Abdominal Migraine Research Articles

Cyclic Vomiting Syndrome in Patients Affected by Jansen-de Vries Syndrome: Results From an International Survey.

Jansen-de Vries syndrome (JdVS) is an autosomal dominant neurodevelopmental disorder with intellectual disability and gastrointestinal (GI) abnormalities, including recurrent vomiting. This study aimed to understand the frequency and severity of GI symptoms in JdVS patients and to investigate the potential association with cyclic vomiting syndrome (CVS), which has not been previously reported. An international online survey assessed the prevalence and features of CVS and GI disorders in JdVS patients using Rome IV Criteria. The anonymous survey was conducted via Google Forms in April 2021. A total of 21 patients/guardians responded to the survey. The average age at JdVS diagnosis was 8.22 years (range: 1-42). Of the respondents, 6 (28.5%) had a CVS diagnosis, 5 (23.8%) had migraine, and 2 (9.5%) had abdominal migraine. Additionally, 8 (38%) had gastroesophageal reflux disease (GERD) and 8 (38%) had functional constipation. An analysis targeted questions showed that 7 (33%) met the Rome IV Criteria for CVS but were undiagnosed, leading to a CVS prevalence of 61% in this cohort. This study highlights a high prevalence of CVS in JdVS patients and underscores the need for increased awareness and accurate diagnosis to address misdiagnosis.

Episodic syndromes associated with migraine (clinical and epidemiological study in pediatric practice)

Migraine in children can manifest itself in non-pain clinical phenotypes, among which several episodic syndromes associated with migraine (ESAM) are identified. A significant association with the later development of migraine was found for infantile colic syndrome, benign torticollis, abdominal migraine (AM), cyclic vomiting syndrome (CVS) and benign paroxysmal vertigo (BPV).Objective: to identify the clinical and epidemiological characteristics of childhood ESAM and its association with migraine.Material and methods. The study was conducted in Tambov Children's Clinical Hospital. A total of 250 children were included in the study: 120 (48%) girls and 130 (52%) boys aged 5 to 18 years (mean age 13±2.9 years, median age 13 [11; 15] years) with headache complaints. The diagnosis of ESAM was made according to the ICHD-3 criteria.Results. ESAM was observed in 95 (38%) patients aged 5–18 years. An analysis of the prevalence of ESAM in the different age groups showed that in children aged 5–10 years CVS (n=12; 4.8%) was more common than AM (n=6; 2.4%) and BPV (n=5; 2%). In the group of 11–14 year-old children, the frequency of AM clearly predominated (n=11; 4.4%), while in the group of 15–18 year-old adolescents, BPV (n=15; 6%) was observed more frequently compared to CVS (n=9; 3.5%) and AM (n=5; 2%).Conclusion. The results of the study indicate a high incidence of ESAM in child and adolescent patients of somatic and neurological hospitals. The data obtained show the importance of timely diagnosis and correct treatment of ESAM.

Abdominal migraine - a literature review

Abdominal migraine - a literature review

Translation process of the tested Rome IV diagnostic questionnaire for functional gastrointestinal disorders into Saudi-Arabian Arabic: A mixed-methods approach.

A report on the cross-cultural adaptation and validation process of the Rome IV Diagnostic Questionnaire for children aged four years and over into Saudi-Arabian Arabic for use in assessing the prevalence of functional gastrointestinal disorders in children in Saudi Arabia. A mixed-methods approach was used in translating the 60-item original English version of the questionnaire. The process included four steps followed by a cognitive debriefing and was guided by the Rome Foundation. The questionnaire was tested for practicability with 10 participants of children aged four years and older. The whole study took place between October 2020 and April 2021. The original questionnaire repeated information on areas of pain experienced by children, which did not show up in the backward, English, translation. The back-translated version occasionally provided medical expressions that were then explained between parentheses in plain English, for example, dyspepsia (burning feeling). The expert panel indicated that all questionnaire items reached the set 90% agreement level, confirming that the questionnaire is fully understandable and valid for use. Preliminary testing with 10 participants (four years and older) revealed functional constipation to have the highest prevalence among the participants (40%, n=4), followed by irritable bowel syndrome (20%) and abdominal migraine (20%). This study provides a detailed report on the translation process of the tested ROME- IV Diagnostic Questionnaire for children aged four years and over into Saudi Arabic following Rome Foundation guidelines. The results of the preliminary test should encourage researchers and clinicians in Saudi Arabia to utilize the tool for non-invasive diagnosis of functional gastrointestinal disorders in children.

Evidence-based review and frontiers of migraine therapy.

Cyclic vomiting syndrome (CVS) is identified as one of the "episodic syndromes that may be associated with migraine," along with benign paroxysmal torticollis, benign paroxysmal vertigo, and abdominal migraine. It has been proposed that CVS and migraine may share pathophysiologic mechanisms of hypothalamic activation and altered dopaminergic signaling, and impaired sensorimotor intrinsic connectivity. The past decade has brought groundbreaking advances in the treatment of migraine and other headache disorders. While many of these therapies have yet to be studied in episodic syndromes associated with migraine including CVS and abdominal migraine, the potential shared pathophysiology among these conditions suggests that use of migraine-specific treatments may have a beneficial role even in those for whom headache is not the primary symptom. This manuscript highlights newer therapies in migraine. Calcitonin gene-related peptide (CGRP) and its relation to migraine pathophysiology and the therapies that target the CGRP pathway, as well as a 5HT1F receptor agonist and neuromodulation devices used to treat migraine are briefly discussed as they may potentially prove to be useful in the future treatment of CVS.

Exploring the Prevalence of Functional Gastrointestinal Diseases and the Accompanied Differences in Dietary and Lifestyle Patterns: A Two-Generational Study.

Generation Z and millennials in Saudi Arabia both experienced the stress of the COVID-19 pandemic and the accompanying factors that may have had an impact on the incidence of functional gastrointestinal diseases (FGIDs) in both generations. This study aims to explore how prevalent FGIDs are among adolescents and their parents. A cross-sectional, school-based study conducted in public high schools for boys and girls in Jeddah, Saudi Arabia. We adapted 37 items from the ROME IV Diagnostic Questionnaires for children and adults, as well as other questionnaires. IBM SPSS Statistics (Version 28.0) was used. Generation Z showed a higher prevalence of FGIDs (33.5%, n = 126) in comparison with millennials (20.0%, n = 28). In both generations, the most prevalent FGID was functional constipation; the least prevalent were irritable bowel syndrome and abdominal migraine, with no significant change in the severity or frequency of symptoms during the pandemic. The type of commonly consumed beverages was a risk factor for FGIDs. Participants in generation Z were less likely to use complementary and alternative medicine (67.4%) to prevent diseases and enhance immunity compared with millennials (82.9%). The study results confirmed disparities in the prevalence of FGIDs between the two generations before and during the COVID-19 pandemic, which requires further research in other areas of Saudi Arabia. Recognizing the differences between the millennial parents and the generation Z high schoolers could assist health professionals in planning individualized, generation-based interventions and educators in designing and tailoring programs based on generational differences.

That’s annoying! In the brain—Migraine. In the gut—Abdominal migraine

That’s annoying! In the brain—Migraine. In the gut—Abdominal migraine

BIOM-08. CDKN2A --AN INDEPENDENT CYCLIN-DEPENDENT KINASE INHIBITOR VARIANT ASSOCIATED WITH MALIGNANCY AND WITH SMALL VESSEL STROKE, AS A POTENTIAL MARKER FOR RISK OF LARGE-VESSEL STROKE COMPLICATING BENIGN TERATOMA

Abstract BACKGROUND Cyclin-dependent kinase inhibitor variants, particularly those of CDKN2A are known to be associated with autosomal dominant Familial Atypical Multiple Mole/Melanoma Syndrome and pancreatic cancer predisposition. These variants are associated with risk of small vessel stroke in African/ African-American populations, and are risk factors for stroke in Nordic populations with hypertension, independent of cardiovascular risk factors. METHODS We performed a case review of a female presenting in late infancy with a central nervous system teratoma, that later was complicated by a right hemispheric middle cerebral artery (MCA)stroke, associated with a CDKN2A germline mutation. RESULTS This 14month old female presented with transient alterations of consciousness and apparent abdominal migraine events with pernicious vomiting. Neuroimaging revealed a right heterogeneous para- suprasellar mass and bilateral complex arachnoid adjacent cysts. She was observed closely for any progression, as the lesion was immediately adjacent to the optic chiasm. One year after presentation, she developed an acute ischemic right middle cerebral artery (MCA) stroke and had radiographic evidence of severe stenosis and decreased flow primarily within the right supra-clinoid internal carotid artery, the M1 segment and portion of the right A1 segment of cerebral vessels, with decreased enhancement and number of vessels in the distal right MCA territory. The vessels did not appear to be compressed by any mass effect. The radiologic appearance was consistent with vasospasm. The patient upon stoke recovery, underwent near- complete resection of the mass with no evidence of disruption of the capsule surrounding it and no vascular infiltration. Pathology revealed the expected teratoma with prominence of pancreatic acinar structures, and molecular evidence of a variant of CDKN2A, which was present in the patient and mother in the germline. CONCLUSION We propose that the imaging evidence of a vasculopathy was related to the genotype at the cyclin- dependent kinase site.

Functional Abdominal Pain in Children

Background: Functional abdominal pain (FAP), often affecting girls and those with mental health issues, is a prevalent pediatric disorder characterized by persistent symptoms without a clear identifiable organic pathology. The Rome IV Criteria classify it into subtypes, which have distinct symptoms and required tailored management approaches. Discussion: Subtypes classified by the Rome IV Criteria include irritable bowel syndrome (IBS), functional dyspepsia, abdominal migraine, and FAP - not otherwise specified (NOS). The pathophysiology involves gut hypersensitivity, hyperalgesia, genetic predispositions, and psychosocial triggers. Diagnosis relies on medical history, physical examination, the presence of alarm signs, and the characteristic of pain. Treatment strategies encompass dietary modifications, psychological interventions, pharmacology treatment including proton pump inhibitors, prokinetics, and antidepressants like amitriptyline. Conclusion: Recognizing the specific subtypes, as defined by the Rome IV Criteria, allows healthcare professionals to implement individualized care strategies for optimal outcomes.

It's Not Cyclic Vomiting Syndrome Until Dietl's is Ruled Out: A Case for Point of Care Renal Ultrasound

BackgroundAbdominal pain and vomiting are frequent complaints for pediatric patients presenting to the Emergency Department (ED). When a diagnosis such as chronic abdominal pain, cyclic vomiting, or abdominal migraine has previously been made, it can lead to diagnostic momentum and confirmation bias on behalf of the treating physician. Dietl's crisis is a commonly missed diagnosis in the pediatric population that presents with intermittent episodes of pain and vomiting. It can be readily diagnosed at the bedside by the emergency physician (EP) through the employment of point of care ultrasound (POCUS). Case SeriesWe present two cases of pediatric patients with episodic abdominal pain and vomiting who were previously diagnosed with cyclic vomiting syndrome. In both cases, pediatric gastroenterology evaluations had occurred with negative diagnostic testing having been performed. Both patients also presented to their primary pediatrician and the ED multiple times with each encounter resulting in treatment of symptoms and discharge. Each patient eventually presented to the ED when an EP was present who performed a renal POCUS. In each patient, the POCUS revealed severe unilateral hydronephrosis. Subsequent workup confirmed the diagnosis of Dietl's crisis as the etiology of symptoms. Why Should an Emergency Physician Be Aware of This?In pediatric patients, EPs should be wary of the diagnosis of cyclic vomiting syndrome until ureteral obstruction has been ruled out. A bedside POCUS can rapidly establish this diagnosis and potentially preclude recurrent health care visits, unnecessary diagnostic testing, and permanent loss of renal function.

Синдром функциональной абдоминальной боли: обзор литературы

ABSTRACT INTRODUCTION. About 40–60% of adult patients with complaints of abdominal pain suffer from functional gastrointestinal disorders. Currently, functional disorders of the gastrointestinal tract are associated with disturbances in the gut-brain interaction. Abdominal pain syndrome can be one of the leading manifestations of irritable bowel syndrome, functional dyspepsia syndrome and abdominal migraine. The exclusion of organic disorders of the gastrointestinal tract is an essential condition for the diagnosis of functional disorders. The basic principles of the treatment of functional abdominal pain syndrome should be aimed at correcting the psychological disorders involved in the formation of pain sensation. MATERIAL AND METHODS. A review of the literature on this topic was conducted in the following databases: PubMed, Research Gate, Elsevier. The following phrases were used to search for literature: “Functional abdominal pain syndrome”, “Disorders of the gastrointestinal tract”. DISCUSSION. Functional abdominal pain syndrome is a rather complex and ambiguous disease, which is based on complex cerebroabdominal connections (direct and reverse). This diagnosis is an exception, in other words, the diagnosis takes place when there are no obvious organic causes of the disease. The diagnosis of the functional abdominal pain syndrome is long and complex and includes various instrumental and laboratory methods of examination. Various methods are used in the treatment of the functional abdominal pain syndrome, ranging from non-drug methods (cognitive behavioral therapy, hypnotherapy) and ending with the use of medicines (antidepressants). It is important to keep in mind that the diagnosis and treatment of the functional abdominal pain syndrome requires the active participation of doctors of different specialties who are able to build a personalized diagnostic and therapeutic route using a biopsychosociocultural approach. CONCLUSION. Functional abdominal pain syndrome attracts special attention in the diagnostic and therapeutic aspect. Although the exclusion of organic diseases is an essential condition for the diagnosis of the functional abdominal pain syndrome, it is necessary to take into account the connection and involvement of mental factors in the phenomenon of abdominal pain. Taking into account the complexity of the mechanisms involved in the development of functional gastrointestinal diseases, the basic principles of functional abdominal pain syndrome treatment should be aimed at correcting psychological disorders involved in the formation of pain sensation. KEYWORDS: functional abdominal pain syndrome, disturbances in the gut-brain interaction, interaction

Evaluation of functional gastrointestinal disorders in children aged 4-10 years with autism spectrum disorder.

Gastrointestinal system disorders are known to be prevalent among children with autism spectrum disorder (ASD). Some ASD-associated comorbidities are abdominal pain, constipation, diarrhea, gastroesophageal reflux, sleep disturbances, epilepsy, and psychiatric problems. Nonetheless, there is still limited information about the presence of functional GI disorders (FGIDs) among children with ASD, especially in Türkiye. Using the Rome criteria, we aimed to investigate FGIDs in children with ASD. The sample of the study consisted of 68 children aged 4-10 years, diagnosed with ASD according to the DSM-5 diagnostic criteria and had scores greater than 30 on the Childhood Autism Rating Scale (CARS-2) and an age-sex matched control group (n=78). The Rome III criteria were used to evaluate FGIDs. The frequency of FGIDs in the ASD group was higher (76.5%) compared to the control group (p < 0.001). Compared to the control group, abdominal migraine frequency increased 10 times (p=0.012), functional constipation 7 times (p < 0.001), and fecal incontinence 6 times (p < 0.001) in the ASD group. Stool retention was not present in most children in the ASD group who were found to have fecal incontinence. In this study, the most common FGIDs in the ASD group were abdominal migraine, functional constipation, and non-retentive fecal incontinence. The finding that most children with ASD who had fecal incontinence did not show stool retention implicated social, psychological, and behavioral factors as the causes of incontinence. Raising awareness of healthcare professionals about the frequency of FGIDs in children with ASD will improve many areas in the daily lives of these children.

Эпизодические синдромы, ассоциированные с мигренью (клинико-эпидемиологическое исследование в педиатрической практике)

Abstract. Episodic syndromes of childhood that may be associated with migraine is an understudied condition rarely diagnosed in pediatric practice. The features of course in children of different age groups are not well described. The research purpose is to analyze the prevalence and characteristics of the course of childhood equivalents of migraine in children of various age groups in pediatric practice. Materials and methods. The study included the 1st (main) group of 250 children (120 (48 %) girls and 130 (52 %) boys) aged from 5 to 18 years (mean age – 13 (2.9) years, median age – 13 (11‒15) years) with complaints of headaches. The 2nd (comparative) group consisted of 250 children (119 (47.6 %) girls and 131 (52.4 %) boys) aged 5 to 18 years (mean age – 10.7 (3.6) years, median age – 10 (8‒14) years), who were treated in the pediatric department due to various somatic and neurological diseases (diabetes mellitus type I and II, gastritis, tachycardia, anemia, ventricular extrasystole, etc.) with no current complaints of headaches. An analysis of the socio-demographic, anamnestic, clinical and clinical-psychological characteristics of the studied groups was carried out. For statistical analysis and visualization of the obtained data we used the statistical computing environment R 4.3.0 (R Foundation for Statistical Computing, Vienna, Austria). The association was considered statistically significant at p &lt; 0.05. Results. All episodic syndromes associated with migraine are connected with a high possibility of developing subsequent migraine headaches. These syndromes include recurrent gastrointestinal disorders (cyclic vomiting syndrome; abdominal migraine), benign paroxysmal torticollis, benign paroxysmal vertigo. Conclusion. Episodic syndromes associated with migraine are considered as precursors of migraine in children. As a rule, they appear in the early stages. For example, abdominal migraine, infant colic – an analogue of adult migraine. Children who suffer from these diseases at an early age are significantly more likely to suffer from migraine in adulthood, which is accompanied by gastrointestinal disorders and other syndromes. It should also be noted that episodic childhood syndromes associated with migraine are often observed in children not as separate, isolated syndromes, but are harbingers of migraine itself, that is, they are observed in the prodrome phase followed by a migraine attack. It has also been shown that episodic childhood syndromes associated with migraine can also be observed in the postdrome phase after a migraine attack.

Prevalence and pattern of functional gastrointestinal disorders among secondary school adolescents in Lagos, Nigeria.

Limited data exist on functional gastrointestinal disorders (FGIDs) among sub-Saharan African children. This study aimed to determine FGID prevalence and pattern among secondary school adolescents in Lagos, Nigeria. This descriptive cross-sectional study was conducted among adolescents aged 10-18 years in Isolo, Lagos, Nigeria from December 2020 to March 2021. A multi-stage sampling technique was used to select a total of 696 students from four secondary schools. Data were collected using a specifically designed questionnaire, the ROME IV questionnaire (QPGS-IV), and analyzed using the Statistical Package for the Social Sciences (SPSS) version 24. The mean age of the adolescents was 13.6 ± 2.1. A total of 221 (31.8%) adolescents fulfilled the criteria for at least one of the FGIDs. The most common FGIDs were functional constipation (10.1%), functional dyspepsia (9.4%) and abdominal migraine (8.6%). There was no significant difference in the overall prevalence of FGIDs between age groups (p = 0.07) and genders (p = 0.949). However, the prevalence of FGID sub-types showed that abdominal migraine, irritable bowel syndrome and functional non-retentive fecal incontinence were significantly higher in the age group 10-12 years (p = 0.045, p = 0.029 and p = 0.027, respectively) while only functional vomiting was significantly higher in male compared to female (p = 0.038). FGIDs are common among adolescents in Lagos, Nigeria. The pattern of FGIDs shows similarities and differences with reports from other parts of the world. Healthcare workers must be aware of these disorders to provide optimal care.

ESPGHAN and NASPGHAN 2023 protocol for paediatric FAPD treatment guidelines (standard operating procedure)

IntroductionTo date, no international guidelines have been published for the treatment of paediatric functional abdominal pain disorders (FAPDs), subcategorised into functional abdominal pain–not otherwise specified (FAP-NOS), irritable bowel syndrome (IBS),...

Unraveling Abdominal Migraine in Adults: A Comprehensive Narrative Review.

Abdominal migraine is a condition characterized by recurrent episodes of abdominal pain accompanied by migraine-associated symptoms, primarily affecting pediatric populations. Its occurrence in adults is often overlooked due to limited literature on adult abdominal migraine. This article provides an overview of the current understanding and management of abdominal migraine in adult populations, including the diagnostic criteria, pathophysiology, differentiating features of other associated gastrointestinal pain syndromes, and various treatment approaches based on available literature. The review acknowledges the limitations, including the scarcity of literature on adult abdominal migraine and the absence of a systematic approach. It emphasizes the need for further research to enhance our understanding of this condition and establish evidence-based treatment guidelines specifically for adults. Accurate diagnosis and patient education are crucial for physicians in recognizing abdominal migraine as a differential diagnosis in cases of long-standing recurrent abdominal pain, promoting the importance of further research to advance our knowledge and improve patient outcomes.

Otizm Spektrum Bozukluğu Olan Çocuklarda Gastrointestinal Sistem ve Uyku Sorunları: Bunların Problemli Davranışlarla İlişkisi

Objective: The purpose of this research is to investigate sleep and gastrointestinal problems in children with autism spectrum disorder (ASD) and their relationship with each other, autism severity and problematic behavior. Material and Methods: The children who were admitted to outpatient clinics of child psychiatry at our hospital in a 3-months period and had diagnosis of ASD according to DSM-5 were included. The parents filled Aberrant Behavior Checklist (AbBC), Rome-3 Diagnostic Questionnaire for Pediatric Functional Gastrointestinal Disorders Parent Report Form (QPGS-RIII), Children’s Sleep Habits Questionnaire (CSHQ), Autism Behavior Checklist (ABC) and sociodemographic data form. The clinician applied Childhood Autism Rating Scale (CARS). Results: Ninety-seven children with ASD were included. According to QPGS-RIII, 38.1% of the cases had probable functional gastrointestinal problems. Those were 26.8% (n=26) functional constipation, 8.2% (n=8) nonretentive fecal incontinence, 2.1% (n=2) aerofaji, 3.1% (n=3) rumination syndrome, 4.1% (n=4) irritable bowel syndrome, 1% (n=1) functional abdominal pain syndrome, 1% (n=1) functional dyspepsia, 3.1% (n=3) functional abdominal pain, 1% cyclic vomiting and 1% (n=1) abdominal migraine. According to CSHQ 58.8% of the cases had sleep problems. ASD patients with functional gastrointestinal problems, had higher total scores of CSHQ, ABC and AbBC, compared to children with no functional gastrointestinal problems. Conclusion: Our findings revealed that frequency of gastrointestinal and sleep problems were high in children with ASD. It is appropriate to evaluate patients with ASD in terms of gastrointestinal and sleep problems especially if behavioral problems accompanies. And treating gastrointestinal and sleep problems might decrease challenging behaviors that seen in ASD.

Functional abdominal pain disorders in children in southern Anhui Province, China are related to academic stress rather than academic performance

BackgroundFunctional abdominal pain disorders (FAPDs) are one of the most common gastrointestinal disorders in children. The aim of this study was to investigate the prevalence of FAPDs in children in southern Anhui Province, China and their association with academic stress.MethodsIn this cross-sectional survey, we randomly selected children aged 6–17 years from 11 public schools in southern Anhui Province. FAPDs were diagnosed according to the Rome IV criteria, and a custom-designed questionnaire was used to investigate the association between academic stress and FAPDs in children.ResultsA total of 2,344 children aged 6–17 years were enrolled. The mean age was 12.4 ± 3.0 years. Of these children, 335 (14.3%) were diagnosed with FAPDs according to the Rome IV criteria. Among the children with FAPDs, 156 (46.6%) were boys, and 179 (53.4%) were girls. The prevalence was higher in girls than in boys. The most common disorder was irritable bowel syndrome (IBS) (n = 182 (7.8%)). Other types of FAPDs included functional abdominal pain–not otherwise specified (FAPNOS) (n = 70 (3.0%)), functional dyspepsia (FD) (n = 55 (2.3%)), and abdominal migraine (AM) (n = 28 (1.2%)). Academic stress, not meeting parental expectations, poor relationships with parents, and sleep disturbances were independent risk factors for FAPDs in children; academic performance was not associated with the development of FAPDs.ConclusionThere was a high prevalence of FAPDs among children in southern Anhui Province, China, and IBS was the most common subtype of functional abdominal pain. Academic stress, rather than academic performance, was associated with FAPDs in children.

Prevalence of functional gastrointestinal disorders in Italian children living in different regions: analysis of the difference and the role of diet

BackgroundFunctional Gastrointestinal Disorders (FGIDs) are common in pediatric age. AimsTo estimate the prevalence of FGIDs in Italian children and evaluate the impact of diet. MethodsHealthy children aged 4–18 years were recruited in a multicenter cross-sectional study. We evaluated their eating habits and the presence of FGIDs, using Rome IV criteria, 3-day food diaries and Mediterranean Diet Quality Index (KIDMED) questionnaires. ResultsSeven hundred forty subjects were enrolled:369 children aged 4–9 years (Group A), and 371 adolescents 10–18 years old (Group B). The overall prevalence of FGIDs was 26.4% in Group A and 26.2% in Group B, with a significant higher prevalence in females in both groups. The most frequent disorders were functional constipation, functional dyspepsia, and abdominal migraine. No significant difference in FGIDs prevalence was found between Northern and Southern Italy, despite significant variation in diet. In Group A there was a significant difference in KIDMED between North and South (5.3 ± 1 vs 6 ± 1.2, respectively; p = 0.001). A significant association between FGIDs and KIDMED was found in Group A (OR=0.83, p = 0.034), but not in Group B (OR=0.89, p = 0.166). ConclusionsFGIDs are common in Italian children, with a higher prevalence in females. Despite significant differences in dietary habits between North and South, FGIDs prevalence does not vary significantly.

Association of Anxiety and Gastrointestinal Comorbidities in Repeat Hospital Admissions in Pediatric Cyclic Vomiting Syndrome.

Cyclic vomiting syndrome (CVS) is a functional gastrointestinal disorder with recurrent episodes of intense nausea and vomiting and thus may require frequent hospitalizations. There is paucity of data exploring the association of psychiatric and gastrointestinal comorbidities in repeat hospitalizations among pediatric patients with CVS. We analyzed the Pediatric Health Information System database and included all patients up to 18 years of age with a diagnosis of CVS between 2016 and 2020. We excluded patients with chronic conditions, which mimic CVS. The primary outcome variable was 90-day admission rate, which was defined as a visit to emergency department or admission to observation/inpatient unit with a primary diagnosis of CVS within 90 days after an index CVS hospitalization. We evaluated a total of 2,604 hospitalizations represented by 1,370 unique individuals. The overall 90-day admission rate was 28.5%, which steadily decreased from 35.7% in 2016 to 23% in 2019 ( P < 0.001). Patients in the repeat hospitalization cohort were slightly older and more often men. Patients with repeat admissions had an increased proportion of anxiety and other gastrointestinal disorders. Multivariable logistic regression showed that anxiety, gastroesophageal reflux disease, functional dyspepsia, and abdominal migraine were associated with increased odds of repeat admissions. Ninety-day admission rates in pediatric CVS are decreasing overall, although still contributing to significant healthcare expenditure. Anxiety and gastrointestinal comorbidities were associated with increased risk of repeat admissions. Further prospective studies are needed to better understand the complex interactions of these comorbidities and their management affecting the natural course of CVS.