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Abdominal radiographs commonly are obtained by pediatric gastroenterologists in the evaluation and management of constipation. The majority used it to make a diagnosis, and nearly one-half changed their management based on the imaging findings. Overall, they reported an improved confidence in their management plan, despite evidence that radiographic findings poorly correlate with clinical severity. This study highlights the need for further provider education regarding the recommendations delineated in existing constipation guidelines.

Background: Pediatric Irritable Bowel Syndrome (IBS) is common and can be associated with disabling gastrointestinal symptoms. Comprehensive data regarding utilization and cost of pediatric IBS are lacking. Our aim was to determine the annual all-cause spending and healthcare utilization in pediatric IBS.Methods: Cross-sectional cohort study using a national claims database of commercially insured individuals. 932,592 members, age 8-18 years, were included. Members were selected based on PheWas codes and continuous enrollment in 2014. Linear and binomial regression models were used to calculate healthcare spending and compare comorbidities between IBS subjects and controls.Key Results: 1215 members with claims for IBS (68.4% female) and 931,377 controls (55.7% female) were included. Mean age was 15.03 ± 2.83 (median 16) years in the IBS group and 13.14 ± 3.12 (median 13) years in controls. Mental health and chronic pain comorbidities were more prevalent in the IBS cohort. Healthcare spending: The mean annual all-cause incremental spending of members with IBS was $6,364.60 compared to controls when adjusting for age and gender. Healthcare utilization: Members with IBS had increased healthcare utilization including higher rates of inpatient, outpatient, and emergency room visits, and higher rates of health service utilization including medical care, radiology/laboratory services, surgery, anesthesia, mental health, and physical therapy. General pediatrics was more frequently consulted by controls. All subspecialty consultations, with the exception of dental medicine and endocrinology, were sought more frequently by IBS patients. Conclusion:Patients with IBS incur significant annual spending through increased healthcare utilization.

Objective: We aimed to assess how the first phase of coronavirus disease 2019 (COVID-19) pandemic influenced symptoms in children with functional abdominal pain disorders (FAPDs) and to characterize their quality of life (QoL), anxiety and global health. Methods: This was a multicenter, observational, international study conducted between April and July 2020 at six different referral centers. Children diagnosed with FAPDs between October 2019 and February 2020 were enrolled and prospectively interviewed at 4 months of follow-up during the first pandemic phase (Quarantine group). Patients were asked to complete PedsQL 4.0 Generic Core Scale and PROMIS Anxiety and Global Health questionnaires. A cohort of children diagnosed with FAPDs between October 2018 and February 2019 was used as a Control group. Results: Three-hundred-fifty-six children were enrolled of whom 180 (mean age at diagnosis: 14 AE 2.8 years) in the Quarantine group and 176 (mean age at diagnosis: 13 AE 2.8 years) in the Control group. At 4 months of follow-up, we observed a significant reduction of children reporting >5 episodes of abdominal pain per month when compared to baseline, in both groups (Quarantine group: 63.9% vs 42.2%, P < 0.001; Control group: 83.5% vs 50%, P < 0.001). The Quarantine group had median QoL values of 84.8 with 16.6% of children showing high anxiety values and 55% having decreased global health score. Conclusions: We demonstrated symptoms' improvement at 4 months of follow-up in both cohorts. During the first months of the COVID-19 quarantine children with FAPDs showed satisfactory QoL and anxiety scores, suggesting positive effects of school closure and increased parental attention.