ABSTRACT
<p><b>OBJECTIVE</b>To evaluate the clinical effect of traditional Chinese spinal orthopedic manipulation (TCSOM) in treating patients with functional abdominal pain syndrome (FAPS) in comparison with Pinaverium Bromide (Dicetel, PBD), and to assess a possible cause for FAPS.</p><p><b>METHODS</b>Eighty patients with FAPS were randomly and equally assigned to the TCSOM group and PBD group according to the random number table. All patients in the TCSOM group were treated with a maximum of 5 times of spinal manipulations. Patients in the PBD group were instructed to take 50 mg 3 times a day, consistently for 2 weeks. The symptoms of pre- and post-treatment were assessed on a visual analog scale (VAS) pain score. A symptom improvement rating (SIR) was implemented to evaluate the effects of the treatments.</p><p><b>RESULTS</b>The symptoms of 27 cases of the TCSOM group were relieved soon after the first TCSOM treatment and 9 cases were significantly improved. The VAS pain scores in the TCSOM group were significantly lower than those in the PBD group after 2 weeks treatment. According to the SIR based on VAS, the TCSOM group included 30 cases with excellent results, 7 cases with good, and 3 cases with poor. Adverse events to the treatment were not reported. Based on VAS, the PBD group reported 8 cases with excellent results, 10 cases with good and 22 cases with poor. There was a significant difference between the two groups (P<0.01).</p><p><b>CONCLUSIONS</b>The displacement of intervertebral discs and/or vertebra in the thoracic or lumbar region seems to be a contributing factor in the symptoms of FAPS. TCSOM is an effective treatment for FAPS.</p>
ABSTRACT
Background: Chronic abdominal pain (CAP) is a prevalent condition with a wide etiology and is often associated with significant health care utilization. A functional diagnosis, particularly, Functional abdominal pain syndrome (FAPS) is more challenging and has been a less extensively studied condition in adults as compared to other common functional gastrointestinal disorders. Hence, this study attempts to formulate a definite line of investigations, study various causes of chronic abdominal pain and to evaluate FAPS, in a population from Central India. Methods: 100 patients in the age-group of 10-60 years with chronic abdominal pain were selected. A careful history, clinical examination and investigations were performed and final diagnosis was made on the basis of the available data. Results: Eighty-nine out of hundred patients were found to be having some organic disorder causing CAP while eleven had functional gastrointestinal disorders. FAPS was diagnosed in three patients on the basis of Rome III diagnostic criteria while one had unspecified functional abdominal pain. Conclusions: CAP is a multifactorial condition yet, a thorough history coupled with a complete physical examination and investigative profile help to a great extent in diagnosing the cause. FAPS should be diagnosed on the basis of a careful clinical history and characteristic pain behaviour during physical examination. A cost-effective and conservative approach should be adopted for investigations. Unlike the organic causes, FAPS should be treated with a biopsychosocial approach with a variable combination of pharmacological, cognitive-behavioural and psychological interventions.
ABSTRACT
The thoracic splanchnic nerve block has been used in managing abdominal pain, especially for pains arising from abdominal cancers. A 27-year-old male patient who had a constant abdominal pain was referred to our clinic for pain management but had no organic disease. The numeric rating scale (NRS) for pain scored 7/10. We applied a diagnostic thoracic splanchnic nerve block under the diagnosis of functional abdominal pain syndrome. Since the block reduced the pain, we applied a radiofrequency thermocoagulation at the T11 and T12 vertebral level. Thereafter, his symptoms improved markedly with pain decreasing to an NRS score of 2-3/10. Hereby, we report a successful management of functional abdominal pain via radiofrequency thermocoagulation of the thoracic splanchnic nerves.
Subject(s)
Adult , Humans , Male , Abdominal Pain , Electrocoagulation , Pain Management , Splanchnic NervesABSTRACT
[Background]Functional abdominal pain syndrome (FAPS) represents a chronic pain disorder localized in the abdomen and the symptoms largely are unrelated to food intake and defecation, which differ from other painful functional gastrointestinal disorders.<BR>We report a case of FAPS whose symptom was successfully improved by acupuncture.<BR>[Case Report]A 75-year-old female had been hospitalized at Meiji University of Integrative Medicine Hospital because of left lower abdominal pain from which she had repeatedly suffered for more than 2 years. Despite strict medication, her symptom had not been improved. After admission to the hospital, according to recommendation by her physician, acupuncture treatment was started. The patient received TCM-based acupuncture treatments five times a week over 13weeks. Primary acupuncture points used for the patient were LV3(Taichong), SP6 (Sanyinjiao), ST36 (Zusanli) and PC6 (Neiguan). Evaluation of the left lower abdominal pain was carried out with a Visual Analogue Scale (VAS). The Gastrointestinal Symptom Rating Scale (GSRS) was used to evaluate QOL related to the digestive symptoms. VAS for the left lower abdominal pain showed a remarkable decrease immediately after the initial acupuncture session. The symptom disappeared within 4 weeks after commencement of the treatment and never appeared during her hospitalization. GSRS was also improved and it was maintained during hospitalization.<BR>[Conclusion]We suggested that acupuncture treatment might be one of the useful, non-pharmacological alternatives for symptoms of FAPS.