Functional abdominal pain in children

Abstract

Abdominal pain is one of the most common children’s complaints in the practice of a pediatrician and a family doctor. In most cases, the cause of chronic abdominal pain is non-organic, functional abdominal pain syndrome (FAPS) without objective signs of an underlying organic disorder. At present, among various groups of antispasmodics, selective myotropic antispasmo­dics, namely myocyte cell membrane fast sodium channel blockers (mebeverine), are chosen for the treatment of functional gastrointestinal disorders. In clinical practice, mebeverine hydrochloride (SPARK®, JSC Farmak) is of interest for the treatment of patients with abdominal pain. SPARK® is available in capsules; one capsule contains 200 mg of mebeverine hydrochloride. The pathogenetically justified indication of mebeverine is a relief of chronic abdominal pain in adults and children over 10 years. The drug has no systemic effects. The efficacy of SPARK® (mebeverine) for FAPS in children was studied in the gastroenterological department of the Children’s Clinical Hospital No. 19 in Kharkiv. Forty-four children aged 10 to 18 years with FAPS were examined. The functional pathologies included: functional dyspepsia (FD) — 54.1 %, irritable bowel syndrome (IBS) — 20.8 %, functional biliary disorders (FBD) — 79.2 %; FD + FBD — 34.1 %, FD + IBS — 16 %, FBD + IBS — 8.3 %. The diagnosis was verified according to unified treatment protocols. The patients received a comprehensive pathogenetic therapy and a selective antispasmodic, SPARK®, 1 capsule twice daily for seven days. The pain syndrome was evaluated at admission and every day during the observation period [17]. A numerical pain rating scale was used to assess pain intensity. A tendency towards abdominal pain relief was observed in all patients from the study group; children with mild pain did not report abdominal pain from day 5 of therapy and patients with moderate pain — from day 6. The pain persisted longer, up to 7 days, in children with severe pain. Therefore, abdominal pain is one of the most common and complex problems in medical practice. It mostly occurs in functional gastrointestinal disorders. The use of selective myotropic antispasmodics (mebeverine) to relieve abdominal pain is pathogenetically justified. The results obtained showed the efficacy of SPARK® in the treatment of functional abdominal pain in children. Side effects and allergic reactions to the drug were not observed. Mebeverine (SPARK®) can be the drug of choice and is recommended for abdominal pain in adults and children over 10 years.

Keywords

• functional abdominal pain
• overlap syndrome
• fast sodium channel blockers