Prevalence of overlap syndromes and symptoms in pediatric functional dyspepsia.

Craig A Friesen,John M Rosen,Jennifer V Schurman

doi:10.1186/s12876-016-0495-3

Craig A Friesen, John M Rosen + Show 1 more

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https://doi.org/10.1186/s12876-016-0495-3

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Journal: BMC gastroenterology	Publication Date: Jul 25, 2016
Citations: 47	License type: cc-by

Affiliation: Children's Mercy Hospital

Abstract

BackgroundThe purpose was to evaluate the overlap frequency of irritable bowel syndrome (IBS), gastroesophageal reflux disease (GERD), and overactive bladder syndrome (OBS), as well as other gastrointestinal and systemic symptoms, in functional dyspepsia (FD). Additionally, we sought to determine whether adult Rome III FD subtypes were uniquely related to overlap syndromes or symptoms.MethodsThe study was a retrospective review of 100 consecutive pediatric patients, age 8–17 years, diagnosed with FD. All had completed a standardized medical history including gastrointestinal and systemic symptoms as well as specific symptoms related to GERD and OBS. The frequency of overlap with IBS, GERD, and OBS were determined for the whole group and for those fulfilling adult FD subtype criteria. Individual symptoms were also compared by FD subtype.ResultsOverlap IBS was present in 33 % of the FD patients. At least one GERD symptom was present in 74 % of patients with 41 % reporting heartburn. At least one OBS symptom was present in 44 % of patients with 29 % reporting urinary urgency. Other than pain, the most common reported gastrointestinal symptom was nausea (86 %). Systemic symptoms were common. Overlap syndromes/symptoms did not vary by FD subtype. Postprandial distress syndrome was associated with pain with eating, weight loss, and waking at night to have a stool.ConclusionsFD is a heterogeneous condition in children and adolescents with significant variability in the presence of gastrointestinal and non-gastrointestinal symptoms and overlap syndromes. Varying symptom profiles need to be accounted for and analyzed in studies involving subjects with FD.

Highlights

The purpose was to evaluate the overlap frequency of irritable bowel syndrome (IBS), gastroesophageal reflux disease (GERD), and overactive bladder syndrome (OBS), as well as other gastrointestinal and systemic symptoms, in functional dyspepsia (FD)
There are a number of pain-associated functional gastrointestinal disorders (FGIDs) defined by Rome III for children/adolescents, namely irritable bowel syndrome (IBS), functional dyspepsia (FD), abdominal migraines, functional abdominal pain, and functional abdominal pain syndrome [1]
Forty percent were treated with ranitidine (>6 mg/Kg/day up to 150 mg twice daily) and 72 % were treated with a proton pump inhibitor (PPI; >1 mg/Kg/day up to 40 mg twice daily for omeprazole, pantoprazole, and esomeprazole and up to 30 mg twice daily for lansoprazole)

Summary

Introduction

The purpose was to evaluate the overlap frequency of irritable bowel syndrome (IBS), gastroesophageal reflux disease (GERD), and overactive bladder syndrome (OBS), as well as other gastrointestinal and systemic symptoms, in functional dyspepsia (FD). Most children and adolescents with chronic abdominal pain fulfill criteria for an FGID with FD and IBS being the two most common [1, 5, 6] These diagnoses form the entry criteria for most abdominal pain studies and therapeutic trials. We have previously found that FD/IBS overlap accounts for 30 % of youth presenting for initial evaluation of chronic abdominal pain [6] This represents another area of variability in utilization of Rome criteria as some investigators diagnose overlap FD/IBS while others presumably default to IBS when symptoms of both are present [7]. It is important to determine to what degree, if any, individual FGIDs overlap with other syndromes or symptoms in order to understand variability within a diagnostic category which may affect study results or patient outcomes

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