Objectives: Functional gastrointestinal disorders (FGIDs) are common. Diagnosis is based on the Rome criteria. It has been argued that performing endoscopies could help by providing reassurance and thus improve outcomes. This study was conducted to evaluate the impact of obtaining normal endoscopies in the outcome of children with FGIDs. Methods: Medical records of patients diagnosed with abdominal pain related-FGIDs were reviewed. To assess the child’s symptoms at follow-up, parents completed the Questionnaire on Pediatric Gastrointestinal Symptoms III (QPGS III). Primary outcome was presence of abdominal pain (AP) and secondary outcomes were AP severity. Results: A total of 301 patients were diagnosed with abdominal pain—related FGIDs. Overall, 62.6% reported persistence of AP and 37.4% were asymptomatic at follow-up. Among patients with endoscopies, 61% reported AP. Among patients without endoscopies, 64% were symptomatic (P = .76). AP frequency, AP intensity, and child’s disability were similar in those with and without endoscopies. Conclusion: The study does not suggest that a negative endoscopy improves the outcome of children with FGIDs.
Nurko S., Di Lorenzo C.Functional abdominal pain: time to get together and move forward. J Pediatr Gastroenterol Nutr. 2008;47:679-680.
2.
Starfield B. , Hoekelman RA, McCormick M., et al. Who provides health care to children and adolescents in the United States? Pediatrics. 1984;74:991-997.
3.
Saps M., Seshadri R., Sztainberg M., Schaffer G., Marshall BM, Di Lorenzo C.A prospective school-based study of abdominal pain and other common somatic complaints in children. J Pediatr. 2008;154:322-326.
4.
Chitkara DK, Rawat DJ, Talley NJThe epidemiology of childhood recurrent abdominal pain in Western countries: a systematic review. Am J Gastroenterol. 2005 ;100: 1868-1875.
5.
Rasquin-Weber A., Hyman PE, Cucchiara S., et al. Childhood functional gastrointestinal disorders. Gut.1999; 45(Suppl2):1160-1168.
6.
Rasquin A., Di Lorenzo C., Forbes D., et al. Childhood functional gastrointestinal disorders: child/adolescent . Gastroenterology. 2006;130:1527-1537.
7.
Primavera G., Amoroso B., Barresi A., et al. Clinical utility of Rome criteria managing functional gastrointestinal disorders in pediatric primary care. Pediatrics.2010;125: e155-e161.
8.
Di Lorenzo C. , Colletti RB, Lehmann HP, et al; AAP Subcommittee; NASPGHAN Committee on Chronic Abdominal Pain. Chronic abdominal pain in children: a technical report of the American Academy of Pediatrics and the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition. J Pediatr Gastroenterol Nutr. 2005;40:249-261.
9.
Miele E., Giannetti E., Martinelli M., Tramontano A., Greco L., Staiano A. Impact of the Rome II pediatric criteria on the appropriateness of the upper and lower gastrointestinal endoscopy in children. Aliment Pharmacol Ther. 2010; 32:582-590.
10.
Saps M., Youssef N., Miranda A., et al. Multicenter, randomized, placebo-controlled trial of amitriptyline in children with functional gastrointestinal disorders. Gastroenterology . 2009;137-1261-1269.
11.
Campo JV, Comer DM, Jansen-Mcwilliams L., Gardner W., Kelleher KJRecurrent pain, emotional distress, and health service use in childhood. J Pediatr. 2002;141: 76-83.
12.
Greco LA, Freeman KE, Dufton L.Overt and relational victimization among children with frequent abdominal pain: links to social skills, academic functioning, and health service use . J Pediatr Psychol. 2007;32:319-329.
13.
Caplan A., Walker L., Rasquin A.Validation of the pediatric Rome II criteria for functional gastrointestinal disorders using the questionnaire on pediatric gastrointestinal symptoms. J Pediatr Gastroenterol Nutr. 2005;41: 305-316.
14.
Caplan A., Walker L., Rasquin A.Development and preliminary validation of the questionnaire on pediatric gastrointestinal symptoms to assess functional gastrointestinal disorders in children and adolescents . J Pediatr Gastroenterol Nutr. 2005;41:296-304.
15.
Helgeland H. , Flagstad G., Grøtta J., Vandvik PO, Kristensen H., Markestad T. Diagnosing pediatric functional abdominal pain in children (4-15 years old) according to the Rome III criteria: results from a Norwegian prospective study. J Pediatr Gastroenterol Nutr. 2009;49: 309-315.
16.
Lembo T., Munakata J., Mertz H., et al: Evidence for the hypersensitivity of lumbar splanchnic afferents in irritable bowel syndrome. Gastroenterology. 1994;107:1686-1696.
17.
Dhroove GN, Chogle A., Saps M.A million-dollar work-up for abdominal pain. is it worth it?J Pediatr Gastroenterol Nutr. 2010;51:579-583.
18.
van Tilburg MA, Chitkara DK, Palsson OS, et al. Audio-recorded guided imagery treatment reduces functional abdominal pain in children: a pilot study. Pediatrics.2009; 124:e890-e897.
19.
Youssef NN, Rosh JR, Loughran M., et al. Treatment of functional abdominal pain in childhood with cognitive behavioral strategies. J Pediatr Gastroenterol Nutr. 2004;39:192-196.
20.
Spiegel BM, Gralnek IM, Bolus R., et al. Is a negative colonoscopy associated with reassurance or improved health-related quality of life in irritable bowel syndrome? Gastrointest Endosc. 2005;62:892-899.
21.
Lindley KJ, Glaser D., Milla PJConsumerism in healthcare can be detrimental to child health: lessons from children with functional abdominal pain. Arch Dis Child. 2005; 90:335-337.
22.
Rabeneck L. , Wristers K., Souchek J., Ambriz E.Impact of upper endoscopy on satisfaction in patients with previously uninvestigated dyspepsia. Gastrointest Endosc. 2003;57:295-299.
23.
Chey WD, Nojkov B., Rubenstein JH, Dobhan RR, Greenson JK, Cash BDThe yield of colonoscopy in patients with non-constipated irritable bowel syndrome: results from a prospective, controlled US trial. Am J Gastroenterol. 2010;105:859-865.
24.
Drossman DA , Whitehead WE, Camilleri M.Irritable bowel syndrome: a technical review for practice guideline development. Gastroenterology. 1997;112:2120-2137.
25.
Crushell E. , Rowland M., Doherty M., et al. Importance of parental conceptual model of illness in severe recurrent abdominal pain. Pediatrics . 2003;112(6Pt1):1368-1372.
26.
van Tilburg MA, Venepalli N., Ulshen M., Freeman KL, Levy R., Whitehead WEParents’ worries about recurrent abdominal pain in children. Gastroenterol Nurs. 2006 ; 29:50-55.
27.
Owens DM, Nelson DK, Talley NJThe irritable bowel syndrome: long-term prognosis and the physician-patient interaction. Ann Intern Med. 1995;122:107-112.
28.
Barbara G., Stanghellini V.Biomarkers in IBS: when will they replace symptoms for diagnosis and management ? Gut. 2009;58:1571-1575.
