Dergi Ara >>
Yıl:2008; Cilt: 15; Sayı: 1>> Özet
TAM METİN
Çocuk ve Gençlik Ruh Sağlığı Dergisi; 2008;15(1):47-56
Travma sonrası beslenme bozukluğu: Tanıdan tedaviye
S Hergüner, S Gökçe, G Gökçay, Ü Tüzün
İstanbul Üniv. İstanbul Tıp Fak. Çocuk Ruh Sağlığı ve Hastalıkları Anabilim Dalı, İstanbul
Amaç: Travma sonrası beslenme bozukluğu (TSBB) ağız, yutak ve/veya yemek borusunu etkileyen travmatik olaylardan (ör; boğulma, kusma, şiddetli tıkanma, zorla besleme, reflü ve nazogastrik ya da endotrekeal tüp yerleştirilmesi) sonra gelişen yeme reddi ile karakterizedir. Bu makalede, son yıllarda sıklığı giderek arttığı düşünülen TSBB ile ilgili çalışmalar gözden geçirilmiştir. Yöntem: Bebeklik ve erken çocukluk dönemi beslenme bozuklukları ve TSBB ile ilgili çalışmalar yazından taranmış ve tanımlama, sınıflama, tanı ölçütleri, etyoloji, klinik özellikler, ayırıcı tanı ve tedavi ile ilgili veriler değerlendirilmiştir. Sonuçlar: Travmatik deneyimleri olan çocukların ancak bir kısmı beslenme sorunları geliştirir. Bu, kaygı ve korkuya daha yatkın ve ağrıya daha hassas olmalarından dolayı olabilir. Söndürme ve kademeli duyarsızlaştırma gibi davranışsal yöntemlerin TSBB tedavisinde etkin olduğu görülmektedir. Tartışma: TSBB'nin daha iyi anlaşılması için, bu olguların mizaç özelliklerini, fizyolojik tepkilerini ve kaygı bozuklukları ile birlikteliğini inceleyen ileri araştırmalara gereksinim vardır. Ekip yaklaşımı içinde erken tanı ve müdahale yöntemlerinin uygulanması gerek çocukların gerekse ebeveynlerin yaşam kalitesini arttıracak, ortaya çıkabilecek fizyolojik, psikolojik ve sağlık sorunlarını azaltacaktır.

: Posttraumatic feeding disorder: From diagnosis to treatment
Objective: Posttraumatic feeding disorder (PTFD) is characterized by food refusal after traumatic events to oropharynx and/or esophagus (e.g., choking, vomiting, severe gagging, force-feeding, reflux and insertion of nasogastric or endotreacheal tubes). In this article, we reviewed studies on PTFD which is believed to be common in infants. Method: Studies on feeding disorders of infancy and early childhood and PTFD were retrieved, and data about the definition, classification, diagnostic criteria, etiology, clinical features, differential diagnosis and treatment were evaluated. Results: Only a few children who experienced traumatic events develop feeding problems. This may be due to their increased sensitivity, anxiety andfear before the traumatic experience. Behavioral approaches including extinction and gradual desensitization seem to be effective in treatment of PTFD. Discussion: Further studies are needed to explore the temperamental characteristics, physiological reactivity, and comorbidity with anxiety disorders to better understand the phenomenon of PTFD. Early diagnosis and treatment in a multidisciplinary approach will improve the quality of life, and physiologic, psychological and health problems experienced by infants and their parents.

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