Risk Factors for Transition of Care in Disorders of Gut-Brain Interaction: A Narrative Review and Expert Opinion.

IF 2.1 4区 医学 Q2 PEDIATRICS
Miguel Saps, Samantha Arrizabalo, Jose M Garza
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Abstract

Background: Disorders of gut-brain interaction (DGBI) have a significant impact on the quality of life of children and families. Forty percent of children with recurrent abdominal pain continue to have symptoms into adulthood. Specialized programs for the transition of adolescents with DGBI to adult care are scarce. There are no widely accepted guidelines for transition of care. Identifying risk factors for persistence of symptoms into adulthood is key to identifying the optimal population that should be part of such programs and guidelines design.

Methods: A narrative comprehensive review was conducted using predefined keywords to identify risk factors for persistent DGBI in children/adolescents.

Results: Female sex, psychological distress, family history of DGBI, and certain comorbidities had stronger evidence for persistence, whereas other risk factors rely on limited data.

Conclusions: It is suggested that transition programs should focus on adolescents presenting with multiple coexisting risk factors. The program should at least include pediatric and adult neurogastroenterologists, dieticians, psychologists, and social workers. Tertiary prevention through psychological support, school-based programs, and management of anxiety and sleep disturbances may reduce the persistence of symptoms. Prospective studies should refine risk stratification and guide transition strategies.

Abstract Image

Abstract Image

肠-脑相互作用障碍护理转移的危险因素:叙述回顾和专家意见。
背景:肠脑相互作用障碍(DGBI)对儿童及其家庭的生活质量有显著影响。40%患有复发性腹痛的儿童成年后仍有症状。为有DGBI的青少年过渡到成人护理的专门方案很少。目前还没有被广泛接受的护理转移指南。确定症状持续到成年的危险因素是确定最佳人群的关键,这些人群应该成为此类规划和指南设计的一部分。方法:使用预定义的关键词进行叙述性综合评价,以确定儿童/青少年持续性DGBI的危险因素。结果:女性、心理困扰、DGBI家族史和某些合并症具有较强的持续性证据,而其他危险因素依赖于有限的数据。结论:建议对有多重危险因素并存的青少年进行转学治疗。该计划至少应该包括儿童和成人神经胃肠病学家、营养师、心理学家和社会工作者。通过心理支持、校本项目、焦虑和睡眠障碍管理的三级预防可以减少症状的持续。前瞻性研究应细化风险分层并指导过渡策略。
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来源期刊
Children-Basel
Children-Basel PEDIATRICS-
CiteScore
2.70
自引率
16.70%
发文量
1735
审稿时长
6 weeks
期刊介绍: Children is an international, open access journal dedicated to a streamlined, yet scientifically rigorous, dissemination of peer-reviewed science related to childhood health and disease in developed and developing countries. The publication focuses on sharing clinical, epidemiological and translational science relevant to children’s health. Moreover, the primary goals of the publication are to highlight under‑represented pediatric disciplines, to emphasize interdisciplinary research and to disseminate advances in knowledge in global child health. In addition to original research, the journal publishes expert editorials and commentaries, clinical case reports, and insightful communications reflecting the latest developments in pediatric medicine. By publishing meritorious articles as soon as the editorial review process is completed, rather than at predefined intervals, Children also permits rapid open access sharing of new information, allowing us to reach the broadest audience in the most expedient fashion.
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