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Adult Rome IV Disorders of Gut-Brain Interaction in a Pediatric Population
Natali González Rozo1,2, Carlos Alberto Velasco-Benítez3,4, Michelle Higuera Carrillo5,6
1Faculty of Medicine, Department of Pediatrics, Universidad de Pamplona, Cucuta 540001, Colombia.
Insights
Adult gut-brain interaction disorders (DGBIs) affect children, with 5.8% prevalence found in this study. These conditions are linked to depression and absenteeism, highlighting the need for a biopsychosocial approach in pediatric care.
Area of Science:
- Pediatric Gastroenterology
- Gut-Brain Interaction Disorders
- Functional Gastrointestinal Disorders
Background:
- Disorders of the Gut-Brain Interaction (DGBIs) are recognized in adults but underrepresented in pediatric diagnostic criteria.
- These conditions can manifest in childhood, impacting clinical and psychosocial well-being.
- Early identification is crucial for managing the impact on quality of life.
Purpose of the Study:
- To determine the prevalence of adult-defined DGBIs in a pediatric population using Rome IV criteria.
- To identify factors associated with these DGBIs in children and adolescents.
- To explore the relationship between DGBIs, mental health, and functional outcomes.
Main Methods:
- An observational, prospective, cross-sectional study involving 704 participants aged 13.7 ± 2.8 years from three Colombian cities.
- Utilized the adapted Questionnaire for Pediatric Gastrointestinal Symptoms Rome IV (QPGS-IV) based on adult criteria.
- Assessed quality of life and anxiety/depression using PROMIS scales, followed by statistical analyses including multivariate logistic regression.
Main Results:
- A prevalence of 5.8% for adult DGBIs was observed in the pediatric cohort, with proctalgia fugax being most common.
- Bivariate analysis revealed associations with race, school/social absenteeism, depressive traits, and impaired quality of life.
- Multivariate analysis identified depressive traits (OR=4.08), school absenteeism (OR=2.51), and social absenteeism (OR=4.04) as independent factors.
Conclusions:
- DGBIs, as defined in adults, occur in pediatric populations and are linked to psycho-emotional and functional issues.
- Depression and school/social absenteeism are significantly associated with these conditions in children.
- Findings support a biopsychosocial model and suggest a need to revise pediatric diagnostic criteria for DGBIs.
Abstract:
Background: Disorders of the gut-brain interaction (DGBIs) constitute a group of functional conditions widely described in adults; however, some of these have not been included in pediatric Rome criteria, despite the fact that they may manifest during childhood. Early identification of these conditions is relevant due to their clinical/psychosocial impact as well as their effect on quality of life. The aim was to determine the prevalence and associated factors of some DGBIs described in adults according to the Rome IV criteria in pediatric population. Methods: An observational/prospective/cross-sectional study was conducted in toddlers, school-aged children, and adolescents from three Colombian cities. The adapted Questionnaire for Pediatric Gastrointestinal Symptoms Rome IV (QPGS-IV) using adult criteria was applied, along with quality-of-life scales and PROMIS for anxiety/depression. Descriptive uni/bivariate analyses were performed as well as a multivariate logistic regression model. Results: A total of 704 participants were included (13.7 ± 2.8 years old). The prevalence of DGBIs described in adults according to QPGS-IV was 5.8%, with proctalgia fugax being the most frequent. In the bivariate analysis, race, school/social absenteeism, depressive traits, and impaired quality of life were significantly associated. In the multivariate model depressive traits (OR = 4.08; 95%CI = 1.82-9.12; p = 0.001), school (OR = 2.51; 95%CI = 1.06-5.98; p = 0.036), and social absenteeism (OR = 4.04; 95%CI = 1.70-9.62; p = 0.002) were the factors independently associated. Conclusions: These adult DGBIs, according to the QPGS-IV, can occur in pediatric populations and are closely related to psycho-emotional and functional factors. These are mainly associated with depression and school/social absenteeism, supporting the need for a biopsychosocial approach and a revision of the pediatric diagnostic criteria.
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