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Functional gastrointestinal disorders frequency by Rome IV criteria
Claudia Alonso-Bermejo1, Josefa Barrio1, Beatriz Fernández1
1Servicio de Pediatría, Unidad de Gastroenterología Pediátrica, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, Spain.
Insights
Functional gastrointestinal disorders (FGIDs) are common in children, diagnosed in about a third of pediatric gastroenterology consultations. Rome IV criteria are more inclusive, but nearly 30% of suspected FGID cases do not meet these criteria, with no significant seasonal diagnostic variability observed.
Area of Science:
- Pediatric Gastroenterology
- Functional Gastrointestinal Disorders
- Clinical Epidemiology
Background:
- Functional gastrointestinal disorders (FGIDs) are highly prevalent in children, significantly impacting their well-being and family life.
- Current diagnostic criteria, such as Rome IV, aim to standardize FGID diagnosis in pediatric populations.
Purpose of the Study:
- To determine the frequency of FGIDs in a pediatric gastroenterology setting based on Rome IV criteria.
- To investigate potential seasonal variations in the diagnosis of pediatric FGIDs.
Main Methods:
- A prospective, descriptive study was conducted over 12 months.
- Children under 16 with suspected FGIDs undergoing their first pediatric gastroenterology consultation were enrolled.
- Diagnosis and classification were performed according to Rome IV criteria.
Main Results:
- FGIDs were suspected in 44.6% and diagnosed in 32.4% of 574 pediatric consultations.
- Functional constipation was the most common FGID in younger children (<4 years), while functional abdominal pain and dyspepsia were most frequent in older children (>4 years).
- No statistically significant seasonal variation in FGID diagnosis was found for the overall population or by age group.
Conclusions:
- FGIDs represent a substantial proportion (one-third) of pediatric gastroenterology consultations.
- Despite the inclusivity of Rome IV criteria, a notable percentage of patients with suspected FGIDs do not meet diagnostic thresholds.
- The study found no significant seasonal influence on the diagnosis of FGIDs in the pediatric population.
Introduction:
Functional gastrointestinal disorders (FGIDs) are a very common pediatric disease, with strong implications for children and their families. We aimed to determine their frequency in our environment (per Rome IV criteria) and to establish if there is seasonal variability in diagnosis.
Methods:
Descriptive, prospective study. For 12 months, children under 16 years of age with suspected FGIDs who had a first pediatric gastroenterology consultation were included and classified according to Rome IV criteria. Statistical analysis was done with SPSS v22.
Results:
574 children received consultations, 67% were >4 years of age. FGIDs were suspected in 44.6% of the patients, 32.4% were diagnosed according to Rome IV criteria (16.4% <4 years, 40.3% >4 years). 51.1% were female, average age of 8.4 ± 4.2 years and mean of 7 months of symptoms until diagnosis (range 3-150). In patients <4 years, the most common disorders were functional constipation (48.4%), regurgitation (22.5%) and functional diarrhea (16.1%); in patients >4 years of age, functional abdominal pain (29%), functional dyspepsia (28.4%) and functional constipation (16.8%) were most frequent. We didn't discern seasonal variations in diagnosis in the global study population (p = 0.96) or by age group (<4 p = 0.51; >4 p = 0.57).
Conclusions:
FGIDs account for one third of our patients' consultations. While the Rome IV criteria are more inclusive than before, almost 30% of patients with suspected FGIDs don't meet said criteria. Although a seasonal difference regarding diagnosis was observed, it wasn't statistically significant either in the sample group as a whole or by age group.
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