Trivić Ivana, Hojsak Iva
Referral Centre for Pediatric Gastroenterology and Nutrition, Children's Hospital Zagreb, Croatia.
School of Medicine, University of Zagreb, Zagreb, Croatia.
Pediatr Gastroenterol Hepatol Nutr. 2018 Oct;21(4):264-270. doi: 10.5223/pghn.2018.21.4.264. Epub 2018 Oct 10.
The aim of this study was to describe functional gastrointestinal disorders (FGID) presented in a tertiary medical center, characteristics of patients and results of the diagnostic work-up together with an outcome during the follow up.
This was a retrospective, single center, observational study including all patients who were diagnosed with FGID based on Rome III criteria from January to December 2015 in tertiary medical center.
Overall 294 children were included (mean age, 8.9 years [range, 1-18 years]; 165 females). Majority had functional constipation (35.4%), followed by functional abdominal pain (30.6%), irritable bowel syndrome (17.0%), functional dyspepsia (12.6%), functional nausea (3.4%) and abdominal migraine (1.0%). Regression model found that only significant factor associated with improvement of symptoms is the establishment of the functional diagnosis at the first visit (hazard ratio, 2.163; 95% confidence inverval, 1.029-4.544). There was no association between improvement of symptoms and presence of alarm signs/symptoms (weight loss, nocturnal symptoms and severe vomiting) at diagnosis. Furthermore, in pain symptoms (functional abdominal pain, irritable bowel syndrome, dyspepsia) no treatment positively correlated with pain improvement.
Regardless of the initial diagnosis of FGID, positive diagnosis at the first visit increases a chance for resolution of symptoms.
本研究旨在描述一家三级医疗中心出现的功能性胃肠疾病(FGID)、患者特征、诊断检查结果以及随访期间的结局。
这是一项回顾性、单中心观察性研究,纳入了2015年1月至12月在该三级医疗中心根据罗马III标准诊断为FGID的所有患者。
共纳入294名儿童(平均年龄8.9岁[范围1 - 18岁];165名女性)。大多数患有功能性便秘(35.4%),其次是功能性腹痛(30.6%)、肠易激综合征(17.0%)、功能性消化不良(12.6%)、功能性恶心(3.4%)和腹型偏头痛(1.0%)。回归模型发现,与症状改善相关的唯一显著因素是首次就诊时确立功能性诊断(风险比,2.163;95%置信区间,1.029 - 4.544)。症状改善与诊断时出现警示体征/症状(体重减轻、夜间症状和严重呕吐)之间无关联。此外,在疼痛症状(功能性腹痛、肠易激综合征、消化不良)方面,未发现任何治疗与疼痛改善呈正相关。
无论FGID的初始诊断如何,首次就诊时的明确诊断会增加症状缓解的机会。