Background and Purpose
This Korean Medicine clinical practice guideline is a guideline to the Korean Medicine treatments such as herbal medicine, acupuncture, and manual/exercise therapy for children under the age of 20 who eat less and show maladaptive eating habits. Although the child does not suffer from anorexia, the overall physical condition is weakened, and growth disorders, developmental delays, malnutrition, anemia, rickets, lowered immunity, and behavioral disorders can be induced. In clinical sites, gastrointestinal exercise promoters, probiotics, vitamins, zinc, and iron intake have been suggested, but the verification of their effectiveness is insufficient and some side effects such as abdominal cramps and skin rash have been reported. Although comparatively good improvement effects have been reported in domestic and foreign studies applying Korean medicine treatment to pediatric anorexia, clinical practice guideline for Korean medicine for pediatric anorexia is still insufficient. Accordingly, the Korea Institute of Oriental Medicine and the Development Committee for Korean medicine clinical practice guideline agreed in the necessity of providing a standard clinical practice guideline for pediatric anorexia. This clinical practice guideline aims to help making more objective judgements on diagnosis, Korean medicine treatment, and improvement of patients’ symptoms by inputting the best accessible evidence at the time of development.
Overview of disease
Children with loss of appetite(R63.0) in the 8th revision of the Korea Standard Classification of Diseases(KCD) show a long-term decrease in the amount of food, lack of interest in food, and, in severe cases, refuse to eat. Pediatric anorexia has been expressed as no-desire-to-eat(不思食), no-amuse-to-eat(不嗜食), dislike of-food(惡食) in Korean medicine. In China, it is called children-full-of-food(小兒饜食症) to distinguish it from anorexia nervosa(拒食症). The prevalence is about 14-50% of pre-school children and about 7-27% of post-school children. Pediatric anorexia can be diagnosed by referring to the Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood (DC:0-5) for undereating disorder or Diagnostic and Statistical Manual of Mental Disorders, 5th edition(DSM-5) for avoidant/restrictive food intake disorder. In Western medicine, there is no specific treatment for anorexia with no organic disease, and symptomatic treatment is performed only when children with anorexia have nausea, vomiting, abdominal pain, and dyspepsia. In Korean medicine, herbal medicine, acupuncture, manipulation and exercise therapy have been used for quick recovery of pediatric anorexia.
