Prevalence of functional gastrointestinal disorders in infants and young children in China

Abstract Background The prevalence of functional gastrointestinal disorders (FGIDs) in children, particularly from Asia, is largely unknown. There are not many studies done in Asia especially using the Rome IV criteria. The aim of this study is to assess the prevalence of FGIDs in infants and young children in a representative sample in China. Methods A prospective, cross-sectional, community-based survey was conducted among healthy infants and young children between the ages of 0–4 years in Jinhua and Shanghai, China. A total of 2604 subjects (1300 subjects from Jinhua and 1304 subjects from Shanghai) completed a validated questionnaire on pediatric gastrointestinal symptoms. FGIDs in infants and young children were diagnosed using the Rome IV criteria. Results According to the Rome IV criteria, the prevalence of having a FGID in Chinese infants and young children is 27.3%. Infant regurgitation (33.9%) was the most common FGID among the 0–6 months old while functional constipation (7.0%) was the most common among the 1–4 years old. Risk factor analysis revealed that prevalence of infantile colic was higher with better maternal education and low birth weight. Prevalence of infantile regurgitation was significantly greater in males, living in a rural area, being exclusively breast fed at least up to 4 months and starting formula feeds within the first month. The risk of functional constipation was lower for infants who were delivered vaginally. Conclusions Infantile regurgitation was the most common FGID in Chinese infants while functional constipation was most prevalent among young Chinese children. Trial registration Netherlands Trial Registry Identifier: NL6973/NTR7161.

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Functional gastrointestinal disorders in children: agreement between Rome III and Rome IV diagnoses

European Journal of Pediatrics ◽

10.1007/s00431-021-04013-2 ◽

2021 ◽

Author(s):

Desiree F. Baaleman ◽

Carlos A. Velasco-Benítez ◽

Laura M. Méndez-Guzmán ◽

Marc A. Benninga ◽

Miguel Saps

Keyword(s):

Diagnostic Criteria ◽

Functional Dyspepsia ◽

Functional Gastrointestinal Disorders ◽

Functional Constipation ◽

Final Analysis ◽

Gastrointestinal Disorders ◽

Rome Iii ◽

Sample Characteristics ◽

Irritable Bowel ◽

Rome Iv

AbstractTo evaluate the agreement between the Rome III and Rome IV criteria in diagnosing pediatric functional gastrointestinal disorders (FGIDs), we conducted a prospective cohort study in a public school in Cali, Colombia. Children and adolescents between 11 and 18 years of age were given the Spanish version of the Questionnaire on Pediatric Functional Gastrointestinal Disorders Rome III version on day 0 and Rome IV version on day 2 (48 h later). The study protocol was completed by 135 children. Thirty-nine (28.9%) children were excluded because of not following the instructions of the questionnaire. The final analysis included data of 96 children (mean 15.2 years old, SD ± 1.7, 54% girls). Less children fulfilled the criteria for an FGID according to Rome IV compared to Rome III (40.6% vs 29.2%, p=0.063) resulting in a minimal agreement between the two criteria in diagnosing an FGID (kappa 0.34, agreement of 70%). The prevalence of functional constipation according to Rome IV was significantly lower compared to Rome III (13.5% vs 31.3%, p<0.001), whereas functional dyspepsia had a higher prevalence according to Rome IV than Rome III (11.5% vs 0%).Conclusion: We found an overall minimal agreement in diagnosing FGIDs according to Rome III and Rome IV criteria. This may be partly explained by the differences in diagnostic criteria. However, limitations with the use of questionnaires to measure prevalence have to be taken into account. What is Known:• The Rome IV criteria replaced the previous Rome III criteria providing updated criteria to diagnose functional gastrointestinal disorders (FGIDs).• Differences found between Rome IV and historic Rome III FGID prevalence may have been affected by changes in prevalence over time or differences in sample characteristics. What is New:• We found a minimal agreement between Rome III and Rome IV FGID diagnosis, especially in the diagnoses of functional constipation, irritable bowel syndrome, and functional dyspepsia.• The minimal agreement may be partly explained by changes in diagnostic criteria, but limitations with the use of questionnaires to measure prevalence have to be taken into account.

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Functional Gastrointestinal Disorders in Outpatients Aged up to 12 Months: A French Non-Interventional Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17114031 ◽

2020 ◽

Vol 17 (11) ◽

pp. 4031

Author(s):

Florence Campeotto ◽

Marie-Odile Barbaza ◽

Veronique Hospital

Keyword(s):

High Frequency ◽

Functional Gastrointestinal Disorders ◽

Specific Treatment ◽

Maternity Hospital ◽

Cow’S Milk ◽

Gastrointestinal Disorders ◽

Cross Sectional ◽

Cow's Milk ◽

New Information ◽

Rome Iv

Background: The aim of this study was to estimate the frequency of functional gastrointestinal disorders (FGIDs) in infants aged up to 12 months according to the new ROME IV criteria defining these disorders, and to describe the management of FGIDs in France. Methods: This French non-interventional, cross-sectional, and multicenter study was conducted among private-outpatient physicians who each included four consecutive patients aged up to 12 months. The frequency of FGIDs was described using the ROME IV criteria versus clinicians’ diagnosis. The characteristics of infants with and without FGID were compared, and the management of the FGIDs was described. Results: In the 1722 infants analyzed, the following frequencies were observed according to the ROME IV criteria versus the physicians’ diagnosis: regurgitation 41% versus 45%; colic 18% versus 30%; constipation 9% versus 19%; diarrhea 3% versus 8%. Of note, FGID infants were less frequently exclusively breastfeeding at the maternity hospital (p < 0.001), were introduced to cow’s milk earlier after leaving the maternity hospital (p < 0.001), and more frequently had symptoms suggestive of cow’s milk protein allergy (p < 0.001). Physicians frequently recommended an adapted infant formula (in 77% to 82% of cases depending on the FGID diagnosed) and prescribed a specific treatment in 51% to 66% of infants (probiotics: 35% to 64%). Conclusions: This real-world study confirms the high frequency of FGIDs in infants in France, and provides new information regarding the characteristics of FGID infants.

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Functional gastrointestinal disorders in infants and toddlers. Online survey results

Russian Medical Inquiry ◽

10.32364/2587-6821-2020-4-5-274-281 ◽

2020 ◽

Vol 4 (5) ◽

pp. 274-281

Author(s):

M.I. Dubrovskaya ◽

◽

E.I. Gryaznova ◽

Keyword(s):

Online Survey ◽

Functional Gastrointestinal Disorders ◽

Functional Constipation ◽

Health Condition ◽

Cyclic Vomiting Syndrome ◽

Gastrointestinal Disorders ◽

Infants And Toddlers ◽

Survey Results ◽

Delivery Obstetric ◽

Rome Iv

Aim: to study the possibilities of online surveys for mothers using a questionnaire on the basis of the Rome IV criteria (2016) as a screening for functional gastrointestinal disorders (FGID) in infants and toddlers. Patients and Methods: an anonymous online survey of 477 mothers was conducted regarding the health condition of their children under the age of 4 years. The survey consisted of 2 question pools. The first pool included general questions regarding the age of the mother at the time of delivery, obstetric and gynecological history, feeding of an infant/toddler at the time of the survey. The second pool included questions regarding FGID in infants and toddlers on three separate topics: functional disorders of the first year of life; diagnosis of cyclic vomiting syndrome; bowel movement disorder. Results: among 130 infants, regurgitation was in 50% of cases (at the age of 6 months — in 75%, at the age of 6 to 12 months — in 35%), baby colic — in 49%. The incidence of functional constipation in children under 6 months was 5.8%, from 6 to 12 months — 7.6%, gradually increasing by 3–4 years to 21.5%. Toilet skills were taught to 15 (12%) children aged 1 year — 1 year 11 months, 58 (59%) — at the age of 2 years — 2 years 11 months, and 119 (98%) — at the age of 3 years — 3 years 11 months. Mothers who were unaware of their child’s physical development and/or defecation problems accounted for 20.1% of those who took part in the survey. Conclusion: online survey results of mothers coincide with modern statistical data on FGID disorder. The survey results generally reflect the anatomical and physiological patterns of the child’s GI development. Online survey on the detection of FGID in infants/toddlers allows to make a preliminary diagnosis, identify existing problems and determine further patient management tactics. KEYWORDS: functional gastrointestinal disorders, infant, toddler, Rome IV criteria, questionnaire for parents, functional constipation, online survey, baby colic, regurgitation, toilet skills. FOR CITATION: Dubrovskaya M.I., Gryaznova E.I. Functional gastrointestinal disorders in infants and toddlers. Online survey results. Russian Medical Inquiry. 2020;4(5):274–281. DOI: 10.32364/2587-6821-2020-4-5-274-281.

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Gastrointestinal Symptoms in Diabetes Occur Long Before Diabetic Complications

10.21203/rs.3.rs-594914/v1 ◽

2021 ◽

Author(s):

Hwanseok Jung ◽

Eun-Jung Rhee ◽

Mi Yeon Lee ◽

Jung Ho Park ◽

Dong Il Park ◽

...

Keyword(s):

Irritable Bowel Syndrome ◽

Functional Dyspepsia ◽

Diabetes Complications ◽

Functional Gastrointestinal Disorders ◽

Gastrointestinal Symptoms ◽

Functional Constipation ◽

Gastrointestinal Disorders ◽

Gi Symptoms ◽

Irritable Bowel ◽

Diabetes Patients

Abstract Background: Gastrointestinal (GI) manifestations are common in patients with diabetes complications such as autonomic neuropathy. However, the prevalence of GI symptoms before the development of diabetes complications remains unclear.Method: We performed an interview survey of functional gastrointestinal disorders in diabetes patients who visited the endocrinology clinic of a general hospital using the ROME III criteria. The investigation consisted of various questions on functional dyspepsia, irritable bowel syndrome, and functional constipation including functional defecation disorder.Results: A total of 509 patients were included in this analysis. The patients were analyzed in three groups, prediabetes patients (n = 115), diabetes patients without neuropathy (n = 275), and diabetes patients with neuropathy (n = 119). The prevalence of gastrointestinal symptoms in prediabetes patients, diabetes patients without neuropathy, and diabetes patients with neuropathy was estimated at 16.52%, 27.27%, and 23.53% for functional dyspepsia; 8.7%, 11.68%, and 16.81% for irritable bowel syndrome; and 8.85%, 11.85%, and 15.25% for functional constipation. In the subgroup analysis, postprandial distress syndrome symptoms such as postprandial fullness and early satiation were more prevalent than epigastric pain symptoms. In the constipation group, pelvic outlet obstruction symptoms such as the sensation of anorectal obstruction or blockage and manual maneuvers to facilitate defecation were more frequently observed than slow transit constipation symptomsConclusions: The prevalence of functional gastrointestinal disorders increased with diabetes severity. Diabetes-related GI symptoms appeared long before the diabetes complications

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Subthreshold Psychiatric Psychopathology in Functional Gastrointestinal Disorders: Can It Be the Bridge between Gastroenterology and Psychiatry?

Gastroenterology Research and Practice ◽

10.1155/2017/1953435 ◽

2017 ◽

Vol 2017 ◽

pp. 1-8 ◽

Cited By ~ 9

Author(s):

Cristina Stasi ◽

Cristiana Nisita ◽

Sonia Cortopassi ◽

Giorgio Corretti ◽

Dario Gambaccini ◽

...

Keyword(s):

Irritable Bowel Syndrome ◽

Functional Dyspepsia ◽

Functional Gastrointestinal Disorders ◽

Gastrointestinal Symptoms ◽

Functional Constipation ◽

Psychiatric Evaluation ◽

Gastrointestinal Disorders ◽

Axis I ◽

Spectrum Disorders ◽

Irritable Bowel

Background and Aims. Functional gastrointestinal disorders (FGDs) are multifactorial disorders of the gut-brain interaction. This study investigated the prevalence of Axis I and spectrum disorders in patients with FGD and established the link between FGDs and psychopathological dimensions.Methods. A total of 135 consecutive patients with FGD were enrolled. The symptoms’ severity was evaluated using questionnaires, while the psychiatric evaluation by clinical interviews established the presence/absence of mental (Diagnostic and Statistical Manual—4th edition, Axis I Diagnosis) or spectrum disorders.Results. Of the 135 patients, 42 (32.3%) had functional dyspepsia, 52 (40.0%) had irritable bowel syndrome, 21 (16.2%) had functional bloating, and 20 (15.4%) had functional constipation. At least one psychiatric disorder was present in 46.9% of the patients, while a suprathreshold panic spectrum was present in 26.2%. Functional constipation was associated with depressive disorders (p<0.05), while functional dyspepsia was related to the current major depressive episode (p<0.05). Obsessive-compulsive spectrum was correlated with the presence of functional constipation and irritable bowel syndrome (p<0.05).Conclusion. The high prevalence of subthreshold psychiatric symptomatology in patients with FGD, which is likely to influence the expression of gastrointestinal symptoms, suggested the usefulness of psychological evaluation in patients with FGDs.

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Systematic Review of Pediatric Functional Gastrointestinal Disorders (Rome IV Criteria)

Journal of Clinical Medicine ◽

10.3390/jcm10215087 ◽

2021 ◽

Vol 10 (21) ◽

pp. 5087

Author(s):

Angharad Vernon-Roberts ◽

India Alexander ◽

Andrew S Day

Keyword(s):

Systematic Review ◽

Functional Gastrointestinal Disorders ◽

Symptom Burden ◽

Functional Constipation ◽

Final Analysis ◽

Gastrointestinal Disorders ◽

Prevalence Data ◽

Irritable Bowel ◽

Significant Symptom ◽

Rome Iv

Functional gastrointestinal disorders (FGID) are common among children and may cause a significant symptom burden. The Rome criteria are symptom-based guidelines for the assessment of FGID among children and adults. The aim of this systematic review was to estimate the prevalence of FGID utilizing the revised Rome IV criteria. Nine health databases were searched. The inclusion criteria were: prospective FGID prevalence data using the Rome IV criteria for children up to 18 years, and the exclusion criteria were: cohorts with known gastrointestinal or organic conditions. The data were presented as a percentage of children experiencing at least one FGID, as well as in individual categories. The searches identified 376 papers, with 20 included in the final analysis, providing a pooled cohort of 18,935 children. The median prevalence of FGID for children aged up to four years was 22.2% (range 5.8–40%), and aged four–eighteen years was 21.8% (range 19–40%). The most common FGID for children aged 0–12 months was infant regurgitation, the most common FGID for those aged 13–48 months were functional constipation and cyclic vomiting, and, for those aged over four years, functional constipation, functional dyspepsia, and irritable bowel syndrome. This reported overall incidence of FGID may be used as a benchmark of normative data among the general population and comparative data for those with comorbid disease.

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Acute tonsillitis and pediatric functional gastrointestinal disorders: the first result of a possible association analysis

CHILDREN INFECTIONS ◽

10.22627/2072-8107-2020-19-4-19-29 ◽

2020 ◽

Vol 19 (4) ◽

pp. 19-29

Author(s):

E. R. Meskina ◽

L. A. Galkina ◽

T. V. Stashko

Keyword(s):

Clinical Symptoms ◽

Respiratory Infections ◽

Pediatric Population ◽

Functional Gastrointestinal Disorders ◽

Clinical Manifestations ◽

Gastrointestinal Symptoms ◽

Functional Constipation ◽

Cross Sectional Study ◽

Acute Tonsillitis ◽

Cross Sectional

Acute tonsillitis (AT) and functional disorders of the digestive system (FDDS) are widespread among children. There is insufficient information about whether FDDS affects the incidence and course of АT, or whether АT may predispose to the development of АT. The aim is to discover a possible relationship between acute exudative tonsillitis and FDDS in children in the context of clinical and medico-social assessment. Materials and Methods: An observational cross-sectional study was performed using the continuous sampling method. There were 137 patients under observation, aged from one to 18 years, hospitalized in a hospital with АT, proceeding with overlaps on the tonsils, including 44 children younger and 93 older than 4 years. Bacterial АT was diagnosed on the MacIsack scale (≥ 4 points) in combination with the determination of inflammatory markers (leukocytosis, CRP). Epstein-Barr viral etiology of АT was diagnosed based on the detection of anti-EBV-VCA IgM and/or anti-EBV-EA IgG in the absence of anti-EBV-NA IgG. The legal representatives of the children agreed to participate in the study and completed a developed questionnaire containing 41 questions to assess medical and social factors, health status and gastrointestinal symptoms. FDDS diagnosis was carried out according to Rome IV 2016 criteria. Stool character was assessed using the Bristol scale, and clinical symptoms of АT were also analyzed. Results: Bacterial АT was diagnosed in 51.1% (70) of patients and EBV tonsillitis — in 48.9% (67), namely with equal frequency. The incidence of FDDS was 41.6% (95% CI (confidence interval) (33.3, 50.3), including 38.7% in children from 1 to 4 years old (95% CI (24.4, 54.5) and over 4 years 43.0% (95% CI (32.8, 53.7). Functional constipation (25.0%) and functional diarrhea (13.6%) were found in young children, all children over the age of 4 years had abdominal pain (including irritable bowel syndrome with a predominance of constipation — 4.3%). In EBV-RT with FDDS, the incidence of hepatolienal syndrome was 33.3% higher (RR (relative risk) 2.40; 95% CI (1.02, 5.66) and OR (odds ratio) 5.46; 95% CI (1.39, 21.28). Children with FDDS are 22.4% more likely (RR 1.65; 95% CI (1.21, 2.24) and OR 4.1; 95% CI (1.39, 12.07) suffered from recurrent acute respiratory infections; their relatives were more likely to have gastroenterological diseases (RR 1.54; 95% CI (1.12, 2.13) and OR 2.99; 95% CI (1.22, 7.34). Perinatal hypoxic lesions of the central nervous system were more often recorded in patients with FDDS in the anamnesis (RR 1.99; 95% CI (1.25, 3.15) and OR 4.13; 95% CI (1.37, 12.42). Conclusion: The etiological role of EBV among children with exudative АT admitted to the hospital is high. FDDS is more common among children with exudative АT over 4 years of age than in the general pediatric population. The influence of FDDS on the clinical manifestations of EBV-RT is highly probable. It is advisable to continue the study to determine the significance of АT in the development of FDDS in children and adolescents; their results may be useful for clinical practice.

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Functional constipation masked as irritable bowel syndrome

10.21203/rs.2.21118/v1 ◽

2020 ◽

Author(s):

Monica Tosto ◽

Paola D’Andrea ◽

Ignazio Salamone ◽

Salvatore Pellegrino ◽

Stefano Costa ◽

...

Keyword(s):

Irritable Bowel Syndrome ◽

Abdominal Pain ◽

Functional Gastrointestinal Disorders ◽

Functional Constipation ◽

Gastrointestinal Disorders ◽

Number Of Patients ◽

Erroneous Diagnosis ◽

Irritable Bowel ◽

Mixed Pattern ◽

Rome Iv

Abstract Background Rome IV criteria for functional gastrointestinal disorders state that children suspected of having Irritable Bowel Syndrome (IBS) with Constipation (IBS-C) should be preliminarily treated for constipation. We aimed at verifying if functional constipation may indeed lead to an erroneous diagnosis of IBS with diarrhea (IBS-D) or IBS with mixed pattern of diarrhea and constipation (IBS-M).Methods We prospectively enrolled in an unblinded fashion 10 and 16 consecutive children referred to our center who met Rome IV criteria for a diagnosis of IBS-D and IBS-M, respectively. Patients who fulfilled criteria for suspect “occult constipation” were then given a bowel cleaning regimen with PEG 3350, re-evaluated at 2 months and followed up for at least 6 months. Sixteen additional patients with IBS with Constipation (IBS-C) referred in the same period served as control. The endpoints were: 1) a decrease of more than 50% in abdominal pain intensity and frequency scores; and 2) for patients with IBS-D and IBS-M: resolution of diarrhea.Results The endpoints were met by 8 (80%) and 14 (87%) of the patients with IBS-D and IBS-M, respectively, with decrease of abdominal pain and resolution of “diarrhea”. The response was not significantly different from that observed in 15 (93%) of the IBS-C control group.Conclusion acknowledging the limitations of the small number of patients and of the uncontrolled nature of the study, we suggest that a possibly large number of patients labeled as IBS-D or IBS-M may actually simply present functional constipation and should be managed as such.

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A69 MULTIPLE FUNCTIONAL GASTROINTESTINAL DISORDERS IN JORDANIAN CHILDREN, NATIONWIDE STUDY

Journal of the Canadian Association of Gastroenterology ◽

10.1093/jcag/gwz047.068 ◽

2020 ◽

Vol 3 (Supplement_1) ◽

pp. 82-83

Author(s):

E Altamimi

Keyword(s):

Functional Gastrointestinal Disorders ◽

Functional Constipation ◽

Arabic Language ◽

Cross Sectional Study ◽

Gastrointestinal Disorders ◽

Rome Iii Criteria ◽

Cross Sectional ◽

Funding Agencies ◽

Rome Iii ◽

Common Combination

Abstract Background Functional gastrointestinal disorders (FGIDs) are common in children worldwide. Multiple FGIDs might share some etiopathogenesis, which makes finding multiple disorders in a child a possibility. Aims Estimate the prevalence of FGIDs in Jordanian children prospectively, whether as a single or combined disorders. Methods A prospective, cross-sectional study was conducted in 6 cities in Jordan. Children between the ages of 4–18 were recruited. A validated Arabic language questionnaires based on Rome III criteria were filled by the participants if older than 10 years and by the parents if younger than 10 years. Results A total of 1587(79.35%) participants filled the questionnaires. 814 (51.29%) were younger than 10 years. FGIDs was diagnosed in 204 (25.03%) of younger children. In children between (11 and 18), 310 (40%) were diagnosed with FGIDs. In children (4–10 yrs.) who were diagnosed with FGIDs, 15.5 % had two disorders, while 3% had three or more disorders. The most common combination was aerophobia and functional constipation, comprising 22.58% of combined disorders. In children (11–18 yrs.) with FGIDs, 22.27% had two disorders and 7% had three or more disorders. Interestingly, the most common combination was aerophagia and functional constipation also, representing 34% of the combined cases. Conclusions Functional gastrointestinal disorders are common in Jordanian children. Multiple Functional gastrointestinal disorders may coexist. Diagnosis of one disorder should not prevent us from investigating other disorders. Funding Agencies None

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