Postinfectious Functional Gastrointestinal Disorders in Children: A Multicenter Prospective Study - 26/03/15

Doi : 10.1016/j.jpeds.2014.12.050

Licia Pensabene, MD, PhD ^1,^⁎ , Valentina Talarico, MD ¹, Daniela Concolino, MD ¹, Domenico Ciliberto, MD ², Angelo Campanozzi, MD ³, Teresa Gentile, MD ⁴, Vincenzo Rutigliano, MD ⁵, Silvia Salvatore, MD ⁶, Annamaria Staiano, MD ⁷, Carlo Di Lorenzo, MD ⁸
on behalf of the
Post-Infectious Functional Gastrointestinal Disorders Study Group of the Italian Society for Pediatric Gastroenterology, Hepatology and Nutrition^{^∗}
List of members of the Post-Infectious Functional Gastrointestinal Disorders Study Group of the Italian Society for Pediatric Gastroenterology, Hepatology and Nutrition is available at www.jpeds.com (Appendix).
Francesca Graziano, MD, Bianca Virginia Palermo, MD, Mariateresa Sanseviero, MD, Federica Altomare, MD, Elvira Cozza, MD, Antonella Falvo, MD, Antonio Marseglia, MD, Elisabetta Gatta, MD, Domenica De Venuto, MD, Antonio Ripepi, MD, Rossella Turco, MD

¹ Department of Pediatrics, University Magna Graecia, Catanzaro, Italy
² Department of Oncology, University Magna Graecia, Catanzaro, Italy
³ Department of Pediatrics, University of Foggia, Foggia, Italy
⁴ Department of Pediatrics, University of L'Aquila, L'Aquila, Italy
⁵ Department of Pediatrics, University of Bari, Bari, Italy
⁶ Department of Pediatrics, University of Varese, Varese, Italy
⁷ Department of Translational Medical Science, Section of Pediatrics, University of Naples, Naples, Italy
⁸ Department of Pediatrics, Nationwide Children's Hospital, Columbus, OH

^∗Reprint requests: Licia Pensabene, MD, PhD, Department of Pediatrics, University “Magna Græcia” of Catanzaro, Pugliese-Ciaccio Hospital, Viale Pio X, 88100 Catanzaro, Italy.

Abstract

Objectives

To prospectively investigate the occurrence of postinfectious functional gastrointestinal disorders (FGIDs), diagnosed according to the Rome III criteria, in children with acute diarrhea of different infectious etiology.

Study design

This was a prospective cohort multicenter study. Children 4-17 years of age presenting with acute diarrhea who tested positive for an enteric infection were recruited within 1 month from the episode and matched with control subjects of similar age and sex. Symptoms were evaluated with a validated questionnaire for FGIDs at the time of enrollment in the study and after 3 and 6 months.

Results

A total of 64 patients (36 boys; median age 5.3 years; age range 4.1-14.1 years) were recruited, 32 subjects in each arm. Infections included rotavirus (56.8%), salmonella (30%), adenovirus (6.6%), norovirus (3.3%), and Giardia lamblia (3.3%). FGIDs were significantly more common in exposed patients compared with controls within 1 month from acute diarrhea (40.6% vs 12.5% [P = .02, relative risk (RR) = 1.9]), 3 months (53% vs 15.6% [P = .003, RR = 2.2]), and 6 months (46.8% vs 15.6% [P = .01, RR = 1.9]) later. No correlation was found between different etiologies, age, or sex, and any type of FGIDs. Among exposed children, abdominal pain–related FGIDs were significantly more frequent compared with controls after 6 months from infection (P = .04, RR = 1.7).

Conclusion

This prospective cohort multicenter study supports postinfectious FGIDs as a true entity in children. There seems to be a significant increase in abdominal pain–related FGIDs after acute diarrhea in children within 1 month and 3 and 6 months later.

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Keyword : AP-FGID, FGID, IBS, PI-FGID, PI-IBS, QPGS-RIII

Plan

The authors declare no conflicts of interest.

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Vol 166 - N° 4

P. 903 - avril 2015 Retour au numéro

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Postinfectious Functional Gastrointestinal Disorders in Children: A Multicenter Prospective Study - 26/03/15

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