Functional Abdominal Pain and Nutritional Status of Children. A School-Based Study.

Publisher: MDPI Publishing Country of Publication: Switzerland NLM ID: 101521595 Publication Model: Electronic Cited Medium: Internet ISSN: 2072-6643 (Electronic) Linking ISSN: 20726643 NLM ISO Abbreviation: Nutrients Subsets: MEDLINE

Original Publication: Basel, Switzerland : MDPI Publishing

Nutritional Status*; Abdominal Pain/*epidemiology ; Overweight/*epidemiology ; Thinness/*epidemiology; Abdominal Pain/physiopathology ; Adolescent ; Child ; Colombia/epidemiology ; Comorbidity ; Cross-Sectional Studies ; Female ; Humans ; Male ; Overweight/physiopathology ; Prevalence ; Schools ; Thinness/physiopathology

Functional abdominal pain disorders (FAPD) are the most common chronic pain conditions in pediatric gastroenterology. They account for 50% of all pediatric gastroenterology clinic visits. The pathophysiology of FAPDs is poorly understood, but there is growing understanding of the role of food and the patient's nutritional state in both their treatment and prognosis. Clinic-based studies have shown a higher prevalence of FAPDs, and worse prognosis among obese children with FAPDs. We aimed to assess the nutritional status of children with FAPD to determine if there is increased prevalence of FAPDs in obese or underweight patients. We conducted a cross sectional study of schoolchildren in Colombia. We enrolled 1030 patients from five schools and screened them for FAPDs using Rome IV criteria. Data on weight, height, abdominal circumference and BMI were collected for each child. Cases (FAPDs) were compared with a control group of enrolled children who did not meet diagnostic criteria for any functional gastrointestinal disorders (FGID). We diagnosed 58 (5.8%) children with FAPDs based on Rome IV criteria. When we compared to participants who were not diagnosed with FGIDs by screening, there was no statistically significant difference in children who were obese (OR 0.34 CI: 0.03-1.34, p = 0.124) or overweight (OR 1.00 CI: 0.46-2.02, p = 0.984) or those with increased abdominal circumference (OR 0.94, CI: 0.10-3.90, p = 0.943). FAPDs are not more common among obese children compared with healthy controls at a community level. Obese children may have been overrepresented in previous studies which were done at a clinical level due to comorbidities and a more severe phenotype that makes them more likely to consult. Nutritional status is not a useful predictor for the occurrence of FAPDs in children in the general population.

Pediatrics. 1984 Dec;74(6):991-7. (PMID: 6504643)
J Pediatr Gastroenterol Nutr. 2012 Dec;55(6):707-10. (PMID: 22744191)
Pediatrics. 2009 Apr;123(4):e565-72. (PMID: 19336348)
J Pediatr Gastroenterol Nutr. 2008 Nov;47(5):679-80. (PMID: 18955874)
Gastroenterology. 2006 Apr;130(5):1527-37. (PMID: 16678566)
BMC Public Health. 2010 Apr 09;10:184. (PMID: 20380692)
Am J Clin Nutr. 2002 Jun;75(6):978-85. (PMID: 12036802)
J Pediatr Gastroenterol Nutr. 2018 Jun;66 Suppl 3:S56-S60. (PMID: 29762380)
Int J Obes (Lond). 2011 Apr;35(4):517-21. (PMID: 21079618)
Am J Gastroenterol. 2013 May;108(5):694-7. (PMID: 23545712)
N Engl J Med. 1984 Mar 29;310(13):824-9. (PMID: 6700671)
J Acad Nutr Diet. 2016 Sep;116(9):1458-1464. (PMID: 27316779)
Int J Obes (Lond). 2014 Oct;38(10):1324-7. (PMID: 24781857)
J Pediatr. 2018 Aug;199:171-177. (PMID: 29709346)
BMC Pediatr. 2020 May 6;20(1):193. (PMID: 32375714)
Pediatr Rev. 2000 Aug;21(8):257-64; quiz 264. (PMID: 10922022)
Pediatr Radiol. 2009 Jul;39(7):647-56. (PMID: 19415261)
Gastroenterology. 1993 Sep;105(3):681-91. (PMID: 8359640)
J Pediatr. 2009 Mar;154(3):322-6. (PMID: 19038403)

Keywords: functional abdominal pain; functional dyspepsia; functional gastrointestinal disorders; irritable bowel syndrome; obesity

Date Created: 20200828 Date Completed: 20210329 Latest Revision: 20210329

20240105

PMC7551899

10.3390/nu12092559

32846953