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Epidemiology of functional gastrointestinal disorders in infants and toddlers: A systematic review
Ana Paula Ferreira-Maia1, Alicia Matijasevich1, Yuan-Pang Wang1
1Ana Paula Ferreira-Maia, Yuan-Pang Wang, Institute and Department of Psychiatry (LIM-23), University of São Paulo Medical School, São Paulo 01060-970, SP, Brazil.
Insights
Functional gastrointestinal disorders (FGID) affect up to 38% of infants and toddlers. Infant regurgitation and functional constipation are the most common FGID, highlighting the need for better diagnostic criteria.
Area of Science:
- Pediatric Gastroenterology
- Epidemiology
- Functional Gastrointestinal Disorders
Background:
- Functional gastrointestinal disorders (FGID) are common in infants and toddlers.
- Accurate prevalence data is crucial for understanding and managing these conditions in pediatric populations.
Purpose of the Study:
- To systematically review and assess the prevalence of FGID in infants and toddlers.
- To identify the most common FGID and evaluate the quality of existing epidemiological research.
Main Methods:
- A systematic literature search was conducted using PubMed, EMBASE, and Scopus.
- Studies reporting FGID prevalence in children up to 4 years old, using Rome II or III criteria, were included.
- Study quality was assessed using Loney's proposal; data extraction and review were performed by two independent reviewers.
Main Results:
- Thirteen studies met the inclusion criteria, published between 2004 and 2015, primarily from Europe.
- Prevalence estimates for any FGID ranged from 27.1% to 38%, with 20.8% experiencing multiple FGID.
- Infant regurgitation (up to 25.9%) and functional constipation (up to 31%) were the most prevalent FGID. Study quality was generally moderate to poor.
Conclusions:
- There is a significant prevalence of FGID in infants and toddlers, with considerable variation.
- The heterogeneity and quality limitations of current data underscore the need for rigorous, well-designed epidemiological studies.
- Refinement of diagnostic criteria and research methodologies is essential for accurate FGID assessment in pediatric practice.
Aim:
To assess the functional gastrointestinal disorders (FGID) prevalence in infants and toddlers.
Methods:
PubMed, EMBASE, and Scopus were searched for original articles from inception to February 2016. The literature search was made in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). For inclusion, each study had to report epidemiological data of FGID on children up to 4 years old and contain standardized outcome Rome II or III criteria. The overall quality of included epidemiological studies was evaluated in accordance to Loney's proposal for prevalence studies of health literature. Two reviewers assessed each study for inclusion and extracted data. Discrepancies were reconciled through discussion.
Results:
It was identified a total of 101 articles through the databases and two through the manual search. A total of 28 articles fulfilled the eligibility criteria. After reading the full articles, 13 of them were included in the present review. Twelve studies were written in English and one in Chinese, and published between 2004 and 2015. Eight articles (61.5%) were performed in Europe, three (23.1%) in America and two (15.4%) in Asia. Sample size varied between 45 and 9660 subjects. Cross-sectional frequency was reported in majority of studies (k = 9) and four studies prospectively followed the subjects. 27.1% to 38% of participants have met any of Rome's criteria for gastrointestinal syndromes, of those 20.8% presented two or more FGID. Infant regurgitation and functional constipation were the most common FGID, ranging from less than 1% to 25.9% and less than 1% to 31%, respectively. Most included studies were of moderate to poor data quality with respect to absence of confidential interval for prevalence rate and inadequate sampling methods.
Conclusion:
The scarcity and heterogeneity of FGID data call for the necessity of well-designed epidemiological research in different levels of pediatric practice and refinement of diagnostic.
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