Functional gastrointestinal disorders in childhood (FGIDs) constitute a significant time-consuming clinical problem for healthcare practitioners, and they carry an important psychosocial burden for patients and their families. The aim of this study was to characterize etiology, clinical features, and interventions in a paediatric cohort of patients with FGIDs, who were referred to a tertiary care university-affiliated centre. Methods A retrospective study of children aged 1-15 years old referred to the Clinic for Children’s Diseases, University Clinical Center Tuzla, from January 2022 to December 2022, who fulfilled criteria for FGIDs (n=209), were divided in three groups: 0-3, 4-10 and 11-15 years old. Demographic characteristics, number of examinations, duration of symptoms, initial diagnosis, hospital evaluation and outcomes of each child were collected. Results During the study period, 670 patients were referred to a gastroenterologist, out of whom 209 (31.2%) fulfilled the criteria for FGIDs, with median age of 8.0 years. Females were predominant in all groups (p=0.0369). Children aged 4 to 10 years were significantly more frequent (p<0.0001). A median duration of symptoms was one year. Functional constipation was the most common diagnosis, 99 (47.4%), followed by functional abdominal pain not otherwise specified, 67 (37.2%), and functional dyspepsia, 25 (12.0%). Fifty-two percent of patients did not require further follow-up by the gastroenterologist. Conclusion Although FGDIs are frequent, they are not well accepted neither among patients nor physicians. Extensive diagnostic procedures are often unnecessary and the cessation of specialized care follow-up is possible in a significant number of cases.
Andrews ET, Beattie RM, Tighe MP. Functional abdominal pain: what clinicians need to know. Arch Dis Child. 2020;105:938–44.
2.
Vernon-Roberts A, Alexander I, Day AS. Systematic review of pediatric functional gastrointestinal disorders (Rome IV criteria. J Clin Med. 2021;10(5087).
3.
Strisciuglio C, Cenni S, Serra MR, Dolce P, Kolacek S, Sila S, et al. Functional gastrointestinal disorders in mediterranean countries according to Rome IV criteria. J Pediatr Gastroenterol Nutr. 2022;74:361–7.
4.
Tran DL, Sintusek P. Functional constipation in children: What physicians should know. World J Gastroenterol. 2023;29:1261–88.
5.
Brusaferro A, Farinelli E, Zenzeri L, Cozzali R, Esposito S. The management of paediatric functional abdominal pain disorders: latest evidence. Paediatr Drugs. 2018;20:235–47.
6.
Alkhuzaei H, Almatrafi MA, Alqahtani W, Alotaibi R, Eid D, Matar E, et al. Patterns of functional gastrointestinal disorders among children in Makkah City: a single institutional experience. Cureus. 2022;14 32224.
7.
Michael R, Bettina V, Eckehard L. Functional gastrointestinal disorders in children: effectivity, safety, and tolerability of the herbal preparation STW5 (Iberogast®) in general practice. Complement Ther Med. 2022;71(102873).
8.
Martins GP, Sandy NS, Alvarenga LR, Lomazi EA, Bellomo-Brandão MA. Functional abdominal pain is the main etiology among children referred to tertiary care level for chronic abdominal pain. Arq Gastroenterol. 2022;59:97–101.
9.
Bermejo CA, Barrio J, Fernández B, García-Ochoa E, Santos A, Herreros M, et al. Functional gastrointestinal disorder frequency by Roma IV criteria. An Pediatr (Barc. 2022;96:441–7.
10.
Jyoti M, Shailender M, Thomas R. Economic impact and prognostic factors of functional dyspepsia in children. J Pediatr Gastroenterol Nutr. 2020;70:65–70.
11.
Robin SG, Keller C, Zwiener R, Hyman PE, Nurko S, Saps M, et al. Prevalence of pediatric functional gastrointestinal disorders utilizing the Rome IV criteria. J Pediatr. 2018;195:134–9.
12.
Sperber AD, Bangdiwala SI, Drossman DA, Ghoshal UC, Simren M, Tack J, et al. Worldwide prevalence and burden of functional gastrointestinal disorders, results of Rome foundation global study. Gastroenterology. 2021;160:99–114.
13.
Boronat AC, Ferreira-Maia AP, Matijasevich A, Wang YP. Epidemiology of functional gastrointestinal disorders in children and adolescents: a systematic review. World J Gastroenterol. 2017;23:3915–27.
14.
Petersen MW, Schröder A, Jørgensen T, Ørnbøl E, Meinertz Dantoft T, Eliasen M, et al. Irritable bowel, chronic widespread pain, chronic fatigue and related syndromes are prevalent and highly overlapping in the general population: DanFunD. Sci Rep. 2020;10(3273).
15.
Kovacic K, Kapavarapu PK, Sood MR, Li BUK, Nugent M, Simpson P, et al. Nausea exacerbates symptom burden, quality of life, and functioning in adolescents with functional abdominal pain disorders. Neurogastroenterol Motil Off J Eur Gastrointest Motil Soc. 2019;31:e13595.
16.
Chumpitazi BP, Palermo TM, Hollier JM, Self MM, Czyzewski D, Weidler EM, et al. Multisite pain is highly prevalent in children with functional abdominal pain disorders and is associated with increased morbidity. J Pediatr. 2021;36:131–6.
17.
Nightingale S, Sharma A. Functional gastrointestinal disorders in children: what is new? J Pediatr Child Health. 2020;56:1724–30.
18.
Rutsch A, Kantsjö JB, Ronchi F. The gut-brain axis: how microbiota and host inflammasome influence brain physiology and pathology. Front Immunol. 2020;11(604179).
19.
F FN, MR S, S C, D P, M M, E M, et al. Prevalence of functional gastrointestinal disorders in children with celiac disease on different types of gluten-free diets. World J Gastroenterol. 2022;28:6589–98.
20.
Sabo CM, Dumitrascu DL. Microbiota and the irritable bowel syndrome. Minerva Gastroenterol. 2021;67:377–84.
21.
Schmulson MJ, Drossman DA. What Is New in Rome IV. J Neurogastroenterol Motil. 2017;23:151–63.
22.
Mousavi E, Keshteli AH, Sehhati M, Vaez A, Adibi P. Re-investigation of functional gastrointestinal disorders utilizing a machine learning approach. BMC Med Inform Decis Mak. 2023;23(167).
23.
Drossman DA. Functional gastrointestinal disorders: history, pathophysiology, clinical features and Rome IV. Gastroenterology. 2016;150:1262–79.
24.
Thapar N, Benninga MA, Crowell MD, Lorenzo C, Mack I, Nurko S, et al. Paediatric functional abdominal pain disorders. Nat Rev Dis Primer. 2020;6:1–23.
The statements, opinions and data contained in the journal are solely those of the individual authors and contributors and not of the publisher and the editor(s). We stay neutral with regard to jurisdictional claims in published maps and institutional affiliations.