Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA.
USDA/ARS Children's Nutrition Research Center, Houston, Texas, USA.
Neurogastroenterol Motil. 2024 May;36(5):e14777. doi: 10.1111/nmo.14777. Epub 2024 Mar 7.
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.
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.
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.
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。
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）。
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。
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。
