Prevalence of functional abdominal pain disorders and functional constipation in adolescents

Abstract

Aim: Functional abdominal pain disorders (FAPDs) and functional constipation (FC) are the common functional gastrointestinal disorders in adolescents. We aimed to determine the prevalence of FAPDs and FC in adolescents using the Rome IV Questionnaire of Pediatric Gastrointestinal Symptoms and the factors associated with these two functional gastrointestinal disorders. Methods: A survey for the prevalence of FAPDs and FC in adolescents was carried out at two high schools. A translated and validated Thai version of Rome IV Questionnaire of Pediatric Gastrointestinal Symptoms was used. Potential associated factors were also collected. Psychosocial problems were evaluated by using the Strengths and Difficulties Questionnaire. Results: A total of 1700 adolescents (55.5% females) with a mean age (SD) of 16.1 (0.9) years were enrolled. The prevalence of FAPDs and FC was 5.3% and 8.1%, respectively. The subtypes of FAPDs were functional dyspepsia (4.7%; postprandial distress syndrome 3.9% and epigastric pain syndrome 0.8%), irritable bowel syndrome (0.6%), abdominal migraine (0.4%) and functional abdominal pain not otherwise specified (0.3%). Multiple logistic regression analysis revealed that FAPDs were associated with female gender (odds ratio (OR) 3.3, 95% confidence interval (CI): 1.7-6.4), underlying allergic diseases (OR 3.2, 95% CI: 1.6-6.6) and concomitant emotional problem (OR 2.7, 95% CI: 1.2-5.9). No significant associated factors with FC were found. Conclusion: FAPDs and FC are common in adolescents. Postprandial distress syndrome is the most common subtype of FAPD. Associated factors for FAPDs may suggest hormonal, immune-related and psychological involvement in the disease pathogenesis.

Prevalence and determinants of constipation in children in Asia: a systematic review and meta-analysis

“… 37 , 43 , 46 , 52 Meanwhile, the constipation rate diagnosed with the Rome IV was the lowest, at 4.4%, based on data analysed from five clinic-based studies, 50 , 56 , 57 , 58 , 62 and four community-based studies. 59 , 61 , 63 , 64 We revealed inconsistent results of constipation rates between Rome II and III. Although the only change from Rome II to Rome III was a shortened duration of symptoms (decreased from 3 to 2 months), 9 this discrepancy can be explained by Rome II being appropriate for the diagnosis of constipation in young children, 37 whereas Rome III were more suitable for school-age children and adolescents.…”

“… 30 , 37 Of the 20 studies that used the Rome III, the constipation rate was much lower (12.3%, 95% CI 9.0–15.7%). Nine studies reported the constipation prevalence according to the Rome IV, 50 , 56 , 57 , 58 , 59 , 62 , 63 , 64 , 65 with a prevalence of 5.2% (95% CI 3.2–7.1%) ( Table 3 ).

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“…(2011) 63 Bristol scale/BM per wk Rome II Rome III 19 82,275 12% (0.7–29.6%) a 6 24,984 10.8% (1.4–32.9%) c Chu et al. (2014) 64 BM – – – 14 90,091 18.8% c Koppen et al. (2018) 65 Rome III Rome IV 33 65,147 9.5% (7.5–12.1%) 16 49,148 6.3% (4.0–9.6%) c The present study Self-reported Constipation scale Defecation frequency Rome II Rome III Rome IV – – – 47 311,660 12.0% (9.3–14.6%) Abbreviation: wk, week; BM, bowel movement.…”

“…Out of the nine studies in the Rome IV subgroup analysis, only three originated from community sources. 17 , 59 , 64 Obtaining the population from clinics could lead to a more precise diagnosis of constipation. Additionally, infants make up more than half of the population in the Rome IV analysis.…”