Initial Diagnosis of Functional Gastrointestinal Disorders in Children Increases a Chance for Resolution of Symptoms

Abstract

PurposeThe aim of this study was to describe functional gastrointestinal disorders (FGID) presented in a tertiary medical center, characteristics of patients and results of the diagnostic work-up together with an outcome during the follow up.MethodsThis was a retrospective, single center, observational study including all patients who were diagnosed with FGID based on Rome III criteria from January to December 2015 in tertiary medical center.ResultsOverall 294 children were included (mean age, 8.9 years [range, 1–18 years]; 165 females). Majority had functional constipation (35.4%), followed by functional abdominal pain (30.6%), irritable bowel syndrome (17.0%), functional dyspepsia (12.6%), functional nausea (3.4%) and abdominal migraine (1.0%). Regression model found that only significant factor associated with improvement of symptoms is the establishment of the functional diagnosis at the first visit (hazard ratio, 2.163; 95% confidence inverval, 1.029–4.544). There was no association between improvement of symptoms and presence of alarm signs/symptoms (weight loss, nocturnal symptoms and severe vomiting) at diagnosis. Furthermore, in pain symptoms (functional abdominal pain, irritable bowel syndrome, dyspepsia) no treatment positively correlated with pain improvement.ConclusionRegardless of the initial diagnosis of FGID, positive diagnosis at the first visit increases a chance for resolution of symptoms.

Nationwide Survey for Application of ROME IV Criteria and Clinical Practice for Functional Constipation in Children

“…The diagnosis of pediatric FC is based on a “positive” approach that avoids unnecessary tests to rule out an organic cause 1213. Scarpato et al8 reported that 42% of pediatricians considered FC a diagnosis of exclusion that was reached after a thorough diagnostic evaluation for other etiologies.…”

Functional digestive disorders in children. Guidelines of the Society of Pediatric Gastroenterologists, Hepatologists and Nutritionists. Part 2

“…2.2. Имеются отдельные сообщения, в которых функциональная тошнота и функциональная рвота встречались у 0,7% детей в возрасте 8-18 лет, функциональная тошнота у 3,4% [4][5][6][7].…”

Understanding the Changes in Diagnostic Criteria for Functional Constipation in Pediatric Patients: From Rome III to Rome IV

“…10,11 A recent study also suggested that diagnosing an FGID at the first visit was the only significant prognostic factor associated with symptom resolution. 12 Thus, early and adequate diagnoses are essential for appropriate treatment in patients with FC, ultimately leading to better outcomes in these patients.…”

“…It is noteworthy that this study investigated the Rome IV questionnaires in an unselected outpatient population. Few studies have evaluated the prevalence of FC using the Rome criteria and most of them were conducted in secondary and tertiary hospitals, [12][13][14] while the majority of children suffering from constipation are present and managed in a primary care setting. Moreover, the diagnosis of FC was made not only based on a questionnaire, but also included a physical examination in this study.…”