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

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.

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

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.

scholarly journals Functional constipation masked as irritable bowel syndrome

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.

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

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ying Huang ◽  
Serene Yaling Tan ◽  
Panam Parikh ◽  
Vanitha Buthmanaban ◽  
Shaman Rajindrajith ◽  
...  
Keyword(s):  
Young Children ◽  
Maternal Education ◽  
Functional Gastrointestinal Disorders ◽  
Gastrointestinal Symptoms ◽  
Functional Constipation ◽  
Gastrointestinal Disorders ◽  
Cross Sectional ◽  
Validated Questionnaire ◽  
Rome Iv ◽  
Infants And Young Children

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.

scholarly journals Functional gastrointestinal disorders in infants and toddlers. Online survey results

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.

scholarly journals Functional constipation masked as irritable bowel syndrome

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 ◽  
Control Group ◽  
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 Polyethylene glycol 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.

scholarly journals Gastrointestinal Symptoms in Diabetes Occur Long Before Diabetic Complications

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

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

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
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.

scholarly journals Questionnaire-Based Survey on Epidemiology of Functional Gastrointestinal Disorders and Current Status of Gastrointestinal Motility Testing in Asian Countries

Digestion ◽  
2020 ◽  
Vol 102 (Suppl. 1) ◽  
pp. 73-89
Author(s):  
Takeshi Kamiya ◽  
Satoshi Osaga ◽  
Eiji Kubota ◽  
Shin Fukudo ◽  
Satoshi Motoya ◽  
...  
Keyword(s):  
Gastrointestinal Motility ◽  
Functional Gastrointestinal Disorders ◽  
Southeast Asian ◽  
Colonic Transit ◽  
Current Status ◽  
Gastrointestinal Disorders ◽  
Asian Countries ◽  
Irritable Bowel ◽  
Rome Iv ◽  
Southeast Asian Countries

<b><i>Background/Aims:</i></b> Functional gastrointestinal disorders (FGIDs) are diagnosed and classified using the latest Rome IV criteria, released in 2016. Epidemiology of FGID diagnosed by the Rome IV criteria and current clinical application of gastrointestinal motility testing in Asian countries are not well known. The aims of this survey are to elucidate the present situation of epidemiology and diagnostic tests of FGID in clinical practice in some East and Southeast Asian countries. <b><i>Methods:</i></b> The questionnaire focusing on current situation of FGID diagnosis and gastrointestinal motility testing was distributed to members of the International Gastroenterology Consensus Symposium study group and collected to be analyzed. <b><i>Results:</i></b> The prevalence rates of subtypes of both functional dyspepsia (FD) and irritable bowel syndrome (IBS) are relatively similar in all Asian countries. In these countries, most patients underwent both upper endoscopy and <i>Helicobacter pylori</i> test to diagnose FD. Colonoscopy was also frequently performed to diagnose IBS and chronic constipation. The frequency of gastrointestinal motility testing to examine gastric emptying and colonic transit time varied among Asian countries. <b><i>Conclusions:</i></b> This survey revealed epidemiology of FGIDs and current status of gastrointestinal motility testing in some East and Southeast Asian countries.

A systematic review of the association between fibromyalgia and functional gastrointestinal disorders

2020 ◽  
Author(s):  
Sharon Erdrich
Keyword(s):  
Systematic Review ◽  
Irritable Bowel Syndrome ◽  
Health Care Systems ◽  
Strong Association ◽  
Functional Gastrointestinal Disorders ◽  
Future Research ◽  
Gastrointestinal Disorders ◽  
Irritable Bowel ◽  
Mixed Pattern ◽  
The Relationship

Abstract Background Fibromyalgia and functional gastrointestinal disorders are frequently encountered in clinical settings. Common to both is significant burden on individuals and health care systems, an elusive aetiology and several comorbid conditions. While a relationship between irritable bowel syndrome and fibromyalgia has been demonstrated, a broader review of the relationship between fibromyalgia and other functional gut disorders has not been undertaken. Objectives This paper reports a systematic review of the published literature, identifying the comorbidity of functional gastrointestinal disorders in people with fibromyalgia. We discuss the clinical implications, limitations of current research, and areas of interest for future research Methods A systematic review of the databases Medline, Embase, CINAHL and Web of Science was undertaken in June 2019. Results were screened for original articles meeting strict criteria for identification of functional gastrointestinal disorders in adult subjects with fibromyalgia. ResultsFourteen articles were included investigating 1340 subjects with fibromyalgia, 363 healthy controls and 441 subjects with other pathologies. Functional gut disorders were matched to Rome II criteria for reporting and comparison. In addition to increased abdominal pain and functional bloating/gas, irritable bowel of mixed-pattern and constipation-types were more prevalent that diarrhoea-predominant irritable bowel in adults with fibromyalgia. One study reported the range of functional gastrointestinal disorders. Conclusion Existing research has focused on the relationship between irritable bowel syndrome and fibromyalgia, but sub-typing of irritable bowel syndrome is generally overlooked. A strong association with a range of functional gastrointestinal disorders is suggested. Further investigation is needed to determine the prevalence and relevance of the range of functional gastrointestinal disorders in patients with fibromyalgia.

scholarly journals Symptom-based ordinal scale fuzzy clustering of functional gastrointestinal disorders

2020 ◽  
Author(s):  
Marjan Mansourian ◽  
Hamid Reza Marateb ◽  
Ammar Hassanzadeh Keshteli ◽  
Hamed Daghagh Zadeh ◽  
Miquel Angel Mananas ◽  
...  
Keyword(s):  
Functional Gastrointestinal Disorders ◽  
Functional Constipation ◽  
Ordinal Scale ◽  
Gastrointestinal Disorders ◽  
Rome Iii Criteria ◽  
Gi Symptoms ◽  
Rome Iii ◽  
The Common ◽  
Functional Bloating ◽  
Irritable Bowel

Background The validity of Rome III criteria for diagnosing functional gastrointestinal disorders (FGIDs) have been frequently questioned in the literature. In epidemiology, when a disease is diagnosed, the existence of a true cluster must be proven. Thus, clustering the common GI symptoms of individuals and comparing the clusters with FGIDs defined by the Rome III criteria could provide insights about the validity of FGIDs defined by those criteria. Well-separated compact clusters were detected in responses to questionnaires of the epidemiological features of different FGIDs in Iranian adults using fuzzy ordinal clustering. The representative sample from each cluster i.e. Cluster Representative (CR) was formed whose corresponding FGID was diagnosed with Rome III criteria. Then, FGID diagnosis was performed for all participants in each cluster and the percentage of cases whose FGID was the same as the cluster's identified FGID (agreement) was reported. Results Fourteen valid clusters were detected in 4763 people. The average membership of the objects in each cluster was 77.3%, indicating similarity of the objects in clusters to their corresponding CRs. Eight clusters were assigned to single FGIDs (irritable bowel syndromes: constipation IBS-C, diarrhea IBS-D and un-subtyped IBS-U; functional bloating FB; functional constipation FC; belching disorder BD. The agreement was higher than 50% in single FGID clusters except those whose diagnosis was IBS-U. Conclusions IBS-C, IBS-D, FC, BD, and FB defined with Rome III criteria exist in the population, which is not the case for IBS-U.

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