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Lee SB, Chae HW, Kwon JW, Sung S, Moon SH, Suk KS, Kim HS, Park SY, Lee BH. Association of Functional Gastrointestinal Disorders with Adolescent Idiopathic Scoliosis. CHILDREN (BASEL, SWITZERLAND) 2024; 11:118. [PMID: 38255431 PMCID: PMC10814149 DOI: 10.3390/children11010118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 01/03/2024] [Accepted: 01/15/2024] [Indexed: 01/24/2024]
Abstract
Numerous adolescents diagnosed with adolescent idiopathic scoliosis (AIS) often manifest symptoms indicative of functional gastrointestinal disorders (FGIDs). However, the precise connection between FGIDs and AIS remains unclear. The study involved adolescents drawn from sample datasets provided by the Korean Health Insurance Review and Assessment Service spanning from 2012 to 2016, with a median dataset size of 1,446,632 patients. The AIS group consisted of individuals aged 10 to 19 with diagnostic codes for AIS, while the control group consisted of those without AIS diagnostic codes. The median prevalence of FGIDs in adolescents with AIS from 2012 to 2016 was 24%. When accounting for confounding factors, the analysis revealed that adolescents with AIS were consistently more prone to experiencing FGIDs each year (2012: adjusted odds ratio (aOR), 1.21 [95% confidence interval (CI), 1.10-1.35], p < 0.001; 2013: aOR, 1.31 [95% CI, 1.18-1.46], p < 0.001; 2014: aOR, 1.24 [95% CI, 1.12-1.38], p < 0.001; 2015: aOR, 1.34 [95% CI, 1.21-1.49], p < 0.001; and 2016: aOR, 1.35 [95% CI, 1.21-1.50], p < 0.001). These findings suggest that AIS is correlated with an elevated likelihood of FGIDs, indicating that AIS may function as a potential risk factor for these gastrointestinal issues. Consequently, it is recommended to provide counseling to adolescents with AIS, alerting them to the heightened probability of experiencing chronic gastrointestinal symptoms.
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Affiliation(s)
- Soo-Bin Lee
- Department of Orthopedic Surgery, Catholic Kwandong University International St. Mary’s Hospital, Incheon 22711, Republic of Korea;
| | - Hyun-Wook Chae
- Department of Pediatrics, Yonsei University College of Medicine, Seoul 03722, Republic of Korea;
| | - Ji-Won Kwon
- Department of Orthopedic Surgery, Yonsei University College of Medicine, Seoul 03722, Republic of Korea; (J.-W.K.); (S.-H.M.); (K.-S.S.); (H.-S.K.); (S.-Y.P.)
| | - Sahyun Sung
- Department of Orthopedic Surgery, Ewha Womans University Seoul Hospital, Seoul 07804, Republic of Korea;
| | - Seong-Hwan Moon
- Department of Orthopedic Surgery, Yonsei University College of Medicine, Seoul 03722, Republic of Korea; (J.-W.K.); (S.-H.M.); (K.-S.S.); (H.-S.K.); (S.-Y.P.)
| | - Kyung-Soo Suk
- Department of Orthopedic Surgery, Yonsei University College of Medicine, Seoul 03722, Republic of Korea; (J.-W.K.); (S.-H.M.); (K.-S.S.); (H.-S.K.); (S.-Y.P.)
| | - Hak-Sun Kim
- Department of Orthopedic Surgery, Yonsei University College of Medicine, Seoul 03722, Republic of Korea; (J.-W.K.); (S.-H.M.); (K.-S.S.); (H.-S.K.); (S.-Y.P.)
| | - Si-Young Park
- Department of Orthopedic Surgery, Yonsei University College of Medicine, Seoul 03722, Republic of Korea; (J.-W.K.); (S.-H.M.); (K.-S.S.); (H.-S.K.); (S.-Y.P.)
| | - Byung Ho Lee
- Department of Orthopedic Surgery, Yonsei University College of Medicine, Seoul 03722, Republic of Korea; (J.-W.K.); (S.-H.M.); (K.-S.S.); (H.-S.K.); (S.-Y.P.)
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Newton E, Schosheim A, Patel S, Chitkara DK, van Tilburg MAL. The role of psychological factors in pediatric functional abdominal pain disorders. Neurogastroenterol Motil 2019; 31:e13538. [PMID: 30729663 DOI: 10.1111/nmo.13538] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 12/07/2018] [Accepted: 12/07/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND Pediatric functional abdominal pain disorders (FAPDs) are disorders of brain-gut dysregulation. Psychological factors are known to be related to etiology, maintenance, and exacerbation of pediatric FAPDs. With the evolving literature in the past two decades, a better understanding has emerged of precisely which psychological factors are associated with childhood FAPDs. PURPOSE This narrative literature review summarizes the literature of both child and parent psychological factors in pediatric FAPD. Where anxiety and depression were major targets in the older literature, present-day focus is increasingly on pain-specific cognitions and coping strategies including disease threat and catastrophizing. In addition, parental reaction to a child's pain is increasingly recognized as an important moderator of a child's outcomes and has become an area for clinical intervention. Screening for these factors and integrative treatment approaches are recommended in childhood FAPD.
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Affiliation(s)
- Emily Newton
- Department of Clinical Research, College of Pharmacy and Health Sciences, Campbell University, Buies Creek, North Carolina
| | - Alex Schosheim
- Department of Pediatric Gastroenterology, Stony Brook University Hospital, Stony Brook, New York
| | - Samit Patel
- Department of Pediatric Gastroenterology, Arnold Palmer Hospital, Orlando, Florida
| | - Denesh K Chitkara
- Department of Pediatric Gastroenterology, Saint Peters University Hospital, New Brunswick, New Jersey
| | - Miranda A L van Tilburg
- Department of Clinical Research, College of Pharmacy and Health Sciences, Campbell University, Buies Creek, North Carolina
- Division of Gastroenterology and Hepatology, Department of Medicine, University of North Carolina, Chapel Hill, North Carolina
- School of Social work, University of Washington, Seattle, Washington
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Yoga for Teens With Irritable Bowel Syndrome: Results From a Mixed-Methods Pilot Study. Holist Nurs Pract 2018; 32:253-260. [PMID: 30113959 DOI: 10.1097/hnp.0000000000000288] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Irritable bowel syndrome (IBS) is a common condition associated with recurrent abdominal pain and altered bowel habits. It is particularly pernicious to youth, who may withdraw from life tasks due to pain, diarrhea, and/or fear of symptoms. Emotional stress exacerbates IBS symptoms, and mind-body interventions may be beneficial. In this mixed-methods study of 18 teens aged 14 to 17 years undertaking a 6-week Iyengar yoga intervention, we aimed to identify treatment responders and to explore differences between responders and nonresponders on a range of quantitative outcomes and qualitative themes related to yoga impact, goodness of fit, and barriers to treatment. Half of the teens responded successfully to yoga, defined as a clinically meaningful reduction in abdominal pain. Responders differed from nonresponders on postintervention quantitative outcomes, including reduced abdominal pain, improved sleep, and increased visceral sensitivity. Qualitative outcomes revealed that responders reported generalized benefits early in treatment and that their parents were supportive and committed to the intervention. Responders and nonresponders alike noted the importance of home practice to achieve maximal, sustained benefits. This study reveals the need for developmentally sensitive yoga programs that increase accessibility of yoga for all patients.
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Casaña-Granell S, Lacomba-Trejo L, Valero-Moreno S, Prado-Gasco V, Montoya-Castilla I, Pérez-Marín M. A brief version of the Pediatric Inventory for Parents (PIP) in Spanish population: Stress of main family carers of chronic paediatric patients. PLoS One 2018; 13:e0201390. [PMID: 30048532 PMCID: PMC6062103 DOI: 10.1371/journal.pone.0201390] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 07/13/2018] [Indexed: 02/07/2023] Open
Abstract
A chronic illness in childhood has a negative impact on the paediatric patient and on family functioning. Psychological stress in parents influences the level of adjustment to the illness of their children. The Pediatric Inventory for Parents (PIP) was designed to measure stress in parents whose child has a chronic illness or requires prolonged medical monitoring. The main objective of this study is to provide a brief version of the Spanish translation of the PIP, across a sample consisting of 465 main familial caregivers (85.2% female, n = 396) between 27 and 67 years old ( X¯ = 44.13; SD = 5.35) of paediatric patients between 9 and 18 years old ( X¯ = 12.10, SD = 2.20; 56.8% men, n = 264) diagnosed with diabetes mellitus type I (20.9% of the sample; n = 97), short stature (32.5% of the sample; n = 151), or a chronic respiratory disease (asthma, cystic fibrosis, bronchiolitis obliterans and bronchiectasis) (46.6% of the sample; n = 217). After performing several EFAs (Exploratory Factor Analyses) and CFAs (Confirmatory Factorial Analyses), it was decided that 30 items need to be removed. Reliability and validity results suggest that the new 12-item version possesses appropriate psychometric properties. Cronbach’s alpha value ranging between α = .42 and α = .81 and fit values obtained indicate a good fit: χ2/df (88.393/48) = 1.84 (α < .01); S-B χ2(df) = 88.393 (48); CFI = .95; IFI = .95; RMSEA = .05 (.033 - .074) for the frequency scales and χ2/df (72.002/48) = 1.5 (α < .01); S-Bχ2(df) = 72.002 (48); CFI = .97; IFI = .97; RMSEA = .04 (.011 - .063) for the difficulty scales. The PIP also showed predictive ability in regards to anxiety and depression, a positive relationship between the instrument's own scales and a negative relationship with the caregiver's age. Finally, depending on the paediatric patient's diagnosis, differences in stress levels were found.
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Affiliation(s)
- Sara Casaña-Granell
- Departament of Personality, Assessment and Psychological Treatments, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - Laura Lacomba-Trejo
- Departament of Personality, Assessment and Psychological Treatments, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - Selene Valero-Moreno
- Departament of Personality, Assessment and Psychological Treatments, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - Vicente Prado-Gasco
- Departament of Personality, Assessment and Psychological Treatments, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - Inmaculada Montoya-Castilla
- Departament of Personality, Assessment and Psychological Treatments, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - Marián Pérez-Marín
- Departament of Personality, Assessment and Psychological Treatments, Faculty of Psychology, University of Valencia, Valencia, Spain
- * E-mail:
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Oudenhove LV, Levy RL, Crowell MD, Drossman DA, Halpert AD, Keefer L, Lackner JM, Murphy TB, Naliboff BD. Biopsychosocial Aspects of Functional Gastrointestinal Disorders. Gastroenterology 2016; 150:S0016-5085(16)00218-3. [PMID: 27144624 PMCID: PMC8809487 DOI: 10.1053/j.gastro.2016.02.027] [Citation(s) in RCA: 253] [Impact Index Per Article: 31.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Accepted: 02/11/2016] [Indexed: 12/15/2022]
Abstract
In this paper, we provide a general framework for understanding the functional gastrointestinal disorders (FGID) from a biopsychosocial perspective. More specifically, we provide an overview of the recent research on how the complex interactions of environmental, psychological, and biological factors contribute to the development and maintenance of the FGID. We emphasize that considering and addressing all these factors is a conditio sine qua non for appropriate treatment of these conditions. First, we provide an overview of what is currently known about how each of these factors - the environment, including the influence of those in an individual's family, the individual's own psychological states and traits, and the individual's (neuro)physiological make-up - interact to ultimately result in the generation of FGID symptoms. Second, we provide an overview of commonly used assessment tools which can assist clinicians in obtaining a more comprehensive assessment of these factors in their patients. Finally, the broader perspective outlined earlier is applied to provide an overview of centrally acting treatment strategies, both psychological and pharmacological, which have been shown to be efficacious to treat FGID.
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Affiliation(s)
- Lukas Van Oudenhove
- Laboratory for Brain-Gut Axis Studies, Translational Research Center for Gastrointestinal Disorders, University of Leuven, Leuven, Belgium
| | - Rona L. Levy
- Behavioral Medicine Research Group, School of Social Work, University of Washington, Seattle, Washington
| | - Michael D. Crowell
- Department of Gastroenterology and Hepatology, Mayo Clinic, Scottsdale, Arizona
| | - Douglas A. Drossman
- Center for Education and Practice of Biopsychosocial Care LLC, Drossman Gastroenterology PLLC, Chapel Hill, North Carolina
| | - Albena D. Halpert
- Center for Digestive Disorders, Boston Medical Center, Pentucket Medical Associates, Haverhill, Massachusetts
| | - Laurie Keefer
- Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Jeffrey M. Lackner
- Behavioral Medicine Clinic, Department of Medicine, University at Buffalo School of Medicine and Biomedical Sciences, State University of New York, New York
| | - Tasha B. Murphy
- Behavioral Medicine Research Group, School of Social Work, University of Washington, Seattle, Washington
| | - Bruce D. Naliboff
- Center for Neurobiology of Stress, Departments of Medicine and Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at University of California, Los Angeles, California
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Frequent abdominal pain in childhood and youth: a systematic review of psychophysiological characteristics. Gastroenterol Res Pract 2014; 2014:524383. [PMID: 24744777 PMCID: PMC3976868 DOI: 10.1155/2014/524383] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Accepted: 02/05/2014] [Indexed: 12/27/2022] Open
Abstract
Background. Frequent abdominal pain (AP) in children and adolescents is often designated as functional gastrointestinal disorder. In contrast to research on psychological and social influences on the experience of AP in this population, psychophysiological features such as function of the autonomic nervous system, the central nervous system, or the endocrine system have rarely been studied. Methods. We conducted a systematic literature search for peer-reviewed journal articles referring to children with AP between 4 and 18 years. Studies on experimental baseline characteristics or reactivity of psychophysiological outcome parameters (autonomous nervous system, central nervous system, and endocrine parameters) were included. Key Results. Twelve of 18 included studies found psychophysiological differences between children with AP and healthy ones. These studies indicate a possible autonomic dysregulation and hypersensitivity of the central nervous system in children with AP following stimulation with stress or other intense stimuli. Mainly conflicting results were found regarding baseline comparisons of autonomic and endocrine parameters. Conclusions and Inferences. Frequent AP in children may be associated with an altered psychophysiological reaction on intense stimuli. It has to be considered that the current literature on psychophysiological characteristics of childhood AP is small and heterogeneous. In particular, multiparameter studies using validated experimental paradigms are lacking.
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Sato N, Suzuki N, Sasaki A, Aizawa E, Obayashi T, Kanazawa M, Mizuno T, Kano M, Aoki M, Fukudo S. Corticotropin-releasing hormone receptor 1 gene variants in irritable bowel syndrome. PLoS One 2012; 7:e42450. [PMID: 22957021 PMCID: PMC3434156 DOI: 10.1371/journal.pone.0042450] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2012] [Accepted: 07/05/2012] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Corticotropin-releasing hormone (CRH) acts mainly via the CRH receptor 1 (CRH-R1) and plays a crucial role in the stress-induced pathophysiology of irritable bowel syndrome (IBS). Several studies have demonstrated that variants of the CRH-R1 gene carry a potential risk for depression, but evidence for an association between CRH-R1 genotypes and IBS is lacking. We tested the hypothesis that genetic polymorphisms and haplotypes of CRH-R1 moderate the IBS phenotype and negative emotion in IBS patients. METHODS A total of 103 patients with IBS and 142 healthy controls participated in the study. Three single-nucleotide polymorphisms of the CRH-R1 gene (rs7209436, rs242924, and rs110402) were genotyped. Subjects' emotional states were evaluated using the Perceived-Stress Scale, the State-Trait Anxiety Inventory, and the Self-rating Depression Scale. RESULTS The TT genotype of rs7209436 (P = 0.01) and rs242924 (P = 0.02) was significantly more common in patients with IBS than in controls. Total sample analysis showed significant association between bowel pattern (normal, diarrhea, constipation, or mixed symptoms) and the T allele of rs7209436 (P = 0.008), T allele of rs242924 (P = 0.019), A allele of rs110402 (P = 0.047), and TAT haplocopies (P = 0.048). Negative emotion was not associated with the examined CRH-R1 SNPs. CONCLUSION These findings suggest that genetic polymorphisms and the CRH-R1 haplotypes moderate IBS and related bowel patterns. There was no clear association between CRH-R1 genotypes and negative emotion accompanying IBS. Further studies on the CRH system are therefore warranted.
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Affiliation(s)
- Naoko Sato
- Department of Behavioral Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Naoki Suzuki
- Department of Neurology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Ayaka Sasaki
- Department of Behavioral Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Emiko Aizawa
- Department of Behavioral Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Takeshi Obayashi
- Department of Applied Informatics for Human and Life Sciences, Tohoku University Graduate School of Information Science, Sendai, Japan
| | - Motoyori Kanazawa
- Department of Behavioral Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Tomoko Mizuno
- Department of Behavioral Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Michiko Kano
- Department of Behavioral Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Masashi Aoki
- Department of Neurology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Shin Fukudo
- Department of Behavioral Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
- * E-mail:
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