Section of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, East Tennessee State University, Johnson City, Tennessee, USA.
Dan L, Duncan Institute for Clinical and Translational Research, Baylor College of Medicine, Houston, Texas, USA.
JPEN J Parenter Enteral Nutr. 2020 Nov;44(8):1525-1529. doi: 10.1002/jpen.1771. Epub 2020 Feb 4.
Diet therapies may be recommended for pediatric functional gastrointestinal disorders (FGIDs). However, little is known about the frequency with which diet therapy is recommended in FGIDs. Our aims were to determine and contrast the frequency and types of diet recommendations provided to children with FGIDs by pediatric gastroenterologists (PGIs) versus primary care pediatricians (PCPs).
A retrospective chart review was performed using data from a large, metropolitan children's academic healthcare system to identify subjects meeting Rome IV criteria for functional abdominal pain, functional dyspepsia, irritable-bowel syndrome (IBS), and/or abdominal migraine over a period of 23 months.
Of 1929 patient charts reviewed, 268 were included for further analyses. Of these, 186 patients (69%) were seen by a PGI and 82 (31%) by a PCP. The most common diagnosis was IBS (49% for PGIs and 71% for PCPs). Diet recommendations were provided to 115 (43%) patients (PGI group: 86 [75%] vs PCP group: 29 [25%]; P < .1). The most frequent recommendations were high fiber (PGI: 15%; PCP: 14%) and low fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) diet (PGI: 12%; PCP: 4%). Of those provided with diet recommendations, only 20% (n = 23) received an educational consult by a dietitian. Provision of diet recommendations was not affected by years in practice.
Despite increasing awareness of the role of diet in the treatment of childhood FGIDs, a minority of patients receive diet recommendations in tertiary care or primary care settings. When diet recommendations were given, there was great variability in the guidance provided.
饮食疗法可能被推荐用于儿科功能性胃肠疾病（FGIDs）。然而，对于儿科胃肠病学家（PGIs）与初级保健儿科医生（PCPs）推荐 FGIDs 患者进行饮食治疗的频率知之甚少。我们的目的是确定并对比 PGIs 与 PCPs 向 FGIDs 患儿推荐饮食疗法的频率和类型。
使用大型都市儿童学术医疗保健系统的数据，通过回顾病历，来识别符合罗马 IV 功能性腹痛、功能性消化不良、肠易激综合征（IBS）和/或腹型偏头痛标准的患者，研究时间为 23 个月。
在回顾的 1929 份患者病历中，有 268 份病历被进一步分析。其中，186 例患者（69%）由 PGI 诊治，82 例（31%）由 PCP 诊治。最常见的诊断是 IBS（PGIs 为 49%，PCPs 为 71%）。115 例（43%）患者接受了饮食建议（PGI 组：86 [75%] vs PCP 组：29 [25%]；P <.1）。最常见的建议是高纤维（PGI：15%；PCP：14%）和低可发酵寡糖、双糖、单糖和多元醇（FODMAPs）饮食（PGI：12%；PCP：4%）。在接受饮食建议的患者中，只有 20%（n = 23）接受了营养师的教育咨询。饮食建议的提供不受执业年限的影响。
尽管人们越来越意识到饮食在治疗儿童 FGIDs 中的作用，但在三级保健或初级保健机构中，只有少数患者接受饮食建议。当提供饮食建议时，提供的指导存在很大差异。
