Ugur Halac1, Angela Noble, Christophe Faure. 1. Division of Gastroenterology, Department of Pediatrics, Hôpital Sainte-Justine, Université de Montréal, Montréal, QC, Canada.
Abstract
OBJECTIVE: To evaluate the diagnostic value of the rectal sensory threshold for pain (RSTP) in children and adolescents with chronic abdominal pain. STUDY DESIGN: Fifty-one patients (25 girls; median age 14.2 years; range 8.4-17.6) with abdominal pain >2 months underwent a series of rectal distensions with an electronic barostat. RSTP and viscerosomatic referrals were assessed. Three months after the barostat, the final diagnosis was documented. RESULTS: Thirty-five patients had a functional gastrointestinal disorder (FGID) (irritable bowel syndrome or functional abdominal pain), and 16 had an organic disease. RSTP was lower in the FGID group than in the organic disease group (25.4mm Hg vs 37.1mm Hg; P = .0002). At the cutoff of 30mm Hg, the RSTP measurement for the diagnosis of FGID had a sensitivity of 94% and a specificity of 77%. Both groups similarly reported aberrant viscerosomatic projections. CONCLUSION: In children, RSTP is a diagnostic marker of irritable bowel syndrome and functional abdominal pain. Viscerosomatic referrals are similar in children with FGID and organic diseases.
OBJECTIVE: To evaluate the diagnostic value of the rectal sensory threshold for pain (RSTP) in children and adolescents with chronic abdominal pain. STUDY DESIGN: Fifty-one patients (25 girls; median age 14.2 years; range 8.4-17.6) with abdominal pain >2 months underwent a series of rectal distensions with an electronic barostat. RSTP and viscerosomatic referrals were assessed. Three months after the barostat, the final diagnosis was documented. RESULTS: Thirty-five patients had a functional gastrointestinal disorder (FGID) (irritable bowel syndrome or functional abdominal pain), and 16 had an organic disease. RSTP was lower in the FGID group than in the organic disease group (25.4mm Hg vs 37.1mm Hg; P = .0002). At the cutoff of 30mm Hg, the RSTP measurement for the diagnosis of FGID had a sensitivity of 94% and a specificity of 77%. Both groups similarly reported aberrant viscerosomatic projections. CONCLUSION: In children, RSTP is a diagnostic marker of irritable bowel syndrome and functional abdominal pain. Viscerosomatic referrals are similar in children with FGID and organic diseases.
Authors: Maria Luísa Cordeiro Santos; Ronaldo Teixeira da Silva Júnior; Breno Bittencourt de Brito; Filipe Antônio França da Silva; Hanna Santos Marques; Vinícius Lima de Souza Gonçalves; Talita Costa Dos Santos; Carolina Ladeia Cirne; Natália Oliveira E Silva; Márcio Vasconcelos Oliveira; Fabrício Freire de Melo Journal: World J Clin Pediatr Date: 2022-03-09