Rouster Audra S, Karpinski Aryn C, Silver David, Monagas Javier, Hyman Paul E
*Louisiana State University Health Sciences Center †Children's Hospital of New Orleans, Division of Gastroenterology, New Orleans, LA.
J Pediatr Gastroenterol Nutr. 2016 Jun;62(6):847-51. doi: 10.1097/MPG.0000000000001023.
Symptom-based diagnostic criteria have improved recognition and standardization of pediatric functional gastrointestinal disorders (FGIDs). We used Rome 3 diagnostic criteria to determine the prevalence of FGIDs in pediatric gastroenterology clinic. In the process, we developed a diagnostic questionnaire for infants and toddlers.
We enrolled new patients ≤18 years referred during 19 months to a pediatric gastroenterology clinic. Subjects or parents completed a demographic survey and a the Questionnaire on Pediatric Gastrointestinal symptoms, Rome 3 Version (if ≥4 years, or a new infant-toddler questionnaire) before their appointment.
We acquired data from 976 subjects: 476 boys, 592 white. Of 332 subjects <4 years, 172 (52%) met diagnostic criteria for ≥1 FGIDs. Of 644 subjects ≥4 years, 486 (75%) met diagnostic criteria for ≥1 FGIDs. Thirty one (9%) subjects <4 years and 170 (26%) subjects ≥4 years met the criteria for ≥2 FGIDs. Of the total sample of subjects <4 years, common FGIDs included functional constipation (29%), infant regurgitation (13%), and cyclic vomiting syndrome (10%). Of the total sample of subjects ≥4 years, common FGIDs included irritable bowel syndrome (36%), abdominal migraine (19%), functional constipation (17%), cyclic vomiting syndrome (8%), functional abdominal pain syndrome (7%), aerophagia (7%), and functional dyspepsia (7%).
More than half of new pediatric gastrointestinal clinic patients met the Rome 3 criteria for ≥1 FGIDs. Satisfying the criteria may facilitate diagnosis on the first visit.
基于症状的诊断标准提高了儿童功能性胃肠病(FGIDs)的识别率和标准化程度。我们采用罗马Ⅲ诊断标准来确定儿科胃肠病门诊中FGIDs的患病率。在此过程中,我们编制了一份针对婴幼儿的诊断问卷。
我们纳入了在19个月期间转诊至儿科胃肠病门诊的18岁及以下新患者。受试者或其父母在就诊前完成了一份人口统计学调查问卷以及一份《儿童胃肠道症状问卷,罗马Ⅲ版》(如果年龄≥4岁),或者一份新的婴幼儿问卷。
我们收集了976名受试者的数据:476名男孩,592名白人。在332名4岁以下的受试者中,172名(52%)符合至少1种FGIDs的诊断标准。在644名4岁及以上的受试者中,486名(75%)符合至少1种FGIDs的诊断标准。31名(9%)4岁以下的受试者和170名(26%)4岁及以上的受试者符合至少2种FGIDs的标准。在4岁以下受试者的总样本中,常见的FGIDs包括功能性便秘(29%)、婴儿反流(13%)和周期性呕吐综合征(10%)。在4岁及以上受试者的总样本中,常见的FGIDs包括肠易激综合征(36%)、腹型偏头痛(19%)、功能性便秘(17%)、周期性呕吐综合征(8%)、功能性腹痛综合征(7%)、吞气症(7%)和功能性消化不良(7%)。
超过半数的儿科胃肠病门诊新患者符合罗马Ⅲ标准中至少1种FGIDs的诊断。符合这些标准可能有助于首次就诊时的诊断。