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Epidemiology of functional gastrointestinal disorders in children and adolescents: A systematic review
Alexandre Canon Boronat1, Ana Paula Ferreira-Maia1, Alicia Matijasevich1
1Alexandre Canon Boronat, Ana Paula Ferreira-Maia, Yuan-Pang Wang, Institute & Department of Psychiatry (LIM-23), University of São Paulo Medical School, São Paulo, SP 01060-970, Brazil.
Insights
This systematic review found wide variations in the prevalence of functional gastrointestinal disorders (FGIDs) in children and adolescents globally. Improved study methodologies are needed for accurate FGID prevalence data in pediatric populations.
Area of Science:
- Pediatric Gastroenterology
- Epidemiology
- Systematic Review
Background:
- Functional gastrointestinal disorders (FGIDs) are common in children and adolescents, impacting their quality of life.
- Previous studies on FGID prevalence have shown considerable variability, necessitating a comprehensive review.
Purpose of the Study:
- To systematically assess the global prevalence of functional gastrointestinal disorders (FGIDs) in children and adolescents.
- To identify common FGIDs and their reported prevalence rates in pediatric populations.
Main Methods:
- A systematic literature search was conducted across PubMed, EMBASE, and Scopus databases up to September 2016.
- Studies reporting epidemiological data on FGIDs in children aged 4-18, using Rome criteria (II, III, or IV), were included.
- Study quality was assessed using Loney's proposal, with data extraction performed by two independent reviewers.
Main Results:
- Twenty-six studies, encompassing 132,600 individuals, were included in the final analysis, published between 2005 and 2016.
- FGID prevalence varied significantly, ranging from 9.9% to 29% in student samples and up to 87% in clinical samples.
- Irritable bowel syndrome, functional constipation, and cyclic vomiting were frequently studied, with high prevalence rates reported, though study generalizability was often limited.
Conclusions:
- Significant heterogeneity exists across studies on FGID prevalence in children and adolescents.
- Future research requires standardized sampling, comparable study settings, and consistent data collection methods to improve comparability.
- Enhancing methodological rigor is crucial for accurate and reliable epidemiological data on pediatric FGIDs.
Aim:
To assess the prevalence of functional gastrointestinal disorders (FGIDs) in children and adolescents.
Methods:
PubMed, EMBASE, and Scopus databases were searched for original articles from inception to September 2016. The literature search was made in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. For inclusion, each study had to report epidemiological data on FGIDs in children between 4 and 18 years old and contain standardized outcome based on Rome II, III or IV criteria. The overall quality of included epidemiological studies was evaluated in accordance with Loney's proposal for prevalence studies of health literature. Two reviewers assessed each study for data inclusion and extraction. Discrepancies were reconciled through discussion with seniors.
Results:
A total of 659 articles were identified from the databases and 16 through manual search. A total of 43 articles fulfilled the eligibility criteria for full-text reading, with 26 remaining to be included in the final analysis. All studies were written in English and published between 2005 and 2016. Eight (30.8%) articles were performed in North America, five (19.2%) in Latin America, five (19.2%) in Europe, seven (27%) in Asia, and one (3.8%) in Africa. Sample size varied between 114 and 99416 subjects, totaling 132600 individuals. Fourteen (53.9%) studies recruited their target samples from schools, 11 (42.3%) from healthcare settings and the remaining one (3.8%) from online panel community. The overall FGID prevalence rates for student samples ranged from 9.9% to 29% to as high as 87% in clinical samples. Cyclic vomiting, irritable bowel syndrome and functional constipation were the most researched conditions, with a prevalence ranging from 0.2% to 6.2%, 0% to 45.1% and 0.5% to 86.9%, respectively. The qualitative appraisal revealed that most of the studies showed average or below average generalizability.
Conclusion:
The heterogeneity of the studies on FGIDs must be improved in order to allow comparison. Improvements should include appropriate sampling of representative population, comparable study setting, and consistent data collection.
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