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Doctoral Thesis
DOI
https://doi.org/10.11606/T.61.2021.tde-28102021-153701
Document
Author
Full name
Eliane Alves Motta Cabello dos Santos
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
Bauru, 2021
Supervisor
Committee
Valarelli, Thais Marchini de Oliveira (President)
Almeida, Ana Lúcia Pompéia Fraga de
Salmen, Isabel Cristina Drago Marquezini
Takegawa, Bonifácio Katsunori
Title in Portuguese
Dor abdominal crônica e constipação intestinal em crianças e adolescentes com fissuras labiopalatinas
Keywords in Portuguese
Adolescentes
Constipação intestinal
Crianças
Dor abdominal
Fenda labial
Fissura palatina
Abstract in Portuguese
Esta tese teve o propósito de apresentar cinco artigos científicos, elaborados a partir da pesquisa de dois relevantes distúrbios do trato gastrointestinal (Dor Abdominal Crônica e Constipação Intestinal) em crianças e adolescentes com e sem fissuras labiopalatinas (FLP). Artigo 1 - Revisão crítica da literatura abrangendo aspectos etiológicos, epidemiológicos, diagnósticos e de tratamento das FLP. Artigo 2 - Revisão bibliográfica referente à Dor Abdominal Crônica (DAC) em pediatria. Artigo 3 - Trabalho de revisão da Constipação Intestinal pediátrica, com foco na etiologia funcional. Artigo 4 - Comparação da prevalência de DAC em crianças e adolescentes com e sem FLP. Estudo transversal comparativo, com 400 pacientes de 4 a 18 anos de idade, divididos nos grupos com FLP e sem FLP. Os pais responderam questões baseadas nos critérios de Apley e Naish para o diagnóstico de DAC. As prevalências de DAC foram comparadas através do teste de Qui-quadrado (p<0,05%). A DAC teve prevalência de 36,50% entre os participantes com FLP e de 15,00% no grupo sem FLP (p<0,001). Os pacientes com FLP e DAC tiveram maior propensão ao uso de medicações e realização de exames complementares para a dor. O absenteísmo escolar por causa da dor foi relatado por 24,65% dos indivíduos com FLP. Crianças e adolescentes com FLP têm prevalência de DAC maior que a população sem fissuras. Artigo 5 - Comparação da prevalência de Constipação Intestinal Funcional (CIF) em indivíduos com e sem FLP. Estudo observacional retrospectivo com participantes de 4 a 18 anos de idade. Os pais responderam a questões com base nos critérios de ROMA IV para o diagnóstico de CIF. Os grupos foram comparados quanto à prevalência de CI pelo teste de Qui-quadrado (p<0,05). Participaram do estudo 400 indivíduos, sendo 200 em cada grupo. A prevalência de CIF no grupo com FLP foi de 24,50 % e no grupo sem FLP foi de 18,50% (p=0,181). Quase um quarto dos participantes com FLP apresentaram CIF, sem diferença significativa de prevalência entre os grupos. A presente pesquisa contribuiu para a compreensão da epidemiologia de dois relevantes distúrbios do TGI em crianças e adolescentes com FLP. DAC e CIF são de alta prevalência na população geral pediátrica e observou-se que a DAC é ainda mais prevalente nas crianças e adolescentes com FLP. Estes estudos ressaltam o conceito de que o paciente com FLP deve ser visto sob um contexto mais amplo, que vai além das malformações faciais.
Title in English
Chronic abdominal pain and constipation in children and adolescents with cleft lip and/or palate
Keywords in English
Abdominal pain
Adolescents
Children
Cleft lip
Cleft palate
Intestinal constipation
Abstract in English
The aim of the current thesis was to present five scientific articles. The studies were developed based on the research of two gastrointestinal tract relevant disorders (Chronic Abdominal Pain and Functional Constipation), in children and adolescents with and without cleft lip and/or palate (CL/P). Article 1 - Critical review of the literature concerning to the etiological, epidemiological, diagnosis, and treatment aspects of CL/P. Article 2 - A review paper on Chronic Abdominal Pain (CAP) in children and adolescents. Article 3 - A review study on constipation in children and adolescents, focusing on functional constipation (FC). Article 4 - A study comparing CAP prevalence in children and adolescents with and without CL/P. A Cross-sectional study with 400 participants aged from 4 to 18 years, divided into two groups: with and without CL/P. The parents answered questions based on the Apley and Naish criteria for CAP diagnosis. The CAP prevalence was compared between groups using Chi-square test (p<0.05%). CAP prevalence was 36.50% among participants with CL/P and 15.00% in the group without CL/P (p<0.001). Patients with CL/P and CAP were more likely to use medications and to carry out complementary tests due to pain. School absenteeism occurred in 24.65% of individuals with CL/P. Children and adolescents with CL/P had higher CAP prevalence than the population without clefts. Article 5 - The work compared the prevalence of Functional Constipation (FC) in children and adolescents with and without CL/P. A retrospective study with 400 participants aged from 4 to 18 years were divided into two groups (n=200). The parents answered questions based on ROME IV criteria for FC diagnosis. The results were compared by Chi-square test (p<0.05). FC prevalence in individuals with CLP was 24.50% and in the group without CLP was 18.50% (p=0.181). FC prevalence was high for both groups, but without statistically significant difference. The present research contributed to the understanding of the epidemiology of two relevant gastrointestinal tract disorders in children and adolescents with CL/P. CAP and FC prevalences in general pediatric population are high. Our work found out that the CAP prevalence is even higher in patients with CL/P. We highlighted the concept that the patient with CL/P should be seen in a broader context, which goes beyond facial malformations.
 
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Publishing Date
2021-12-06
 
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