Higher Prevalence of Obesity among Children with Functional Abdominal Pain Disorders

Galai, Tut; Moran‐Lev, Hadar; Cohen, Shlomi; Ben‐Tov, Amir; Levy, Dina; Weintraub, Yael; Amir, Achiya; Segev, Or; Yerushalmy‐Feler, Anat

doi:10.21203/rs.2.20433/v2

Cited by 5 publications

(9 citation statements)

References 29 publications

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“…Our findings seem to contradict the results of previous studies based at a medical clinic level that found an increased prevalence of FAPDs in obese children [ 7 ]. However, this contradiction may only be apparent as the design of previous studies made them prone to selection bias by only including children seeking medical care.…”

Section: Discussioncontrasting

confidence: 99%

“…Nevertheless, we cannot ignore the results of previous studies that found obese patients presenting to clinics were more likely to have FAPDs [ 7 ], and that obese patients had more prolonged, severe symptoms [ 13 ]. Together, the results of the current and previous studies seem to suggest that although obesity is not associated with higher rates of FAPDs at the community level, it may be an identifier for a more aggressive phenotype of FAPDs in children.…”

Section: Discussionmentioning

confidence: 96%

“…Among those factors, food and nutritional status are thought to play a role in triggering symptoms and influencing their prognosis [ 5 ]. Multiple studies performed in clinic settings have found an association between malnutrition and FAPDs [ 6 , 7 ]. However, the relation between the specific type of malnutrition and FAPDs is not clear.…”

Section: Introductionmentioning

confidence: 99%

“…Conversely, an American study that also used the Rome III classification to diagnose children at a general pediatric clinic, found an association between both, functional abdominal pain syndrome and IBS with being obese/overweight [ 8 ]. Additionally, a recent Israeli retrospective study of pediatric gastroenterology clinic patients diagnosed with FAPDs per the Rome IV diagnostic criteria, found that adolescents with FAPDs had a significantly higher prevalence of overweight/obesity compared to a population data base control group [ 7 ]. An important limitation of these studies is their potential for selection bias, as all of them were conducted in patients who presented for consultation.…”

Section: Introductionmentioning

confidence: 99%

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

2020

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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.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

2020

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“…In our current study, diarrhoea, considered one of the ‘classic’ symptoms of CD and a typical expression of malabsorption, was more common among the overweight children. One possible explanation for the coexistence of these findings lies in an unbalanced fat‐rich diet being followed by these youngsters, in addition to a high incidence of functional diarrhoea and irritable bowel syndrome 21,22 . Another possible explanation concerns the low index of suspicion of CD: the diagnosis is usually considered only when the children present with a ‘classic’ symptom of the disease.…”

Section: Discussionmentioning

confidence: 99%

The effect of gluten‐free diet on body mass index in paediatric celiac disease

et al. 2021

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Aim More normal weight and overweight children are currently diagnosed with celiac disease (CD). We aimed to describe the relation between body mass index (BMI) and the clinical characteristics of paediatric CD and to determine the effect of a gluten‐free diet (GFD) on BMI. Methods Data on all children diagnosed with CD during 7/2010–7/2019 with documented anthropometric data at diagnosis were retrospectively analysed. The children were divided into three groups according to BMI status at diagnosis: underweight, normal weight and overweight (BMIs <5%, 5%–85% and >85%, respectively). Results Of the 236 children [median age 7.87 (4.91–11) years] included in the study, 24 (10.1%) were underweight at diagnosis and 32 (13.6%) were overweight. Diarrhoea as the presenting symptom was significantly more common in the overweight group (p = 0.012), while short stature was more common in the underweight group (p = 0.002). Following a GFD had no significant effect on the children's BMI during a median follow‐up of 15.7 (0–85) months, but there was a significant shift of patients between the BMI categories (p < 0.001). Conclusion Although a shift of patients between the BMI categories was observed, following a GFD did not significantly affect the overall BMI in children with CD.

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Association between body mass index and fecal calprotectin levels in children and adolescents with irritable bowel syndrome

Kim

Lee³

et al. 2022

Medicine

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Irritable bowel syndrome (IBS) is a common pediatric functional gastrointestinal disorder. It is characterized by recurrent abdominal pain and changes in bowel habits and is more prevalent in obese patients. We investigated the association between obesity and IBS in pediatric patients through fecal calprotectin testing. Patients under 18 years of age with IBS who underwent fecal calprotectin testing from January 2015 through April 2020 were retrospectively investigated. The patients were divided into groups based on body mass index (BMI): group I (BMI < 85th percentile) and group II (BMI ≥ 85th percentile). Group II was divided into group IIa, overweight (85th percentile ≤ BMI < 95th percentile), and group IIb, obese (BMI ≥ 95th percentile). Among 277 included patients, 202 (72.9%) were in group I, and 75 (27.1%) were in group II (mean calprotectin levels, 75.60 ± 103.48 vs 45.89 ± 66.57 µg/g, respectively; P = .006). There were significant differences in mean calprotectin levels between groups I and IIa (75.60 ± 103.48 vs 45.45 ± 63.38 µg/g, respectively; P = .028) and groups I and IIb (75.60 ± 103.48 vs 46.22 ± 69.59 µg/g, respectively; P = .025). There was a significant difference in mean calprotectin levels between groups I and II (85.69 ± 142.13 vs 32.04 ± 28.17 µg/g, respectively; P = .029) among patients between 6 and 12 years of age but not among adolescents aged between 12 and 18 years ( P = .139). Fecal calprotectin was lower when moderate-to-severe fatty livers were observed by ultrasound compared with normal livers (68.52 ± 97.22 vs 18.53 ± 18.56 µg/g, respectively; P = .017). Fecal calprotectin levels were higher in normal-weight pediatric IBS patients than in their obese counterparts, and this difference was more prominent in younger patients. In young children, IBS symptoms are thought to be influenced more by factors other than intestinal inflammation.

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Higher Prevalence of Obesity among Children with Functional Abdominal Pain Disorders

Cited by 5 publications

References 29 publications

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

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

The effect of gluten‐free diet on body mass index in paediatric celiac disease

Association between body mass index and fecal calprotectin levels in children and adolescents with irritable bowel syndrome

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