Functional Gastrointestinal Disorders in African American Children in Primary Care

Abstract

Objective-To determine the prevalence of functional gastrointestinal disorders (FGIDs) in a primary care setting and to assess the usefulness of pediatric Rome criteria. Methods-TheQuestionnaire on Pediatric Gastrointestinal Symptoms (QPGS) assessing the pediatric Rome criteria was administered to 243 school-age children visiting a general pediatric clinic for annual school physicals. Pearson χ 2 statistics were used to determine the association of various demographic factors with FGIDs.Results-All children were African American, 47.7% were girls, and the mean ± standard deviation age of the group was 10.7 ± 3.9 years. QPGS detected 52 children (21.4%) with FGID. Diagnoses included aerophagia (6), abdominal migraine (1), cyclic vomiting syndrome (2), functional dyspepsia (2), functional abdominal pain syndrome (1), functional constipation (39) and functional fecal retention (1). Thorough clinical evaluation identified 47 (19.3%) children with FGIDs. Five of the children (2.1%) identified as having FGID on QPGS were felt not to have FGID by the examining physician. Children with FGIDs were not different from healthy children in age, insurance, parent's education, employment or number of children in the family. FGIDs were more common in girls (29/47 girls, P = 0.028). Children with FGIDs tended to live in singleparent households and miss school more often than children without FGIDs (P = 0.08).Conclusions-Functional gastrointestinal disorders are common among African American children and adolescents in a primary care setting and predominantly affect girls. Symptom-based criteria are useful in the diagnosis of pediatric FGIDs.

Functional gastrointestinal disorders: past and present

“…[6] Following publication, the Rome II criteria was used by researchers to assess prevalence and estimate rates of FGIDs among children with abdominal pain. [7][8][9][10] The application of the criteria in the clinical setting, however, was limited. [11] Studies showed that 16%-35% of children who previously would have satisfi ed Apley's recurrent abdominal pain criteria did not fi t any of the Rome II criteria.…”

Epidemiology of Uninvestigated Gastrointestinal Symptoms in Adolescents: A Population‐based Study Applying the Rome II Questionnaire

“…Conclusive findings indicated that the majority of GI symptoms in these age groups are because of functional disorders (14,17). Functional GI disorders (FGIDs) are more frequently found in females, and FGID patients exhibit more psychiatric diagnosis and psychosocial disturbances (18).…”

Investigation of Demographic and Clinical Characteristics of Children with Constipation Referring to the Pediatric Gastrointestinal Clinic, Shiraz in 2014 - 2016

“…Constipation comprises 3% -5% of inpatient referrals to pediatric physicians and specialists as well as 25% of cases referring to pediatric gastroenterology clinics (2). This disorder does not usually have any structural, endocrine, or metabolic causes and is therefore identified as idiopathic or functional constipation (3). Some studies have indicated that 90% -95% of cases suffer from functional constipation and only 5% -10% of children have organic factors (4).…”