2012
DOI: 10.1053/j.gastro.2011.12.043
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Pediatric Patients With Dyspepsia Have Chronic Symptoms, Anxiety, and Lower Quality of Life as Adolescents and Adults

Abstract: Background & Aims Little is known about long-term health outcomes of children with dyspeptic symptoms. We studied the natural history of pediatric patients with dyspeptic symptoms, with and without histologic reflux, compared to healthy controls. Methods We performed a prospective study of consecutive new patients, ages 8–16 years, who underwent evaluation for dyspepsia, including upper endoscopy. Patients were assigned to groups with histologic evidence of reflux esophagitis (n=50), or normal histology resu… Show more

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Cited by 40 publications
(37 citation statements)
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“…Wendt, Neubert, Koenig, Thayer & Hamm [55] (p. 1161) postulated that resting HRV “may reflect the capacity of the prefrontal cortex to inhibit subcortical fear response in the presence of safety or when former threat cues are presented in the absence of threat,” and Pappens et al [28] (p. 9) speculated that low resting HRV might reflect subcortical “hard-wired defensive responding.” Thus, low resting HRV among the young women with persistent pain may reflect continuous difficulty adapting to routine changes in internal and external demands. The parasympathetic branch of the ANS is a “rest and digest” system that plays a restorative role during states of safety [31]; that is, application of the parasympathetic action puts a break on heart rate whereas withdrawal acts like an accelerator. Future research will need to address the question of whether ANS dysfunction, in the form of dominant sympathetic activation in the context of reduced parasympathetic activation, was present in childhood before symptoms of FAP occurred, and might even have contributed to the development and persistence of FAP or, alternatively, emerged subsequent to years of chronic pain.…”
Section: Discussionmentioning
confidence: 99%
See 1 more Smart Citation
“…Wendt, Neubert, Koenig, Thayer & Hamm [55] (p. 1161) postulated that resting HRV “may reflect the capacity of the prefrontal cortex to inhibit subcortical fear response in the presence of safety or when former threat cues are presented in the absence of threat,” and Pappens et al [28] (p. 9) speculated that low resting HRV might reflect subcortical “hard-wired defensive responding.” Thus, low resting HRV among the young women with persistent pain may reflect continuous difficulty adapting to routine changes in internal and external demands. The parasympathetic branch of the ANS is a “rest and digest” system that plays a restorative role during states of safety [31]; that is, application of the parasympathetic action puts a break on heart rate whereas withdrawal acts like an accelerator. Future research will need to address the question of whether ANS dysfunction, in the form of dominant sympathetic activation in the context of reduced parasympathetic activation, was present in childhood before symptoms of FAP occurred, and might even have contributed to the development and persistence of FAP or, alternatively, emerged subsequent to years of chronic pain.…”
Section: Discussionmentioning
confidence: 99%
“…The ANS is the primary pathway in brain-gut communication [21, 45], making it particularly relevant to gastrointestinal disorders, such as irritable bowel syndrome (IBS), characterized by functional abdominal pain (FAP). FAP often begins in childhood and may persist into adulthood [18, 26, 31, 33, 52]. …”
Section: Introductionmentioning
confidence: 99%
“…24, 25 The total scores range from 0–60 with higher scores reflecting higher levels of perceived disability. 24, 26 …”
Section: Methodsmentioning
confidence: 99%
“…Several pathophysiologic mechanisms in FD, including delayed impaired gastric emptying or accommodation, hypersensitivity to duodenal lipid or acid exposure, abnormal duodeno‐jejunal motility and visceral hypersensitivity have been proposed . In addition, psychological distress such as anxiety and depression is associated with children with FD having lower quality of life scores and morbidity progressing into early adulthood . Duodenal eosinophilia was observed in 71–95% of paediatric FD patients , but whether this represents true pathology is yet to be confirmed.…”
Section: Introductionmentioning
confidence: 99%