患有胃轻瘫和功能性消化不良的儿童中,回避/限制型食物摄入障碍的患病率很高。
Avoidant/restrictive food intake disorder prevalence is high in children with gastroparesis and functional dyspepsia.
机构信息
Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA.
USDA/ARS Children's Nutrition Research Center, Houston, Texas, USA.
出版信息
Neurogastroenterol Motil. 2024 May;36(5):e14777. doi: 10.1111/nmo.14777. Epub 2024 Mar 7.
BACKGROUND
Avoidant/restrictive food intake disorder (ARFID) prevalence in children with gastroparesis (Gp) and/or functional dyspepsia (FD) is unknown. We aimed to identify ARFID prevalence and trajectory over 2 months in children with Gp, FD, and healthy children (HC) using two screening questionnaires. We also explored the frequency of a positive ARFID screen between those with/without delayed gastric emptying or abnormal fundic accommodation.
METHODS
In this prospective longitudinal study conducted at an urban tertiary care hospital, patients ages 10-17 years with Gp or FD and age- and gender-matched HC completed two validated ARFID screening tools at baseline and 2-month follow-up: the Nine Item ARFID Screen (NIAS) and the Pica, ARFID, and Rumination Disorder Interview-ARFID Questionnaire (PARDI-AR-Q). Gastric retention and fundic accommodation (for Gp and FD) were determined from gastric emptying scintigraphy.
KEY RESULTS
At baseline, the proportion of children screening positive for ARFID on the NIAS versus PARDI-AR-Q was Gp: 48.5% versus 63.6%, FD: 66.7% versus 65.2%, HC: 15.3% versus 9.7%, respectively; p < 0.0001 across groups. Of children who screened positive at baseline and participated in the follow-up, 71.9% and 53.3% were positive 2 months later (NIAS versus PARDI-AR-Q, respectively). A positive ARFID screen in Gp or FD was not related to the presence/absence of delayed gastric retention or abnormal fundic accommodation.
CONCLUSIONS & INFERENCES: ARFID detected from screening questionnaires is highly prevalent among children with Gp and FD and persists for at least 2 months in a substantial proportion of children. Children with these disorders should be screened for ARFID.
背景
患有胃轻瘫(Gp)和/或功能性消化不良(FD)的儿童中,回避/限制型食物摄入障碍(ARFID)的患病率尚不清楚。我们旨在使用两种筛查问卷,确定 Gp、FD 和健康儿童(HC)中 2 个月内 ARFID 的患病率和轨迹。我们还探讨了胃排空延迟或胃底顺应性异常的儿童中阳性 ARFID 筛查的频率。
方法
在这项于城市三级保健医院进行的前瞻性纵向研究中,年龄在 10-17 岁之间的患有 Gp 或 FD 的患者以及年龄和性别匹配的 HC,在基线和 2 个月随访时完成了两种经过验证的 ARFID 筛查工具:九项 ARFID 筛查(NIAS)和异食癖、ARFID 和反刍障碍访谈-ARFID 问卷(PARDI-AR-Q)。通过胃排空闪烁扫描术确定胃潴留和胃底顺应性(用于 Gp 和 FD)。
主要结果
在基线时,NIAS 与 PARDI-AR-Q 筛查阳性的 ARFID 儿童比例在 Gp 中分别为 48.5%和 63.6%,FD 中分别为 66.7%和 65.2%,HC 中分别为 15.3%和 9.7%;各组之间差异有统计学意义(p<0.0001)。在基线筛查阳性并参加随访的儿童中,71.9%和 53.3%在 2 个月后再次阳性(分别为 NIAS 与 PARDI-AR-Q)。Gp 或 FD 中阳性 ARFID 筛查与胃排空延迟或胃底顺应性异常的存在与否无关。
结论
通过问卷调查筛查出的 ARFID 在患有 Gp 和 FD 的儿童中患病率很高,在相当一部分儿童中至少持续 2 个月。这些疾病的患儿应进行 ARFID 筛查。