Biliary-type pain in children with chronic abdominal pain: A cross-sectional, observational study

Functional gallbladder disorders are well-recognized entities in adults with standardized diagnostic criteria since the Rome III criteria. The existence of these disorders in children is still debated. The primary aim was to estimate the prevalence of disorders of gut-brain interaction (DGBIs) with abdominal pain, particularly biliary pain (BP), in children using adult criteria. The secondary aim was to assess their quality of life.

This cross-sectional, observational study (March-November 2023) included children aged 4-18 years with chronic abdominal pain. Children with organic pathologies or comorbidities were excluded. Patients completed the ROMA IV questionnaire for DGBIs and the PedQL4 Generic Core questionnaires for health-related quality of life, and were assessed for whether they fulfilled adult Rome IV criteria for BP.

Among 120 children (median age: 9.4 years; M/F: 49/71), 90 (75%) were diagnosed with DGBIs. An overlap of multiple functional disorders was found in 34 children (28.3%). Functional dyspepsia (25.8%) was the most common. Eleven patients (9.2%) met the adult ROMA IV criteria for BP, and seven (63.3%) showed an overlap with another DGBIs. The median PedsQL4 score was 70.6 (39.1-97.8). No statistically significant differences were found when the cohort was divided by gender (p = 0.5). Patients with possible BP did not report a lower quality of life (total median score: 78.3 [45.6-95.6] vs. 69.6 [39.1-97.8]; p = 0.2).

In a cohort of children with chronic abdominal pain, 9.2% of the cases met adult Rome IV criteria for BP. However, a high risk of overlap with different DGBIs was observed.