Functional Gastrointestinal Disorder, Pediatric

Description

• Term that describes a group of conditions that present with variable combinations of chronic or recurrent gastrointestinal (GI) symptoms not explained by structural or biochemical abnormalities (1)
• Functional GI disorder (FGID) includes cyclic vomiting syndrome, functional nausea and vomiting, rumination syndrome, functional dyspepsia, irritable bowel syndrome, abdominal migraine, functional abdominal pain—not otherwise specified, functional constipation, functional diarrhea, and infant dyschezia.
• Symptoms often affects daily living, but growth and development are normal (2).
• A patient can have >1 FGID (3).
• These conditions can coexist with other medical conditions (3).

Epidemiology

• Common conditions in the group include the abdominal pain-related conditions: irritable bowel syndrome, functional abdominal pain, and functional dyspepsia.
• Abdominal pain is a common complaint in pediatric practices.
  • Up to 5% of pediatric visits are due to abdominal pain (2).
  • Prevalence is increased in children age 4 to 6 years and early adolescents (2).
  • 13–38% of children and adolescents complain of abdominal pain weekly (4).

Incidence

• Incidence and prevalence unknown for some conditions in the group
• Different incidence and prevalence rates have been reported for frequently occurring conditions in the group.

Etiology and Pathophysiology

• The specific etiology is unknown.
• Conditions may occur due to abnormal function of GI tract.
  • Abnormal motility of GI tract
  • Abnormal sensation of GI tract
  • Abnormal brain-gut communication

Risk Factors

• Other family members with similar conditions
• Early life adverse events such as physical or sexual abuse
• Emotional stresses
• Family stresses
• For cyclic vomiting, chronic marijuana use
• Anxiety
• Depression
• Secondary gain
• Other illnesses

General Prevention

No specific prevention but controlling any mental illness and/or stressors may reduce risk