Screening for functional gastrointestinal disorders in children with epilepsy
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Yusuf Aydemir1, Kursat Bora Carman2, Coskun Yarar2
1Department of Pediatrics, Division of Gastroenterology and Hepatology, Eskisehir Osmangazi University Faculty of Medicine, Eskisehir, Turkey.
Insights
Children with epilepsy have a higher prevalence of functional gastrointestinal disorders (FGIDs) compared to healthy children. Screening for FGIDs is recommended for pediatric epilepsy patients, particularly those with gastrointestinal symptoms.
Area of Science:
- Pediatric Gastroenterology
- Pediatric Neurology
- Clinical Medicine
Background:
- Functional gastrointestinal disorders (FGIDs) are common in the general pediatric population.
- Epilepsy is a chronic neurological condition affecting children worldwide.
- The co-occurrence and characteristics of FGIDs in pediatric epilepsy patients are not well-established.
Purpose of the Study:
- To determine the frequency of FGIDs in children diagnosed with epilepsy.
- To investigate the association between FGIDs and specific epilepsy characteristics.
- To compare FGID prevalence in pediatric epilepsy patients versus healthy controls.
Main Methods:
- A case-control study involving pediatric patients (4-18 years) with epilepsy and age/sex-matched healthy controls.
- Exclusion criteria included cerebral palsy, abdominal surgery history, other GI disorders, specific medications, recent GI infections, and ketogenic diet.
- Rome IV criteria were used for FGID screening; epilepsy type, seizure frequency, and antiepileptic drug (AED) requirements were analyzed.
Main Results:
- 33.3% of epilepsy patients (n=78) had FGIDs versus 19.2% of controls (p<0.001).
- Irritable bowel syndrome (IBS) was the most common FGID in epilepsy patients.
- No significant differences in epilepsy type, seizure frequency, or AEDs were found between epilepsy patients with and without FGIDs.
Conclusions:
- Pediatric patients with epilepsy exhibit a significantly higher prevalence of FGIDs compared to healthy children.
- The study highlights the need for increased awareness and screening of FGIDs in children with epilepsy.
- Gastrointestinal symptom evaluation should be a routine part of care for pediatric epilepsy patients.
Background And Aim:
We aimed to examine the frequency of functional gastrointestinal disorders (FGIDs) among pediatric patients with epilepsy and the association of FGIDs with epilepsy characteristics.
Material And Methods:
Patients with epilepsy aged between 4 and 18 years old were enrolled. Age- and sex-matched healthy children were taken as the control group. Children with cerebral palsy, history of abdominal surgery, gastrointestinal disorders, medication affecting gastrointestinal system motility, recent gastrointestinal infection, and those on the ketogenic diet were excluded from the study. Rome IV symptom-based criteria were used to screen FGIDs. Frequencies of FGIDs were compared between patients with epilepsy and controls. Additionally, epilepsy type, seizure frequency, and antiepileptic drug (AED) requirements were also compared between patients with and without FGIDs.
Results:
During the study period, 78 children [41 girls, age between 4 and 17 years, mean ± standard deviation (SD): 11.5 ± 4.3 years] with epilepsy were included in the study. The mean age at epilepsy onset was 7.8 ± 3.7 years, and mean disease duration was 5.1 ± 3.9 years. The most common epilepsy type was focal (74.3%), followed by generalized (25.7%). There was at least one of the FGIDs in 26 children in the patient group and 15 children in the control group (33.3% vs. 19.2%, p < 0.001). The most common FGID in the patient group was irritable bowel syndrome (IBS), which was significantly higher than the control group. While aerophagia and rumination syndrome were not seen in either group, cyclic vomiting syndrome was seen only in the patient group. When the patients with and without FGIDs were compared, there was no difference between the groups in terms of epilepsy type, frequency of seizure, type, and the number of drugs used.
Conclusions:
We found that children with epilepsy have a higher prevalence of FGIDs when compared with age- and sex-matched healthy controls. Our results suggest that children with epilepsy, especially complaining of gastrointestinal symptoms, should be screened for FGIDs.
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