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Objectives-To determine GI permeability and fecal calprotectin concentration in children 7-10 years of age with functional abdominal pain and irritable bowel syndrome (FAP/IBS) vs Controls and ascertain potential relationships with pain symptoms and stooling.Study design-GI permeability and fecal calprotectin concentration were measured. Children kept a two-week diary of pain episodes and stooling pattern.Results-Proximal GI permeability was greater in the FAP/IBS group (n = 93) compared with controls (n = 52) (0.59 ± 0.50 vs. 0.36 ± 0.26, respectively; mean ± SD; P < 0.001) as was colonic permeability (1.01 ± 0.67 vs. 0.81 ± 0.43, respectively; P < 0.05). Gastric and small intestinal permeability were similar. Fecal calprotectin concentration was greater in children with FAP/IBS compared with control children (65.5 ± 75.4 µg/g stool vs. 43.2 ± 39.4, respectively; P < 0.01). Fecal calprotectin concentration correlated with pain interference with activities (P = 0.01, r 2 = 0.36). There was no correlation between GI permeability and pain related symptoms. Neither permeability nor fecal calprotectin correlated with stool form.Conclusions-Children with FAP/IBS have evidence of increased GI permeability and low grade GI inflammation with the latter relating to the degree to which pain interferes with activities.Surveys suggest that 10% -17% of children between the ages of 4 and 16 years meet the criteria for recurrent abdominal pain (1-3). It has been suggested that the term recurrent abdominal pain be replaced by the terms functional abdominal pain (FAP) and irritable bowel syndrome (IBS) (4;5). FAP/IBS in children bear many similarities to IBS in adults and may be precursors for IBS (6-8). Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. GI permeability is increased in adults with IBS (9;10); however, the limited data in children are unclear. Similarly, a few studies report GI inflammation (i.e., increased fecal calprotectin concentration) in adults with IBS (9). Little data are available regarding calprotectin in children (11;12). To our knowledge no pediatric studies have sought to determine if changes in GI permeability and/or fecal calprotectin concentration relate to FAP/IBS symptoms (e.g., pain severity or frequency, stooling pattern). NIH Public AccessThe objectives of this study were to measure permeability throughout the GI tract (using sugar permeability tests) and gut inflammation (using fecal calprotectin) in a large group of well characterized children with FAP/IBS and to compare the results to healthy children without GI complaints. We used a site-speci...

Objectives This study sought to: 1) evaluate the ability of children to reliably use a modified Bristol Stool Form Scale for Children (mBSFS-C), 2) evaluate criterion-related validity of the mBSFS-C, and 3) identify the lower age limit for mBSFS-C use. Study design The mBSFS-C comprises five stool form types described and depicted in drawings. Children 3–18 years rated stool form for ten stool photographs. Due to low reliability when stool form descriptors were not read aloud (n=119), a subsequent sample (n=191) rated photographs with descriptors read. Results Intraclass correlation coefficients for descriptor-unread versus -read samples were 0.62 and 0.79. Children were increasingly reliable with age. Percentage of correct ratings varied by stool form type but generally increased with age. With descriptors unread, children 8 years and older demonstrated acceptable inter-observer reliability with over 78% of ratings correct. With descriptors read, children 6 years and older demonstrated acceptable reliability and over 80% of ratings correct. Conclusions The mBSFS-C is reliable and valid for use by children, age 6 being the lower limit for scale use with descriptors read and age 8 without descriptors read. We anticipate that the mBSFS-C can be effectively used in pediatric clinical and research settings.

Evaluated emotional distress, coping style, and marital adjustment in 84 parents (42 couples) of children with cancer 2 months after diagnosis and again about 20 months after diagnosis. As expected, mothers' mean state anxiety and trait anxiety scores decreased to near normal levels over time. Fathers' scores were lower initially and did not change. Neither mothers' nor fathers' mean marital adjustment scores changed over time. Marital adjustment at treatment follow-up was predicted by depression and the spouse's marital satisfaction in mothers, and depression, child health status, and spouse's marital satisfaction in fathers. In contrast to findings obtained 2 months after diagnosis, coping style was not related to marital adjustment at follow-up. Results are discussed in terms of possible gender differences in the role of social support in marital adjustment and the stability versus situational specificity of coping styles.