Elevated fecal calprotectin is linked to psychosocial complexity in pediatric functional abdominal pain disorders
Erin L Moorman1, Michael Farrell2,3, Neha Santucci2,3
1Department of Clinical and Health Psychology, University of Florida, P.O. Box 100165, Gainesville, FL, 32610-0165, USA. Erin.Moorman@ufl.edu.
Insights
Children with functional abdominal pain disorders and three risk factors (anxiety, disability, pain) showed higher fecal calprotectin (FC) levels, indicating increased gastrointestinal inflammation. This highlights the importance of a biopsychosocial approach for understanding FAPD.
Area of Science:
- Pediatric Gastroenterology
- Child Psychology
- Biomedical Research
Background:
- Functional abdominal pain disorders (FAPD) in children are often linked to persistent disability.
- Anxiety, functional disability, and pain intensity are identified risk factors for FAPD.
- Elevated fecal calprotectin (FC) suggests gastrointestinal inflammation.
Purpose of the Study:
- To investigate the association between the presence of three specific risk factors (anxiety, functional disability, pain) and gastrointestinal inflammation in children with FAPD.
- To compare FC concentrations in children with three risk factors versus those with fewer or no risk factors.
Main Methods:
- Fifty-six children diagnosed with FAPD were assessed for anxiety, functional disability, and pain intensity.
- Participants were categorized into risk groups based on the number of identified risk factors (0-3).
- Fisher's exact tests were used to compare FC levels (≥50 µg/g) between risk groups.
Main Results:
- Children with three risk factors exhibited significantly higher mean FC concentrations (86.04 µg/g) compared to those with zero (25.78 µg/g), one (38.59 µg/g), and two risk factors (45.06 µg/g).
- Children with three risk factors had borderline elevated FC, while those with fewer risk factors had normal FC levels.
- A statistically significant difference in FC levels was observed across the risk groups (p < 0.05).
Conclusions:
- The presence of three risk factors (anxiety, functional disability, pain) in children with FAPD is associated with increased gastrointestinal inflammation.
- These findings underscore the utility of a biopsychosocial model in characterizing FAPD phenotypes.
- Further research may elucidate specific FAPD phenotypes based on risk factor profiles and inflammatory markers.
Objective:
Children with functional abdominal pain disorders (FAPD) and clinical elevations in three risk areas (anxiety, functional disability, and pain) have been found to be at increased risk for persistent disability. We evaluated if the presence of these three risk factors corresponded with greater gastrointestinal inflammation (measured via fecal calprotectin; FC) compared to those with no risk factors. FC concentration differences between children with three risk factors and those with one and two risk factors were explored.
Results:
Fifty-six children with FAPD (Mage = 12.23) completed measures of anxiety (Screen for Child Anxiety Related Disorders), disability (Functional Disability Inventory), and pain intensity (Numeric Rating Scale). Participants were stratified into risk groups (range: 0-3). Fisher's exact tests were conducted to determine if children with three versus fewer risk factors were more likely to have elevated FC (≥ 50 µg/g) versus normal levels. Children with three risk factors (MFC = 86.04) were more likely to have elevated FC compared to children with zero (MFC = 25.78), one (MFC = 38.59), and two risk factors (MFC = 45.06; p's < 0.05). Those with three risk factors had borderline elevated FC concentrations whereas those with fewer had normal FC concentrations. Findings suggest the importance of a biopsychosocial approach to help elucidate a FAPD phenotype.
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