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Psycho-autonomic peculiarities in children with syndrome of irritable bowel syndrome


Author: Viorica Pleşca
Degree:doctor of medicine
Speciality: 14.00.09 - Pediatrics
Year:2007
Scientific adviser: Ion Mihu
doctor habilitat, professor, Public Medical Sanitary Intitution Scientific Research Institute of Mother and Child Health Care
Scientific consultant: Ion Moldovanu
doctor habilitat, professor,
Institution:
Scientific council:

Status

The thesis was presented on the 26 December, 2006
Approved by NCAA on the 1 March, 2007

Abstract

Adobe PDF document – 0.28 Mb / in romanian

Thesis

CZU 616.34-002-053.2/616-85

Adobe PDF document 2.36 Mb / in romanian
158 pages

Keywords

children, IBS, constipation, abdomenalgia, diarrhea, autonomic nervous system, MMPI, autonomic motor profile, hyperventilation, symptomatic, psychotropic, placebo

Summary

The present work shows the results of investigations of 180 children from 10 to 14 years, from whom a group of children with IBS was selected: children with chronic gastroduodenitis in stage of acutization, and healthy children. It was determined that the most important factors of predisposition or "trigger" events are the factors that are the result of socio-familial ecosystem of the child, educational circumstances, environmental stress, taking of antibiotics in the first year of life and improper nutrition.

Concerning children's age, especially in pubertal period and adolescence, the variant of evaluation of threshold of viscero-intestinal sensibility was developed, using the test of balloon dilatation, and it was discovered that children with irritable bowel syndrome presented viscero-intestinal hypersensibility which is not related to specific clinical manifestation, but which is correlated to disorders of nociceptive system of hyperalgesia and allodinia type. To determine relations between viscreo-intestinal system, muscular-skeletal pain threshold and neuro-muscular excitability, authors affirm that in children with IBS the threshold of perceptions and viscero-intestinal pain is reduced, which is accompanied by phenomena of hyperalgesia and allodinia, which evolve against a background of general painful hypersensibility.

Abdomenalgia with disorders of intestinal transit in children with IBS evolves against a neurotic background, with depressive disorders, with a prone to anxiety and hypochondria, long term persistence, which leads to worsening of psychopathological traits of personality. Using autonomic motor profile, it was established that gastrointestinal disorders that are characteristics of this syndrome are not isolated, but make up a part of complex pattern of psycho-autonomic disorders dominated by manifestations of general brain symptomatology, emotional and painful disorders, and temperature sensibility, hyperventilation, which make diagnosis more exact and determine a selection of treatment.

The protocols of treatment of children with irritable bowel syndrome should contain psychotropic drugs, selected taking into account peculiarities of psycho-autonomic status.