Abstract
Functional gastrointestinal disorders (FGID) are common among children and may cause a significant symptom burden. The Rome criteria are symptom-based guidelines for the assessment of FGID among children and adults. The aim of this systematic review was to estimate the prevalence of FGID utilizing the revised Rome IV criteria. Nine health databases were searched. The inclusion criteria were: prospective FGID prevalence data using the Rome IV criteria for children up to 18 years, and the exclusion criteria were: cohorts with known gastrointestinal or organic conditions. The data were presented as a percentage of children experiencing at least one FGID, as well as in individual categories. The searches identified 376 papers, with 20 included in the final analysis, providing a pooled cohort of 18,935 children. The median prevalence of FGID for children aged up to four years was 22.2% (range 5.8–40%), and aged four–eighteen years was 21.8% (range 19–40%). The most common FGID for children aged 0–12 months was infant regurgitation, the most common FGID for those aged 13–48 months were functional constipation and cyclic vomiting, and, for those aged over four years, functional constipation, functional dyspepsia, and irritable bowel syndrome. This reported overall incidence of FGID may be used as a benchmark of normative data among the general population and comparative data for those with comorbid disease.
Highlights
Functional gastrointestinal disorders (FGID) are common conditions among children and are characterised by recurring GI symptoms that are not attributable to structural or biochemical abnormalities or as a comorbidity of organic disease [1]
Three hundred seventy-six publications were identified from the searches (Appendix A), and 20 met the inclusion criteria of reporting the prevalence of FGID among children using the Rome IV criteria (Figure S1)
The prevalence of FGID from the included studies were stratified according to the Rome IV version for children aged up to four years (Table 2) and from four to eighteen years (Table 3)
Summary
Functional gastrointestinal disorders (FGID) are common conditions among children and are characterised by recurring GI symptoms that are not attributable to structural or biochemical abnormalities or as a comorbidity of organic disease [1]. FGID in children lead to a significant symptom burden with associated psychological distress, reduced quality of life, school absenteeism, greater health care expenditure, and missed work for parents [3]. FGID in childhood is linked to the progression of the disorder into adulthood, such that 25% of children who present with recurrent abdominal pain may subsequently develop irritable bowel syndrome (IBS) as an adult [4]. The diagnosis of FGID may be made using the Rome criteria, which are symptombased guidelines developed using scientific evidence and clinical experience [5]. The most recent iteration is Rome IV, which has paediatric versions available for toddlers (up to four years of age) [6] and children and adolescents (aged four to eighteen years) [5]
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