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Symptom Profiles in Patients With Irritable Bowel Syndrome or Functional Abdominal Pain Compared With Healthy
James W Varni1, Robert J Shulman, Mariella M Self
1*Department of Pediatrics, College of Medicine, Texas A&M University, College Station †Department of Pediatrics, Baylor College of Medicine, Houston ‡Center for Motility and Functional Gastrointestinal Disorders, Boston Children's Hospital, Harvard Medical School, Boston, MA §Division of Gastroenterology, Hepatology and Nutrition, Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL ||Division of Gastroenterology, Hepatology and Nutrition, Cincinnati Children's Hospital Medical Center, Cincinnati, OH ¶Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil #Division of Pediatric Gastroenterology, Children's Medical Center of Dallas, University of Texas Southwestern Medical School, Dallas **Department of Psychology, Texas A&M University, College Station ††Department of Pediatric Gastroenterology, Primary Children's Hospital, University of Utah, Salt Lake City.
Insights
Pediatric patients with irritable bowel syndrome (IBS) or functional abdominal pain (FAP) show significantly more gastrointestinal symptoms than healthy children. These findings highlight the need for better treatments to improve children's health and functioning.
Area of Science:
- Pediatric Gastroenterology
- Patient-Reported Outcomes
- Functional Gastrointestinal Disorders
Background:
- Patient-reported outcome (PRO) measures are crucial for assessing treatment efficacy in pediatric irritable bowel syndrome (IBS) and functional abdominal pain (FAP).
- Understanding the specific symptom profiles of these conditions is essential for developing targeted interventions.
Purpose of the Study:
- To compare the gastrointestinal symptom profiles of pediatric patients with IBS or FAP against healthy controls.
- To differentiate symptom patterns between pediatric IBS and FAP patients.
- To establish clinical interpretability of PRO scores using minimal important difference (MID) values.
Main Methods:
- Utilized the PedsQL Gastrointestinal Symptoms and Gastrointestinal Worry Scales in a multi-site study.
- Collected data from 154 pediatric patients (46 IBS, 119 FAP) and 161 parents.
- Compared patient data with a matched sample of 447 healthy children's families.
Main Results:
- Gastrointestinal Symptoms and Worry Scales effectively distinguished between patients with IBS/FAP and healthy controls (P < 0.001).
- Larger effect sizes (>1.50) were observed for symptoms characteristic of IBS or FAP, confirming a broad symptom profile.
- Patients with IBS reported more constipation, gas/bloating, and diarrhea compared to those with FAP.
Conclusions:
- Pediatric patients with IBS or FAP exhibit a wide range of gastrointestinal symptoms compared to healthy peers.
- Significant differences underscore the urgent need for more effective therapeutic interventions.
- Improving patient functioning to align with healthy ranges is a critical goal.
Objectives:
Patient-reported outcome (PRO) measures of gastrointestinal symptoms are recommended to determine treatment effects for irritable bowel syndrome (IBS) and functional abdominal pain (FAP). Study objectives were to compare the symptom profiles of pediatric patients with IBS or FAP with healthy controls and with each other using the PedsQL Gastrointestinal Symptoms and Gastrointestinal Worry Scales, and to establish clinical interpretability of PRO scale scores through identification of minimal important difference (MID) scores.
Methods:
Gastrointestinal Symptoms and Worry Scales were completed in a 9-site study by 154 pediatric patients and 161 parents (162 families; IBS n = 46, FAP n = 119). Gastrointestinal Symptoms Scales measuring stomach pain, stomach discomfort when eating, food and drink limits, trouble swallowing, heartburn and reflux, nausea and vomiting, gas and bloating, constipation, blood in poop, and diarrhea were administered along with Gastrointestinal Worry Scales. A matched sample of 447 families with healthy children completed the scales.
Results:
Gastrointestinal Symptoms and Worry Scales distinguished between patients with IBS or FAP compared with healthy controls (P < 0.001), with larger effect sizes (>1.50) for symptoms indicative of IBS or FAP, demonstrating a broad multidimensional gastrointestinal symptom profile and clinical interpretability with MID scores for individual PRO scales. Patients with IBS manifested more symptoms of constipation, gas and bloating, and diarrhea than patients with FAP.
Conclusions:
Patients with IBS or FAP manifested a broad gastrointestinal symptom profile compared with healthy controls with large differences, indicating the critical need for more effective interventions to bring patient functioning within the range of healthy functioning.
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