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Functional Gastrointestinal Disorders Dominate Pediatric Gastroenterology Outpatient Practice
Audra S Rouster1, Aryn C Karpinski, David Silver
1*Louisiana State University Health Sciences Center †Children's Hospital of New Orleans, Division of Gastroenterology, New Orleans, LA.
Insights
Over half of pediatric gastroenterology patients have functional gastrointestinal disorders (FGIDs). Rome 3 criteria help diagnose FGIDs in children, even on their first visit.
Area of Science:
- Pediatric Gastroenterology
- Functional Gastrointestinal Disorders
Background:
- Symptom-based diagnostic criteria enhance recognition and standardization of pediatric functional gastrointestinal disorders (FGIDs).
- The Rome 3 criteria provide a standardized framework for diagnosing FGIDs in various age groups.
Purpose of the Study:
- To determine the prevalence of FGIDs in a pediatric gastroenterology clinic using Rome 3 diagnostic criteria.
- To develop and utilize a new diagnostic questionnaire for infants and toddlers.
Main Methods:
- Enrolled 976 new patients (≤18 years) referred to a pediatric gastroenterology clinic over 19 months.
- Utilized the Questionnaire on Pediatric Gastrointestinal symptoms, Rome 3 Version, or a new infant-toddler questionnaire.
- Collected demographic data and FGID diagnoses based on Rome 3 criteria.
Main Results:
- 52% of subjects <4 years and 75% of subjects ≥4 years met criteria for at least one FGID.
- Common FGIDs in younger children (<4 years) included functional constipation (29%) and infant regurgitation (13%).
- Common FGIDs in older children (≥4 years) included irritable bowel syndrome (36%) and abdominal migraine (19%).
Conclusions:
- More than half of new patients in a pediatric GI clinic meet Rome 3 criteria for FGIDs.
- Applying these criteria can facilitate timely FGID diagnosis during initial patient consultations.
Objectives:
Symptom-based diagnostic criteria have improved recognition and standardization of pediatric functional gastrointestinal disorders (FGIDs). We used Rome 3 diagnostic criteria to determine the prevalence of FGIDs in pediatric gastroenterology clinic. In the process, we developed a diagnostic questionnaire for infants and toddlers.
Methods:
We enrolled new patients ≤18 years referred during 19 months to a pediatric gastroenterology clinic. Subjects or parents completed a demographic survey and a the Questionnaire on Pediatric Gastrointestinal symptoms, Rome 3 Version (if ≥4 years, or a new infant-toddler questionnaire) before their appointment.
Results:
We acquired data from 976 subjects: 476 boys, 592 white. Of 332 subjects <4 years, 172 (52%) met diagnostic criteria for ≥1 FGIDs. Of 644 subjects ≥4 years, 486 (75%) met diagnostic criteria for ≥1 FGIDs. Thirty one (9%) subjects <4 years and 170 (26%) subjects ≥4 years met the criteria for ≥2 FGIDs. Of the total sample of subjects <4 years, common FGIDs included functional constipation (29%), infant regurgitation (13%), and cyclic vomiting syndrome (10%). Of the total sample of subjects ≥4 years, common FGIDs included irritable bowel syndrome (36%), abdominal migraine (19%), functional constipation (17%), cyclic vomiting syndrome (8%), functional abdominal pain syndrome (7%), aerophagia (7%), and functional dyspepsia (7%).
Conclusions:
More than half of new pediatric gastrointestinal clinic patients met the Rome 3 criteria for ≥1 FGIDs. Satisfying the criteria may facilitate diagnosis on the first visit.
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