Chitkara Denesh K, Talley Nicholas J, Weaver Amy L, Katusic Slavica K, De Schepper Heiko, Rucker Mary Jo, Locke G Richard
Clinical Enteric Neuroscience Translational and Epidemiological Research (C.E.N.T.E.R.) Program, Mayo Clinic College of Medicine and Mayo Foundation, Rochester, Minnesota 55905, USA.
Clin Gastroenterol Hepatol. 2007 Feb;5(2):186-91. doi: 10.1016/j.cgh.2006.06.012. Epub 2006 Aug 8.
BACKGROUND & AIMS: Gastroesophageal reflux disease (GERD), abdominal pain of unknown origin, and constipation are thought to be causes for frequent medical visits during childhood. The aim of this study was to estimate the incidences, repeat presentation, clinical symptoms, and sociodemographic risk factors in children who medically presented for GERD, abdominal pain of unknown origin, and constipation from birth to 5 years.
This was a population-based, retrospective birth cohort study of all children born to mothers residing in Rochester, Minnesota who remained in the area until at least age 5 (n = 5718). The medical records of all individuals were searched for relevant diagnostic billing codes for GERD, abdominal pain of unknown origin, and constipation, without another underlying diagnosis, and manually reviewed. Parental sociodemographic factors collected from birth certificate records on patients and matched controls were compared.
The incidence for childhood (age, <5 y) presentation of GERD, abdominal pain of unknown origin, and constipation was .9/1000 person-years, 4.5/1000 person-years, and 6.8/1000 person-years, respectively; there were no significant differences between boys and girls. Three or more medical visits by age 5 occurred in 11%, 19%, and 24% of children who were seen for abdominal pain of unknown origin, constipation, and GERD, respectively. Single parentage, maternal age (<18 y), and maternal education (<high school) were not associated with abdominal pain or constipation presentation.
The incidences of presentation for GERD, abdominal pain of unknown origin, and constipation are among the highest for pediatric disorders, and a cause for repeated medical consultations.
胃食管反流病（GERD）、不明原因腹痛和便秘被认为是儿童频繁就医的原因。本研究的目的是评估从出生到5岁因GERD、不明原因腹痛和便秘就医的儿童的发病率、复诊情况、临床症状以及社会人口统计学风险因素。
这是一项基于人群的回顾性出生队列研究，研究对象为居住在明尼苏达州罗切斯特市、至少在当地生活到5岁的母亲所生的所有儿童（n = 5718）。检索所有个体的医疗记录，查找无其他潜在诊断的GERD、不明原因腹痛和便秘的相关诊断计费代码，并进行人工审核。比较从患者及其匹配对照的出生证明记录中收集的父母社会人口统计学因素。
儿童期（年龄<5岁）GERD、不明原因腹痛和便秘的发病率分别为0.9/1000人年、4.5/1000人年和6.8/1000人年；男孩和女孩之间无显著差异。分别有11%、19%和24%因不明原因腹痛、便秘和GERD就诊的儿童在5岁前就诊3次或更多次。单亲家庭、母亲年龄（<18岁）和母亲教育程度（<高中）与腹痛或便秘就诊无关。
GERD、不明原因腹痛和便秘的就诊率在儿科疾病中名列前茅，是反复就医的原因之一。
