Araştırma Makalesi
BibTex RIS Kaynak Göster

Okul Çağındaki Çocuklarda Hipermobilite Spektrum Bozuklukları, Fonksiyonel Kabızlık ve İşeme Disfonksiyonu: Birbirleriyle İlişkili midir?

Yıl 2024, Cilt: 11 Sayı: 2, 76 - 81, 31.08.2024
https://doi.org/10.47572/muskutd.1416077

Öz

Hipermobilite spektrum bozuklukları, tanısı konmuş sistemik romatolojik bir hastalık olmaksızın kas-iskelet sistemi bulguları ve yaygın eklem hipermobilitesi ile kendini gösterir. Hipermobilite spektrum bozuklukları, disfonksiyonel işeme bozuklukları ve fonksiyonel kabızlık gibi klinik durumlar için risk oluşturabilir. Amacımız okul çağındaki çocuklarda hipermobilite spektrum bozuklukları, işeme disfonksiyonu ve fonksiyonel kabızlık sıklığını saptamak ve birbirleriyle ilişkilerini değerlendirmektir. Bu kesitsel çalışmaya okul çağındaki 947 çocuk (6–15 yaş) dahil edildi. Bir pediatrik romatolog tüm çocukları hipermobilite tanısı koymak için Beighton Hipermobilite Skoru kullanarak muayene etmiş ve fonksiyonel kabızlık tanısı ise bir pediatrik gastroenterolog tarafından konulmuştur. İşeme disfonksiyonu tanısını koymak için bir pediatrik nefrolog tarafından Disfonksiyonel İşeme ve İnkontinans Semptomları Skorlaması kullanılmıştır. İşeme disfonksiyonu genç yaş grubunda, anne eğitim düzeyi düşük olanlarda, gelir düzeyi düşük olanlarda ve idrar yolu enfeksiyonu öyküsü olanlarda daha sık görüldü (sırasıyla p<0.001, p=0.027, p=0.035, p<0.001). İdrar yolu enfeksiyonu öyküsü olan çocuklarda da kabızlık prevalansı daha yüksekti (p=0.001) ve kabızlık görülme sıklığı, işeme disfonksiyonu olan çocuklarda olmayanlara göre belirgin şekilde daha yüksekti (p<0.001). Hipermobilitesi olan ve olmayan çocuklar arasında işeme disfonksiyonu ve kabızlık oluşumu açısından istatistiksel olarak anlamlı bir fark bulunamadı (p>0.05). Hipermobilitesi olan çocuklarda fonksiyonel kabızlık ve işeme disfonksiyonu gibi şikayetlerin arttığı hipotezini doğrulamak için daha fazla çalışmaya ihtiyaç vardır. İşeme disfonksiyonu ve/veya idrar yolu enfeksiyonu olan çocuklarda kabızlık sorgulanmalı ve etkin bir şekilde tedavi edilmelidir.

Kaynakça

  • 1. Castori M, Tinkle B, Levy H, et al. A framework for the classification of joint hypermobility and related conditions. Am J Med Genet C Semin Med Genet. 2017;175(1):148-57.
  • 2. Bravo JF, Wolff C. Clinical study of hereditary disorders of connective tissues in a Chilean population: joint hypermobility syndrome and vascular Ehlers-Danlos syndrome. Arthritis Rheum. 2006;54(2):515–23.
  • 3. Adib N, Davis K, Grahame R, et al. Joint hypermobility syndrome in childhood. A not so benign multisystem disorder. Rheumatology. 2005;44(6):744-50.
  • 4. Juul-Kristensen B, Schmedling K, Rombaut L, et al. Measurement properties of clinical assessment methods for classifying hypermobility spectrum disordes a systematic review. Am J Med Genet Part C Semin Med Genet. 2017;175(1):116-47.
  • 5. Singh H, McKay M, Baldwin J, et al. Beighton scores and cut-offs across the lifespan: cross-sectional study of an Australian population. Rheumatology (Oxford). 2017:56(11):1857–64.
  • 6. Ting TV, Hashkes PJ, Schikler K, et al. The role of benign joint hypermobility in the pain experience in juvenile fibromyalgia: an observational study. Pediatr Rheumatol Online J. 2012;10(1):16.
  • 7. Aktas I, Ofluoglu D, Albay T. The relationship between benign joint hypermobility syndrome and carpal tunnel syndrome. Clin Rheumatol. 2008;27(10):1283-7.
  • 8. van Eerde AM, Verhoeven VJ, de Jong TP, et al. Is joint hypermobility associated with vesico-ureteral reflux? An assessment of 50 patients. BJU Int. 2012;109(8):1243-8.
  • 9. de Kort LM, Verhulst JA, Engelbert RH, et al. Lower urinary tract dysfunction in children with generalized hypermobility of joints. J Urol. 2003;170(5):1971-4.
  • 10. Reillya DJ, Chaseb JW, Hutsonb JM, et al. Connective tissue disorder—a new subgroup of boys with slow transit constipation? J Pediatr Surg. 2008;43(6):1111–4.
  • 11. Lam CY, Palsson OS, Whitehead WE, et al. Rome IV functional gastrointestinal disorders and health impairment in subjects with hypermobility spectrum disorders or hypermobile ehlers-danlos syndrome. Clin Gastroenterol Hepatol. 2021;19(2):277-87.
  • 12. Ozgenc F, Kara A, Yılmaz N, et al. Validity and reliability study of the pediatric Rome III questionnaire for Turkish children and adolescents Turk J Gastroenterol. 2016;27(2):129-35.
  • 13. Akbal C, Genc Y, Burgu B, et al. Dysfunctional voiding and incontinence scoring system: quantitative evaluation of incontinence symptoms in pediatric population. J Urol. 2005;173(3):969-73.
  • 14. Chelimsky G, Kovacic K, Simpson P, et al. Benign joint hypermobility minimally impacts autonomic abnormalities in pediatric subjects with chronic functional pain disorders. J Pediatr. 2016;177:49-52.
  • 15. Khorasgani SM, Ramezani N, Varnousfaderani NE. Joint hypermobility in children with and without functional constipation. J Res Med Sci. 2020;18:25-8.
  • 16. Velasco-Benitez CA, Axelrod C, Fernandez Valdes L, et al. Functional gastrointestinal disorders, autonomic nervous system dysfunction and joint hypermobility in children: are they related? J Pediatr. 2020;218:114-20.
  • 17. Zaleski A, Gawronska A, Albrecht P, et al. Excessive laxity of connective tissue in constipated children. Sci Rep. 2022;19;12(1):1026.
  • 18. Shulman RJ, Self MM, Czyzewski DI, et al. The Prevalence of hypermobility in children with irritable bowel syndrome and functional abdominal pain is similar to that in healthy children. J Pediatr. 2020;222:134-40.
  • 19. Malek S, Reinhold EJ, Pearce GS. The Beighton Score as a measure of generalised joint hypermobility. Rheumatol Int. 2021;41(10):1707-16.
  • 20. Kajbafzadeh AM, Sharifi-Rad L, Ladi Seyedian SS, et al. Generalized joint hipermobilty and voiding dysfunction in children, is there any relationship? Eur J Pediatr. 2014:173(2):197-201.
  • 21. Averbeck MA, Madersbacher H. Constipation and LUTS - how do they affect each other? Int Braz J Urol. 2011;37(1):16–28.
  • 22. Gilliam E, Hoffman JD, Yeh G. Urogenital and pelvic complications in the Ehlers-Danlos syndromes and associated hypermobility spectrum disorders: A scoping review. Clin Genet. 2020;97(1):168-78.

Hypermobility Spectrum Disorders, Functional Constipation and Voiding Dysfunction in School-Aged Children: Are They Related to Each Other?

Yıl 2024, Cilt: 11 Sayı: 2, 76 - 81, 31.08.2024
https://doi.org/10.47572/muskutd.1416077

Öz

Patients suffering from hypermobility spectrum disorders (HSDs) present with problems related to the musculoskeletal system and have generalized joint hypermobility without a diagnosed systemic rheumatological disease. HSDs represent an underlying risk factor for many clinical conditions, such as dysfunctional voiding disorders and functional constipation (FC). In this study, we investigated ways to detect the frequency of HSDs, voiding dysfunction (VD), and FC in school-aged children and assessed their relationship with each other. In this cross-sectional study, 947 school-aged children (6–15 years old) were included. A pediatric rheumatologist examined all children using the Beighton Hypermobility Score to diagnose hypermobility. FC was diagnosed by a pediatric gastroenterologist. The dysfunctional voiding and incontinence symptoms score questionnaire was used by a pediatric nephrologist to diagnose VD. VD was more frequently observed in the younger age group, those whose mothers had lower education levels, children from lower-income families, and those with a history of urinary tract infection (p<0.001, p=0.027, p=0.035, p<0.001, respectively). Children with a history of urinary tract infection also had a higher prevalence of constipation (p=0.001), and the incidence of constipation was significantly higher in children with VD compared to those without VD (p<0.001). The difference in the occurrence of VD and constipation between children with and without hypermobility was not significant (p > 0.05). Further studies are needed to confirm the hypothesis that problems such as FC and VD are worse in children with hypermobility. Constipation should be investigated in children suffering from VD and/or urinary tract infections for effective treatment of these diseases.

Kaynakça

  • 1. Castori M, Tinkle B, Levy H, et al. A framework for the classification of joint hypermobility and related conditions. Am J Med Genet C Semin Med Genet. 2017;175(1):148-57.
  • 2. Bravo JF, Wolff C. Clinical study of hereditary disorders of connective tissues in a Chilean population: joint hypermobility syndrome and vascular Ehlers-Danlos syndrome. Arthritis Rheum. 2006;54(2):515–23.
  • 3. Adib N, Davis K, Grahame R, et al. Joint hypermobility syndrome in childhood. A not so benign multisystem disorder. Rheumatology. 2005;44(6):744-50.
  • 4. Juul-Kristensen B, Schmedling K, Rombaut L, et al. Measurement properties of clinical assessment methods for classifying hypermobility spectrum disordes a systematic review. Am J Med Genet Part C Semin Med Genet. 2017;175(1):116-47.
  • 5. Singh H, McKay M, Baldwin J, et al. Beighton scores and cut-offs across the lifespan: cross-sectional study of an Australian population. Rheumatology (Oxford). 2017:56(11):1857–64.
  • 6. Ting TV, Hashkes PJ, Schikler K, et al. The role of benign joint hypermobility in the pain experience in juvenile fibromyalgia: an observational study. Pediatr Rheumatol Online J. 2012;10(1):16.
  • 7. Aktas I, Ofluoglu D, Albay T. The relationship between benign joint hypermobility syndrome and carpal tunnel syndrome. Clin Rheumatol. 2008;27(10):1283-7.
  • 8. van Eerde AM, Verhoeven VJ, de Jong TP, et al. Is joint hypermobility associated with vesico-ureteral reflux? An assessment of 50 patients. BJU Int. 2012;109(8):1243-8.
  • 9. de Kort LM, Verhulst JA, Engelbert RH, et al. Lower urinary tract dysfunction in children with generalized hypermobility of joints. J Urol. 2003;170(5):1971-4.
  • 10. Reillya DJ, Chaseb JW, Hutsonb JM, et al. Connective tissue disorder—a new subgroup of boys with slow transit constipation? J Pediatr Surg. 2008;43(6):1111–4.
  • 11. Lam CY, Palsson OS, Whitehead WE, et al. Rome IV functional gastrointestinal disorders and health impairment in subjects with hypermobility spectrum disorders or hypermobile ehlers-danlos syndrome. Clin Gastroenterol Hepatol. 2021;19(2):277-87.
  • 12. Ozgenc F, Kara A, Yılmaz N, et al. Validity and reliability study of the pediatric Rome III questionnaire for Turkish children and adolescents Turk J Gastroenterol. 2016;27(2):129-35.
  • 13. Akbal C, Genc Y, Burgu B, et al. Dysfunctional voiding and incontinence scoring system: quantitative evaluation of incontinence symptoms in pediatric population. J Urol. 2005;173(3):969-73.
  • 14. Chelimsky G, Kovacic K, Simpson P, et al. Benign joint hypermobility minimally impacts autonomic abnormalities in pediatric subjects with chronic functional pain disorders. J Pediatr. 2016;177:49-52.
  • 15. Khorasgani SM, Ramezani N, Varnousfaderani NE. Joint hypermobility in children with and without functional constipation. J Res Med Sci. 2020;18:25-8.
  • 16. Velasco-Benitez CA, Axelrod C, Fernandez Valdes L, et al. Functional gastrointestinal disorders, autonomic nervous system dysfunction and joint hypermobility in children: are they related? J Pediatr. 2020;218:114-20.
  • 17. Zaleski A, Gawronska A, Albrecht P, et al. Excessive laxity of connective tissue in constipated children. Sci Rep. 2022;19;12(1):1026.
  • 18. Shulman RJ, Self MM, Czyzewski DI, et al. The Prevalence of hypermobility in children with irritable bowel syndrome and functional abdominal pain is similar to that in healthy children. J Pediatr. 2020;222:134-40.
  • 19. Malek S, Reinhold EJ, Pearce GS. The Beighton Score as a measure of generalised joint hypermobility. Rheumatol Int. 2021;41(10):1707-16.
  • 20. Kajbafzadeh AM, Sharifi-Rad L, Ladi Seyedian SS, et al. Generalized joint hipermobilty and voiding dysfunction in children, is there any relationship? Eur J Pediatr. 2014:173(2):197-201.
  • 21. Averbeck MA, Madersbacher H. Constipation and LUTS - how do they affect each other? Int Braz J Urol. 2011;37(1):16–28.
  • 22. Gilliam E, Hoffman JD, Yeh G. Urogenital and pelvic complications in the Ehlers-Danlos syndromes and associated hypermobility spectrum disorders: A scoping review. Clin Genet. 2020;97(1):168-78.
Toplam 22 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular İç Hastalıkları
Bölüm Araştırma Makalesi
Yazarlar

Güneş Işık 0000-0002-8532-9168

Elif Sağ 0000-0003-3069-2872

Ferhat Demir 0000-0001-9801-925X

Murat Çakır 0000-0001-8789-8199

Mukaddes Kalyoncu 0000-0001-5378-939X

Yayımlanma Tarihi 31 Ağustos 2024
Gönderilme Tarihi 7 Ocak 2024
Kabul Tarihi 27 Haziran 2024
Yayımlandığı Sayı Yıl 2024 Cilt: 11 Sayı: 2

Kaynak Göster

APA Işık, G., Sağ, E., Demir, F., Çakır, M., vd. (2024). Hypermobility Spectrum Disorders, Functional Constipation and Voiding Dysfunction in School-Aged Children: Are They Related to Each Other?. Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi, 11(2), 76-81. https://doi.org/10.47572/muskutd.1416077
AMA Işık G, Sağ E, Demir F, Çakır M, Kalyoncu M. Hypermobility Spectrum Disorders, Functional Constipation and Voiding Dysfunction in School-Aged Children: Are They Related to Each Other?. MMJ. Ağustos 2024;11(2):76-81. doi:10.47572/muskutd.1416077
Chicago Işık, Güneş, Elif Sağ, Ferhat Demir, Murat Çakır, ve Mukaddes Kalyoncu. “Hypermobility Spectrum Disorders, Functional Constipation and Voiding Dysfunction in School-Aged Children: Are They Related to Each Other?”. Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi 11, sy. 2 (Ağustos 2024): 76-81. https://doi.org/10.47572/muskutd.1416077.
EndNote Işık G, Sağ E, Demir F, Çakır M, Kalyoncu M (01 Ağustos 2024) Hypermobility Spectrum Disorders, Functional Constipation and Voiding Dysfunction in School-Aged Children: Are They Related to Each Other?. Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi 11 2 76–81.
IEEE G. Işık, E. Sağ, F. Demir, M. Çakır, ve M. Kalyoncu, “Hypermobility Spectrum Disorders, Functional Constipation and Voiding Dysfunction in School-Aged Children: Are They Related to Each Other?”, MMJ, c. 11, sy. 2, ss. 76–81, 2024, doi: 10.47572/muskutd.1416077.
ISNAD Işık, Güneş vd. “Hypermobility Spectrum Disorders, Functional Constipation and Voiding Dysfunction in School-Aged Children: Are They Related to Each Other?”. Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi 11/2 (Ağustos 2024), 76-81. https://doi.org/10.47572/muskutd.1416077.
JAMA Işık G, Sağ E, Demir F, Çakır M, Kalyoncu M. Hypermobility Spectrum Disorders, Functional Constipation and Voiding Dysfunction in School-Aged Children: Are They Related to Each Other?. MMJ. 2024;11:76–81.
MLA Işık, Güneş vd. “Hypermobility Spectrum Disorders, Functional Constipation and Voiding Dysfunction in School-Aged Children: Are They Related to Each Other?”. Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi, c. 11, sy. 2, 2024, ss. 76-81, doi:10.47572/muskutd.1416077.
Vancouver Işık G, Sağ E, Demir F, Çakır M, Kalyoncu M. Hypermobility Spectrum Disorders, Functional Constipation and Voiding Dysfunction in School-Aged Children: Are They Related to Each Other?. MMJ. 2024;11(2):76-81.