Initial Diagnosis of Functional Gastrointestinal Disorders in Children Increases a Chance for Resolution of Symptoms
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Purpose: The aim of this study was to describe functional gastrointestinal disorders (FGID) presented in a tertiary medical center, characteristics of patients and results of the diagnostic work-up together with an outcome during the follow up.Methods: This was a retrospective, single center, observational study including all patients who were diagnosed with FGID based on Rome III criteria from January to December 2015 in tertiary medical center. Results: Overall 294 children were included (mean age, 8.9 years [range, 1-18 years]; 165 females). Majority had functional constipation (35.4%), followed by functional abdominal pain (30.6%), irritable bowel syndrome (17.0%), functional dyspepsia (12.6%), functional nausea (3.4%) and abdominal migraine (1.0%). Regression model found that only significant factor associated with improvement of symptoms is the establishment of the functional diagnosis at the first visit (hazard ratio, 2.163; 95% confidence inverval, 1.029-4.544). There was no association between improvement of symptoms and presence of alarm signs/symptoms (weight loss, nocturnal symptoms and severe vomiting) at diagnosis. Furthermore, in pain symptoms (functional abdominal pain, irritable bowel syndrome, dyspepsia) no treatment positively correlated with pain improvement.Conclusion: Regardless of the initial diagnosis of FGID, positive diagnosis at the first visit increases a chance for resolution of symptoms.
Abstract
Purpose: The aim of this study was to describe functional gastrointestinal disorders (FGID) presented in a tertiary medical center, characteristics of patients and results of the diagnostic work-up together with an outcome during the follow up.Methods: This was a retrospective, single center, observational study including all patients who were diagnosed with FGID based on Rome III criteria from January to December 2015 in tertiary medical center. Results: Overall 294 children were included (mean age, 8.9 years [range, 1-18 years]; 165 females). Majority had functional constipation (35.4%), followed by functional abdominal pain (30.6%), irritable bowel syndrome (17.0%), functional dyspepsia (12.6%), functional nausea (3.4%) and abdominal migraine (1.0%). Regression model found that only significant factor associated with improvement of symptoms is the establishment of the functional diagnosis at the first visit (hazard ratio, 2.163; 95% confidence inverval, 1.029-4.544). There was no association between improvement of symptoms and presence of alarm signs/symptoms (weight loss, nocturnal symptoms and severe vomiting) at diagnosis. Furthermore, in pain symptoms (functional abdominal pain, irritable bowel syndrome, dyspepsia) no treatment positively correlated with pain improvement.Conclusion: Regardless of the initial diagnosis of FGID, positive diagnosis at the first visit increases a chance for resolution of symptoms.
참고문헌 (18)
- Drossman DA, "Functional gastrointestinal disorders: history, pathophysiology, clinical features and Rome IV", Gastroenterology, 150, pp.1262~1279 (2016)[DOI]
- Hyams JS, "Functional disorders: children and adolescents", Gastroenterology, 150, pp.1456~1468 (2016)[DOI]
- Scarpato E, "Prevalence of functional gastrointestinal disorders in children and adolescents in the Mediterranean region of Europe", Clin Gastroenterol Hepatol, 16, pp.870~876 (2018)[DOI]
- Di Lorenzo C, "Chronic abdominal pain in children: a technical report of the American Academy of Pediatrics and the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition", J Pediatr Gastroenterol Nutr, 40, pp.249~261 (2005)[DOI]
- Dhroove G, "A million-dollar work-up for abdominal pain: is it worth it?", J Pediatr Gastroenterol Nutr, 51, pp.579~583 (2010)[DOI]
- Rasquin A, "Childhood functional gastrointestinal disorders: child", adolescent, 2006, pp.130, 1527~1537
- Schmulson MJ, "A single session of reassurance can acutely improve the self-perception of impairment in patients with IBS", J Psychosom Res, 61, pp.461~467 (2006)[DOI]
- Assa A, "School attendance in children with functional abdominal pain and inflammatory bowel diseases", J Pediatr Gastroenterol Nutr, 61, pp.553~557 (2015)[DOI]
- Warschburger P, "Health-related quality of life in children with abdominal pain due to functional or organic gastrointestinal disorders", J Pediatr Psychol, 39, pp.45~54 (2014)
- Spee LA, "Prevalence, characteristics, and management of childhood functional abdominal pain in general practice", Scand J Prim Health Care, 31, pp.197~202 (2013)[DOI]
- Helgeland H, "Diagnosing pediatric functional abdominal pain in children (4-15 years old) according to the Rome III criteria: results from a Norwegian prospective study", J Pediatr Gastroenterol Nutr, 49, pp.309~315 (2009)[DOI]
- Saps M, "Prevalence of functional gastrointestinal disorders in Colombian school children", J Pediatr, 164, pp.542~545 (2014)[DOI]
- Miele E, "Functional gastrointestinal disorders in children: an Italian prospective survey", Pediatrics, 114, pp.73~78 (2004)[DOI]
- Korterink JJ, "Epidemiology of pediatric functional abdominal pain disorders: a meta-analysis", PLoS One, 10, pp.e0126982~ (2015)[DOI]
- Gijsbers CF, "Validation of the Rome III criteria and alarm symptoms for recurrent abdominal pain in children", J Pediatr Gastroenterol Nutr, 58, pp.779~785 (2014)
- Lane MM, "Pain symptoms and stooling patterns do not drive diagnostic costs for children with functional abdominal pain and irritable bowel syndrome in primary or tertiary care", Pediatrics, 123, pp.758~764 (2009)[DOI]
- Tabbers MM, "Evaluation and treat- ment of functional constipation in infants and children: evidence-based recommendations from ESPGHAN and NASPGHAN", J Pediatr Gastroenterol Nutr, 58, pp.258~274 (2014)
- Korterink JJ, "Pharmacologic treatment in pediatric functional abdominal pain disorders: a systematic review", J Pediatr, 166, pp.424~431 (2015)[DOI]