Clinical Presentation of Acute Gastroenteritis in Children With Functional Abdominal Pain Disorders
Miguel Saps1, Stijn Mintjens, Cenk K Pusatcioglu
1*Division of Pediatric Gastroenterology, Hepatology and Nutrition, Nationwide Children's Hospital, Columbus, OH †Department of Pediatrics, Emma Kinderziekenhuis, Academic Medical Centre, Amsterdam, the Netherlands ‡Division of Pediatric Gastroenterology Hepatology and Nutrition, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL §Division of Emergency Medicine, Nationwide Children's Hospital, Columbus, OH.
Insights
Children with functional abdominal pain disorders (FAPDs) experience more non-gut physical symptoms during acute gastroenteritis. However, their abdominal pain and other gastrointestinal symptoms are similar to those without FAPDs.
Area of Science:
- Pediatric Gastroenterology
- Functional Gastrointestinal Disorders
- Child Psychology
Background:
- Functional abdominal pain disorders (FAPDs) are prevalent in children, often associated with visceral hypersensitivity and altered coping mechanisms.
- Understanding symptom presentation during acute illness, like gastroenteritis, is crucial for differentiating FAPDs from other conditions.
- Visceral hypersensitivity suggests heightened pain perception, potentially exacerbating symptoms during gut inflammation.
Purpose of the Study:
- To compare clinical symptoms and somatization in children with and without FAPDs during acute gastroenteritis.
- To investigate the relationship between FAPDs, visceral hypersensitivity, and symptom reporting in pediatric patients with acute gastrointestinal infections.
Main Methods:
- A cross-sectional study involving seventy children diagnosed with acute gastroenteritis.
- Utilized the Rome III Diagnostic Questionnaire for Pediatric Functional GI Disorders and the Children's Somatization Inventory.
- Compared symptom profiles, including abdominal pain, nausea, vomiting, school absenteeism, and somatization, between children with and without FAPDs.
Main Results:
- Twenty-one percent of children with acute gastroenteritis were diagnosed with an FAPD.
- Children with FAPDs reported significantly more non-gastrointestinal somatic symptoms compared to their peers without FAPDs.
- No significant differences were observed in the severity of abdominal pain, nausea, vomiting, or school absenteeism between the two groups during the acute illness episode.
Conclusions:
- Children with FAPDs exhibit increased somatization, manifesting as more non-gastrointestinal symptoms, even during acute gastroenteritis.
- The presence of FAPDs does not necessarily correlate with increased gastrointestinal symptom severity or absenteeism during acute infections.
- These findings highlight the complex interplay of gut-brain axis, pain perception, and psychological factors in pediatric functional abdominal pain.
Abstract:
Visceral hypersensitivity and abnormal coping are common in children with functional abdominal pain disorders (FAPDs). Thus, it would be expected that children with visceral hypersensitivity would report more pain if their gut is acutely inflamed. The aim of the study was to compare clinical symptoms and somatization of children with and without FAPDs at time of an episode of acute gastroenteritis. Seventy children with acute gastroenteritis and their parents completed the Rome III Diagnostic Questionnaire for Pediatric Functional GI Disorders and the Children's Somatization Inventory. Twenty-one percent of children were diagnosed with an FAPD. Children with FAPDs showed significantly more nongastrointestinal somatic symptoms than children without FAPDs. There were no significant differences in abdominal pain, nausea, vomiting, or school absenteeism between both groups at time of consultation.
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