Non-pharmacologic Approaches to Treatment of Pediatric Functional Abdominal Pain Disorders

Functional abdominal pain disorders (FAPDs) affect up to 25% of children in the United States. These disorders are more recently known as disorders of brain-gut interaction. The diagnosis is based on the ROME IV criteria, and requires the absence of an organic condition to explain the symptoms. Although these disorders are not completely understood, several factors have been involved in the pathophysiology including disordered gut motility, visceral hypersensitivity, allergies, anxiety/stress, gastrointestinal infection/inflammation, as well dysbiosis of the gut microbiome. The pharmacologic and non-pharmacologic treatments for FAPDs are directed to modifying these pathophysiologic mechanisms. This review aims to summarize the non-pharmacologic interventions used in the treatment of FAPDs including dietary modifications, manipulation of the gut microbiome (neutraceuticals, prebiotics, probiotics, synbiotics and fecal microbiota transplant) and psychological interventions that addresses the brain component of the brain-gut axis (cognitive behavioral therapy, hypnotherapy, breathing and relaxation techniques). In a survey conducted at a large academic pediatric gastroenterology center, 96% of patients with functional pain disorders reported using at least 1 complementary and alternative medicine treatment to ameliorate symptoms. The paucity of data supporting most of the therapies discussed in this review underscores the need for large randomized controlled trials to assess their efficacy and superiority compared to other treatments

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Artículo (Entremeses

Recetas médicas para nuestro lenguaje enfermo. Con un pequeño glosario de dudas y dificultades inglés-español para dismorfólogos, teratólogos y médicos afines

Artículo especialN

Medicine in the literature [reply]

Medicine in the literature [reply

Recetas médicas para nuestro lenguaje enfermo

Primero de una serie de tres artículos en los que el autor expone y comenta algunos de los principales errores del lenguaje médico en español y el modo de evitarlos en las publicaciones médicas especializadas. El uso incorrecto del lenguaje en medicina no es una mera cuestión de purismo lingüístico, sino que afecta seriamente, por introducir graves imprecisiones y restar claridad, a nuestro lenguaje especializado. A partir de ejemplos reales tomados de revistas médicas en español, el autor pasa revista a algunos de los errores más graves del lenguaje médico, que atentan contra los tres rasgos esenciales que deben caracterizar a todo lenguaje científico: la veracidad, la precisión y la claridad. La exposición teórica se complementa con una pequeña selección bibliográfica sobre la redacción y lenguaje médicos, así como un amplio glosario inglés-español con dos centenares de palabras y expresiones inglesas de traducción difícil o engañosa en pediatría. El especialista encontrará en este glosario términos como abuse, acetaminophen, borderline, BRAT diet, cerebral palsy, child life, FLK, follow-up milk, immunization, infant, isolette, parent, pediatric age, percentile, recumbent length, respiratory distress syndrome, shaken baby syndrome, surfactant, toilet training, tweenager, unthriftiness o young children, entre otros muchos de traducción no tan sencilla como a primera vista podría parecer.This is the first of a series of three papers where the author explains and comments some of the most important mistakes of the Spanish medical language, and the way to avoid them in the specialized medical publications. The incorrect use of language in medicine is not just a question of linguistic purism, but it seriously damages our specialised language through the introduction of important imprecision and minimizing clarity. Starting with some real examples taken from medical journals in Spanish, the author checks some of the more serious mistakes of medical language; they attack the three essential features that should characterize every scientific language: truthfulness, precision and clarity. The theoretical presentation is completed with a bibliographic selection on writing and medical language, as well as a wide English-Spanish glossary of terms with over two hundred words and English expressions of difficult or misleading translation in paediatrics. The specialist will find in this glossary terms such as abuse, acetaminophen, borderline, BRAT diet, cerebral palsy, child life, FLK, follow-up milk, immunization, infant, isolette, parent, pediatric age, percentile, recumbent length, respiratory distress syndrome, shaken baby syndrome, surfactant, toilet training, tweenager, unthriftiness or young children, among many others of not so easy translation as at first sight it could seem