Abstract

Pediatric Functional Constipation Gastrointestinal Symptom Profile Compared to Healthy Controls

Varni JW1, Nurko S, Shulman RJ, Self MM, Saps M, Bendo CB, Dark CV, Pohl JF; Pediatric Quality of Life Inventory Gastrointestinal Symptoms Module Testing Study Consortium. J Pediatr Gastroenterol Nutr. 2015 May 25. [Epub ahead of print]
 
     
Author information

1*Department of Pediatrics, College of Medicine, Department of Landscape Architecture and Urban Planning, College of Architecture, Texas A&M University, College Station, TX †Center for Motility and Functional Gastrointestinal Disorders, Boston Children's Hospital, Harvard Medical School, Boston, MA ‡Department of Pediatrics, Baylor College of Medicine, Children's Nutrition Research Center, Texas Children's Hospital, Houston, TX §Departments of Psychiatry and Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, TX ||Division of Gastroenterology, Hepatology and Nutrition, Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL ¶Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil #Department of Psychology, Texas A&M University, College Station, TX **Department of Pediatric Gastroenterology, Primary Children's Hospital, University of Utah, Salt Lake City, UT.

Abstract

OBJECTIVES: Patient-reported outcomes are necessary to evaluate the gastrointestinal symptom profile of patients with functional constipation. Study objectives were to compare the gastrointestinal symptom profile of pediatric patients with functional constipation to matched healthy controls with the PedsQL Gastrointestinal Symptoms and Gastrointestinal Worry Scales and to establish clinical interpretability in functional constipation through identification of minimal important difference (MID) scores. The secondary objective compared the symptom profile of patients with functional constipation to patients with irritable bowel syndrome (IBS).

METHODS: Gastrointestinal Symptoms and Worry Scales were completed in a 9-site study by 116 pediatric patients with functional constipation and 188 parents. Gastrointestinal Symptoms Scales measuring stomach pain, stomach discomfort when eating, food and drink limits, trouble swallowing, heartburn and reflux, nausea and vomiting, gas and bloating, constipation, blood in poop, and diarrhea were administered along with Gastrointestinal Worry Scales. 341 healthy children families and 43 IBS patient families completed the scales.

RESULTS: A broad profile of gastrointestinal symptoms and worry were reported by patients with functional constipation in comparison to healthy controls (P < 0.001) with large effect sizes (>0.80) across the majority of symptom domains. Patients with IBS manifested a broader symptom profile than functional constipation, with differences for stomach pain, stomach discomfort when eating, and worry about stomachaches, with similar constipation scores.

CONCLUSIONS: Pediatric patients with functional constipation report a broad gastrointestinal symptom profile in comparison to healthy controls, and only somewhat fewer symptoms than patients with IBS, highlighting the critical need for more efficacious interventions to achieve healthy functioning.

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