Cerrahpasa Medical Faculty, Paediatric Gastroenterology, Hepatology and Nutrition, Istanbul University-Cerrahpasa, Istanbul, Turkey.
Haseki Education and Training Hospital, Department of Paediatric, University of Health Sciences, Istanbul, Turkey.
Eur J Pediatr. 2021 Aug;180(8):2443-2452. doi: 10.1007/s00431-021-04059-2. Epub 2021 Apr 3.
This study aimed to determine the prevalence of infantile functional gastrointestinal disorders (FGIDs) based on Rome IV diagnostic criteria, and to determine the associated patient demographic and nutritional characteristics. A total of 2383 infants aged 1-12 months which were evaluated by 28 general pediatricians and pediatric gastroenterologists on the same day at nine tertiary care hospitals around Istanbul, Turkey, between November 2017 and March 2018, were included in the study. Patients included consulted the pediatric outpatient clinics because of any complaints, but not for vaccines and/or routine well child follow-ups as this is not part of the activities in the tertiary care hospitals. The patients were diagnosed with FGIDs based on Rome IV diagnostic criteria. The patients were divided into a FGID group and non-FGID group, and anthropometric measurements, physical examination findings, nutritional status, risk factors, and symptoms related to FGIDs were evaluated using questionnaires. Among the 2383 infants included, 837 (35.1%) had ≥1 FGIDs, of which 260 (31%) had already presented to hospital with symptoms of FGIDs and 577 (69%) presented to hospital with other symptoms, but were diagnosed with FGIDs by a pediatrician. Infant colic (19.2%), infant regurgitation (13.4%), and infant dyschezia (9.8%) were the most common FGIDs. One FGID was present in 76%, and ≥2 FGIDs were diagnosed in 24%. The frequency of early supplementary feeding was higher in the infants in the FGID group aged ≤6 months than in the non-FGID group (P = 0.039).Conclusion: FGIDs occur quite common in infants. Since early diversification was associated with the presence of FGIDs, nutritional guidance and intervention should be part of the first-line treatment. Only 31% of the infants diagnosed with a FGID were presented because of symptoms indicating a FGID. What is Known: • The functional gastrointestinal disorders (FGIDs) are a very common disorder and affect almost half of all infants. • In infants, the frequency of FGIDs increases with mistakes made in feeding. When FGIDs are diagnosed in infants, nutritional support should be the first-line treatment. What is New: • This study shows that only a third of children presented to hospital because of the symptoms of FGIDs, but pediatricians were able to make the diagnosis in suspected infants after appropriate evaluation. • The early starting of complementary feeding (<6 months) is a risk factor for the development of FGIDs.
本研究旨在根据罗马 IV 诊断标准确定婴儿功能性胃肠疾病 (FGIDs) 的患病率，并确定相关患者的人口统计学和营养特征。2017 年 11 月至 2018 年 3 月期间，在土耳其伊斯坦布尔的 9 家三级保健医院，28 位普通儿科医生和儿科胃肠病学家对 2383 名 1-12 个月大的婴儿进行了评估，这些婴儿被纳入了研究。这些患者因任何投诉而咨询儿科门诊，但不是为了疫苗接种和/或常规的儿童健康随访，因为这不是三级保健医院活动的一部分。根据罗马 IV 诊断标准，这些患者被诊断为 FGIDs。将患者分为 FGID 组和非 FGID 组，并使用问卷评估体格检查结果、营养状况、危险因素和与 FGIDs 相关的症状。在纳入的 2383 名婴儿中，837 名（35.1%）存在≥1 种 FGIDs，其中 260 名（31%）已因 FGIDs 症状就诊，577 名（69%）因其他症状就诊，但被儿科医生诊断为 FGIDs。婴儿肠绞痛（19.2%）、婴儿反流（13.4%）和婴儿便秘（9.8%）是最常见的 FGIDs。76%的患者存在 1 种 FGID，24%的患者诊断为≥2 种 FGID。≤6 个月龄的 FGID 组婴儿早期补充喂养的频率高于非 FGID 组（P = 0.039）。结论：FGIDs 在婴儿中相当常见。由于早期多样化与 FGIDs 的存在相关，因此营养指导和干预应成为一线治疗的一部分。只有 31%的因 FGIDs 症状就诊的婴儿被诊断为 FGIDs。已知：•功能性胃肠疾病（FGIDs）是一种非常常见的疾病，几乎影响所有婴儿的一半。•在婴儿中，FGIDs 的频率随着喂养错误的增加而增加。当婴儿被诊断为 FGIDs 时，营养支持应作为一线治疗。新内容：•本研究表明，只有三分之一的儿童因 FGIDs 症状就诊，但儿科医生在适当评估后能够在疑似婴儿中做出诊断。•早期开始补充喂养（<6 个月）是 FGIDs 发展的危险因素。
