BA, Waseem S. Chronic recurrent abdominal pain. Pediatr. Rev. 2012 Nov;33(11):509-16; quiz 516-7. PMID:23118316

Saps M, Nichols-Vinueza DX, Rosen JM, Velasco-Benítez CA. Prevalence of functional gastrointestinal disorders in Colombian school children. J Pediatr. 2014; 164: 542-45.e1 [PMID: 24332822 DOI: 10.1016/j.jpeds. 2013.10.088]

Van Tilburg MAL, Walker LS, Palsson OS, Kim SM, Spiegel BM, Siller RC,

et al. Prevalence of child/adolescent functional gastrointestinal disorders in a national U.S. community sample. Gastroenterology 2014;146 5 Suppl 1:S143-S44.

Korterink JJ, Diederen K, Benninga MA, Tabbers MM. Epidemiology of Pediatric Functional Abdominal Pain Disorders: A Meta-Analysis. PLoS ONE. 2015; 10(5): e0126982. https://doi.org/10.1371/ journal.pone.0126982.

Rasquin-Weber A, Hyman PE, Cucchiara S, Fleisher DR, Hyams JS, Milla PJ. Et al. Childhood functional gastrointestinal disorders. Gut. 1999;45(suppl II): 1160-68.

Rasquin A, Di Lorenzo C, Forbes D, Guiraldes E, Hyams JS, Staiano AM, et al. Childhood Functional Gastrointestinal Disorders: Child Adolescent ROMAIII. Gastroenterology. 2006;130(5):1527-37.

Hyams JF, Di Lorenzo C, Saps M, Shulman RJ, Staiano A, van Tilburg M. Childhood Functional Gastrointestinal Disorders: Child/ Adolescent. ROMA IV. Gastroenterology. 2016;150:1456-68.

Rey E, Balboa A, Mearin F. Chronic constipation, irritable bowel syndrome with constipation and constipation with pain/discomfort: Similarities and differences. Am J.Gastroenterol. 2014;109:876-84. PMID: 24589666. doi: 10. 1038/ajg.2014.18.

Schmulson MJ, Drossman DA. What Is New in Rome IV. J Neurogastroenterol Motil. 2017 Apr 30;23(2):151-63. doi: 10.5056/jnm 16214.

Self MM, Czyzewski DI, Chumpitazi BP, Weidler EM, Shulman RJ. Subtypes of irritable bowel syndrome in children and adolescents. Clin Gastroenterol. Hepatol. 2014; 12(9):1468-73. [PubMed: 24486406

Carabotti M, Sciroccoa A, Masellib MA. The gut-brain axis: interactions between enteric microbiota, central and enteric nervous systems. Annals. Gastroenterology. 2015; 28: 203-09.

Drossman DA, Hasler WL. Rome IV - Functional GI disorders: disorders of gut-brain interaction. Gastroenterology. 2016;150:1257-492

Di Lorenzo C, Youssef NN, Sigurdsson L, Scharff L, Griffiths J, Wald A. Visceral hyperalgesia in children with functional abdominal pain. J. Pediatr. 2001;139:838-43.

Saulnier DM, Riehle K, Mistretta TA, Diaz MA, Mandal D, Raza S, et al. Gastrointestinal microbiome signatures of pediatric patients with irritable bowel syndrome. Gastroenterology. 2011 Nov;141(5):1782-91. doi: 10.1053/j.gastro. 2011.06.072. Epub 2011 Jul 8.

Rajilic-Stojanovic M, Biagi E, Heilig HG, Kajander K, Kekkonen RA, Tims S et al. Global and deep molecular analysis of microbiota signatures in fecal samples from patients with irritable bowel syndrome. Gastroenterology. 2011;141:1792-801. http://dx.doi.org/10.1053/j.gastro.2011.07.043

Shankar V, Agans R, Holmes B, Raymer M, Paliy O. Do gut microbial communities differ in pediatric IBS and health? Gut Microbes. 2013 Jul-Aug;4(4):347-52. doi: 10. 4161/ gmic.24827. Epub 2013 May

Waters AM, Schilpzand E, Bell C, Walker LS, Baber K. Functional gastrointestinal symptoms in children with anxiety disorders. J. Abnorm. Child. Psychol. 2013 Jan;41(1):151-63. doi: 10.1007/s10802-012-9657-0. PubMed PMID: 22773359.

Bonilla S, Saps M. Early life events predispose the onset of childhood functional gastrointestinal disorders. Rev. Gastroenterol. Mex. 2013;78:82–91.

Gulewitsch MD, Enck P, Schwille-Kiuntke J, Weimer K, Schlarb AA. Rome III criteria in parents’ hands: pain-related functional gastrointestinal disorders in community children and associations with somatic complaints and mental health. Eur. J. Gastroenterol .Hepatol. 2013;25:1223-29.

Miele E, Simeone D, Marino A, Greco L, Auricchio R, Novek S J, et al. Functional Gastrointestinal Disorders in Children: An Italian Prospective Survey. Pediatrics 2004;114 (1): 73-78.

Walker LS, Lipani TA, Greene JW, Caines K, Stutts J, Polk DB, Caplan A, Rasquin-Webber A. Recurrent abdominal pain: symptom subtypes based on the Rome II. Criteria for pediatric functional gastrointestinal disorders. J. Pediatr. Gastroenterol. Nutr. 2004;38 :187–91.

Reshetnikov OV, Kurilovich SA, Denisova DV. Prevalence of dyspepsia and irritable bowel syndrome among adolescents of Novosibirsk, Western Siberia. Int J.Circumpolar Health. 2001; 60:253-257.

Dong L, Dingguo L, Xiaoxing X, Hanming L. An Epidemiologic Study of Irritable Bowel Syndrome in Adolescents and Children in China: A School-Based Study. Pediatrics. 2005;116 (3):393-96. (doi:10.1542/peds. 2004-2764). Electronic article.

Caplan A, Walker L, Rasquin A. Validation of the pediatric Rome II criteria for functional gastrointestinal disorders using the questionnaire on pediatric gastrointestinal symptoms. J. Pediatr. Gastroenterol. Nutr. 2005;41(3):305-16.

Fragoso T, Díaz T, Rivas D, Llorian ME, Benech Y. Diagnosis of Functional Gastrointestinal Disorders According to Roma II Criteria. J. Pediatric. Gastroenterology. Nutrition. (JPGN) 2006; 43: E60-E61.

Fragoso T, Rivas D, Trujillo ME, Milán R, Purón B, Benech Y. Diagnóstico del dolor abdominal según criterios de Roma II. Revista Gastroenterología México (ISSN 0375-0906) 2006; 71 (Supl 2): 132.

Thornton GCD, Goldacre MJ, Goldacre R, Howarth LJ. Diagnostic Outcomes Following Childhood Non-specific Abdominal Pain. Arch. Dis. Child. 2016;101(4):305-09.

Cheng P, Shih W, Alberto M, Presson A, Licudine A, Mayer E et al. Autonomic response to a visceral stressor is dysregulated in irritable bowel syndrome and correlates with duration of disease. Neurogastroenterol. Motil. 2013; 25:e650–e659.

Ford AC, Lacy BE, Talley NJ. Irritable Bowel Syndrome. N. Engl. J. Med. 2017; 376:2566-78June 29, 2017DOI: 10.1056/NEJMra1607547.

Lacy BE, Mearin F, Chang L, Chey WD, Lembo AJ, Simren M, et al. Bowel disorders. Gastroenterology .2016; 150:1393-1407.

Sandhu BK, Siba Prosad P. Irritable bowel syndrome in children: Pathogenesis, diagnosis and evidence-based treatment. World. J. Gastroenterol. 2014 May 28; 20(20): 6013-23. DOI: 10.3748/wjg. v20.i20.6013. ISSN 1007-9327 (print) ISSN 2219-2840

Chogle A, Mintjens S, Saps M; Pediatric IBS: an overview on pathophysiology, diagnosis and treatment. Pediatr Ann. 2014 Apr;43(4):e76-82. doi: 10.3928 /00 904481-20140325-08.

Aziz I, Sanders DS. The irritable bowel syndrome-celiac disease connection. Gastrointest. Endoscopy. N. Clin. Am. 2012;22:623-37.

Henderson P, Casey A, Lawrence SJ, Kennedy NA, Kingstone K, Rogers P, et al. The diagnostic accuracy of fecal calprotectin during the investigation of suspected pediatric inflammatory bowel disease. Am. J. Gastroenterol. 2012; 107:941-49.

Hungin APS, Molloy-Bland M, Claes R, Heidelbaugh J, Cayley Jr WE, Muris J, et al. Systematic review: the perceptions, diagnosis and management of irritable bowel syndrome in primary care – A Rome Foundation Working Team Report. Aliment. Pharmacol. Ther. 2014; 40:1133-4.

Korterink JJ, Rutten JM, Venmans L, Benninga MA, Tabbers MM. Pharmacologic treatment in pediatric functional abdominal pain disorders: a systematic review. J Pediatr. 2015 Feb;166(2):424-31.e6. doi: 10.1016/j. jpeds. 2014.09.067. Epub 2014 Nov

Vahedi H, Merat S, Momtahen S, Kazzazi AS, Ghaffari N, Olfati G, et al. Clinical trial: the effect of amitriptyline in patients with diarrhoea-predominant irritable bowel syndrome. Aliment. Pharmacol. Ther. 2008 Apr;27(8):678-84. doi: 10.1111/j.1365-2036.2008.03633.x. Epub 2008 Jan 30.

Bahar RJ, Collins BS, Steinmetz B, Ament M. Double-blind placebo-controlled trial of amitriptyline for the treatment of irritable bowel syndrome in adolescents. J Pediatr. 2008 May;152(5):685-9. doi: 10.1016/j.jpeds.2007. 10.012. Epub 2008 Feb 20.

Lucak S, Chang L, Halpert A , Harris L. Current and emergent pharmacologic treatments for irritable bowel syndrome with diarrhea: evidence-based treatment in practice. Ther. Adv. Gastroenterol. 2017; 10:253-75 doi: 10.1177/ 1756283X16663396.

Shulman RJ, Hollister EB, Cain K, Czyzewski DI, Self MM, Weidler EM, et al. Psyllium Fiber Reduces Abdominal Pain in Children With Irritable Bowel Syndrome in a Randomized, Double-Blind Trial. Clin. Gastroenterol. Hepatol. 2017 May;15(5):712-719.e4. doi: 10.1016/j.cgh.2016.03.045. Epub 2016 Apr 11.

Wilson N, Schey R. Lubiprostone in constipation: Clinical evidence and place in therapy. Therapeutic advances in chronic disease. 2015; 6(2):40-50. PMID: 25729555. DOI: 10.1177/2040622314567678

Atluri DK, Chandar AK, Bharucha AE, Falck-Ytter Y. Effect of linaclotide in irritable bowel syndrome with constipation (IBS-C): A systematic review and metaanalysis. Neurogastroenterol. Motil. 2014; 26:499-09. PMID: 24351035. doi: 10.1111/nmo.12292.

Rutten JM, Reitsma JB, Vlieger AM, Benninga MA. Gut-directed hypnotherapy for functional abdominal pain or irritable bowel syndrome in children: a systematic review. Arch Dis Child. 2013 Apr;98(4):252-7. doi: 10.1136/ archdischild-2012-302906. Epub 2012 Dec 6.

Rutten JM, Korterink JJ, Venmans LM Benninga MA, Tabbers MM. Nonpharmacologic treatment of functional abdominal pain disorders: a systematic review. Pediatrics. 2015 Mar;135(3):522-35. doi: 10.1542/peds.2014-2123. Epub 2015 Feb 9.

Didari T, Mozaffari S, Nikfar S, Abdollahi M. Effectiveness of probiotics in irritable bowel syndrome: Updated systematic review with meta-analysis. World. J. Gastroenterol. 2015; 21:3072-84. doi: 10.3748/wjg.v 21.i10.3072.

De Roest RH, Dobbs BR, Chapman BA, Batman B, O’Brien LA, Leeper JA, et al. The low FODMAP diet improves gastrointestinal symptoms in patients with irritable bowel syndrome: A prospective study. Int J Clin Pract. 2013; 67:895-03.

Chumpitazi BP, Hollister EB, Oezguen N, Tsai CM, McMeans AR, Luna RA et al. Gut microbiota influences low fermentable substrate diet efficacy in children with irritable bowel syndrome. Gut. Microbes. 2014; 5(2):165-75. [PubMed: 24637601]

Chumpitazi BP, Cope JL, Hollister EB, Tsai CM, McMeans AR, Luna RA, et al. Randomised Clinical Trial: Gut Microbiome Biomarkers are Associated with Clinical Response to a Low FODMAP Diet in Children with Irritable Bowel Syndrome. Aliment. Pharmacol. Ther. 2015 August ; 42(4): 418-27. doi:10.1111/ apt.13286.173–81.

Böhn L, Störsrud S, Liljebo T, Collin L, Lindfors P, Törnblom H, et al. Diet low in FODMAPs reduces symptoms of irritable bowel syndrome as well as traditional dietary advice: a randomized controlled trial. Gastroenterology. 2015;149:1399-407 doi: 10.1053/j. gastro.2015.07.054.

Madani S, Cortes O, Thomas R. Cyproheptadine use in children with functional gastrointestinal disorders. J. Pediatr. Gastroenterol. Nutr .2016;62 409-13.

Mearin F, Ciriza C, Mínguez M, Rey E, Mascort JJ, Peña E, et al. Guía de Práctica Clínica: Síndrome del intestino irritable con estreñimiento y estreñimiento funcional en adultos. Rev. Esp. Enferm. Dig. (Madrid). 2016;108 (6):332-63. 1130-0108/2016/108/6/332-363.

Enlaces refback

No hay ningún enlace refback.

Esta obra está bajo una licencia de Creative Commons Reconocimiento-NoComercial 4.0 Internacional.