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Is there a relationship between joint hypermobility and gastrointestinal disorders in children?
Paolo Quitadamo, Nikhil Thapar1, Giovanni Di Nardo2
1Gastroenterology Unit, Great Ormond Street Hospital, London, United Kingdom.
Insights
Joint hypermobility (JH) was assessed in children with gastrointestinal (GI) disorders. While JH was more common in ulcerative colitis patients, further research is needed to confirm its link to pediatric GI conditions.
Area of Science:
- Pediatric Gastroenterology
- Rheumatology
- Genetics
Background:
- Joint hypermobility (JH) is a condition affecting connective tissues.
- Gastrointestinal (GI) disorders are common in children.
- The association between JH and pediatric GI disorders requires further investigation.
Purpose of the Study:
- To determine the prevalence of joint hypermobility (JH) in children diagnosed with functional GI disorders (FGIDs), Crohn's disease, and ulcerative colitis.
- To compare JH rates in these pediatric GI patient groups with a healthy control cohort.
- To explore potential links between JH and specific pediatric GI conditions.
Main Methods:
- Children aged 4-17 with FGIDs, Crohn's disease, or ulcerative colitis were screened for joint laxity using the Beighton Score and Brighton Criteria.
- Diagnoses for FGIDs, Crohn's disease, and ulcerative colitis were established using Rome III and Porto Criteria, respectively.
- Age and sex-matched healthy children served as controls for comparison.
Main Results:
- Joint hypermobility (JH) was observed in 10% of children with FGIDs, 8% with Crohn's disease, and 30% with ulcerative colitis.
- The prevalence of JH in children with ulcerative colitis was significantly higher compared to those with FGIDs (p=0.01) and Crohn's disease (p=0.01).
- While JH was more prevalent in ulcerative colitis patients than in controls, this difference did not achieve statistical significance (p=0.09).
Conclusions:
- Joint hypermobility (JH) appears more frequent in pediatric ulcerative colitis patients than in the general healthy population, though not statistically significant.
- The findings suggest a potential association between JH and ulcerative colitis, possibly indicating underlying connective tissue abnormalities.
- Further research is warranted to establish whether JH is a characteristic feature of pediatric GI disorders.
Background:
The main aim of the study was to assess the association between joint hypermobility (JH) and gastrointestinal (GI) disorders in children.
Methods:
All children aged 4-17 years attending the clinics of the participating Pediatric Gastroenterology Centres for functional GI disorders (FGIDs) and inflammatory bowel disease (IBD) were screened for joint laxity. JH diagnosis was inferred using the Beighton Score. JHS diagnosis was inferred based on the Brighton Criteria. Rome III Diagnostic Criteria were used to diagnose possible FGIDs. Ulcerative colitis and Crohn`s disease diagnoses were made according to the Porto Criteria. Age and sex- matched healthy children were enrolled as controls.
Results:
One-hundred-seventy children with GI disorders (70 with FGIDs, 50 with Crohn`s disease, and 50 with ulcerative colitis) and 100 healthy controls were enrolled in the study. JH was reported in 7/70 (10%) children with FGIDs (p=0.26 compared to controls), 4/50 (8%) children with Crohn`s disease (p=0.21 compared to controls) and 15/50 (30%) children with ulcerative colitis (p=0.09 compared to controls; p=0.01 compared to FGIDs; p=0.01 compared to Crohn`s).
Conclusions:
JH is more prevalent in patients suffering from ulcerative colitis compared to the healthy general population, yet the difference did not reach statistical significance. Likely, a proportion of children with ulcerative colitis and JH may show connective tissue abnormalities. However, whether JH can be considered a possible feature of pediatric GI disorders deserves further investigation.
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