Functional gastrointestinal disorders: Dynamic observation of pediatric cases

Abstract

Introduction: Functional gastrointestinal disorders (FGID) are a variable set of clinical cases characterized by recurrent/chronic symptoms not associated with an organic pathology. These disorders are classified using the Rome III criteria. Objective: The study wanted to evaluate the prevalence by gender and age of FGIDs in a pediatric population recruited on the basis of recurrent/chronic abdominal pain, and to follow up patients for six months by administering questionnaires aimed at verifying any changes in symptoms. We also evaluated the possible involvement of factors responsible for these changes. Results: 62 patients between 4 and 17 years of age (27 males and 35 females) were included in our observational-prospective study. 4 cases were ascribed to an organic pathology, while the remaining 58 were confirmed as FGID cases. The most prevalent disorder was functional retentive constipation. After the six-month follow up period, 10% of cases showed improvement, while 5% evolved to another Rome III class. Possible factors of improvement were change in parent behavior, lifestyle and socio-economic status, and disappearance of stressful events. Considering FGIDs’ multifactorial pathogenesis, it is likely that the synergy between these factors contributed to the improvement, without pharmacological interventions. Conclusions: FGIDs are currently on the rise, with an increase in hospitalization and the attached social and economic costs to children, their families and the health care system. In the context of a prospective evaluation, our study emphasizes possible non-pharmacological therapeutic interventions.