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ABSTRACT BACKGROUND: Functional gastrointestinal disorders (FGIDs) are defined as a variable combination of chronic or recurrent gastrointestinal symptoms that are not explained by structural or biochemical abnormalities. Their relationship with prematurity has been increasingly studied. OBJECTIVE: To compare the frequency of FGIDs in preterm and term infants and to evaluate whether invasive procedures during the neonatal period in preterm infants are associated with greater likelihood of FGIDs in the first two years of life. DESIGN AND SETTING: Controlled nested cross-sectional study conducted in a Brazilian university hospital. METHODS: This was a controlled nested cross-sectional study on a retrospective cohort of infants born preterm who were compared with infants born at term regarding the presence of FGIDs. Medical consultations were conducted by a single pediatric gastroenterologist to obtain information on the gestational and neonatal periods and on clinical manifestations of the digestive tract. The Rome IV criteria for the diagnosis of FGIDs were used. RESULTS: A total of 197 infants (< 24 months), including 99 preterm and 98 term infants, were studied. Infant regurgitation was more prevalent in term infants (35.1% and 15.6%; P < 0.001). The frequencies of other FGIDs (infant colic, functional constipation, functional diarrhea and infant dyschezia) in preterm infants did not differ from those of term infants (P > 0.05). No relationship was found between invasive procedures during the neonatal period and development of FGIDs in preterm infants. CONCLUSION: Infants born preterm did not have higher frequency of FGIDs in the first two years of life.
RESUMO
ABSTRACT Objective: To determine the prevalence of functional gastrointestinal disorders (FGIDs) in children according to Rome IV criteria. Methods: We included cohorts and observational descriptive studies, including information for the prevalence of FGIDs according to Rome IV criteria in children 4 to 18 years old. We searched the MEDLINE (Ovid), EMBASE, LILACS, and CENTRAL databases from May 2016 to nowadays. Gray literature and other databases were also consulted. The risk of bias was assessed using the STROBE Statement. The results were reported in forest plots of the estimated effects of the included studies with a 95% confidence interval (95%CI). Results: We included 14 studies involving a total of 17427 participants. Three studies were conducted in Europe, two in North America, and nine in Latin America. Most studies were school-based (n=14670, 84.18%), participants were mostly female (55.49%), white (51.73%), 8 to 18 years old (77.64%), and assisted to a public school (81.53%). Thirteen studies used the Questionnaire on Pediatric Gastrointestinal Symptoms (QPGS-RIV) to assess FGIDs. We found a global prevalence for FGIDs of 23% (95%CI 21-25%, I2 99%). Main disorders were functional constipation (FC) with 12% (95%CI 11-15%) followed by functional dyspepsia (FD) (5%, 95%CI 11-15%) and irritable bowel syndrome (IBS) (3%, 95%CI 2-4%). The prevalence of FGIDs was higher in the Americas, representing 23.67% (95%CI 21.2-26.2%, I2 91.3%). Conclusion: FGIDs are present in one of four children and adolescents, representing a common condition in this age group the central disorders were FC, FD, and IBS.
RESUMO Objetivo: Determinar a prevalência de distúrbios gastrointestinais funcionáis (DGF) em crianças de acordo com os critérios de Roma IV. Métodos: Incluímos coortes e estudos observacionais descritivos, incluindo informações para a prevalência de DGF de acordo com os critérios de Roma IV em crianças de 4 a 18 anos. Pesquisamos nas bases de dados MEDLINE (Ovid), EMBASE, LILACS e CENTRAL de maio de 2016 até os dias atuais. A literatura cinzenta e outras bases de dados também foram consultadas. O risco de viés foi avaliado usando a Declaração STROBE. Os resultados foram relatados em parcelas florestais dos efeitos estimados dos estudos incluídos com um intervalo de confiança de 95% (95%IC). Resultados: Foram incluídos 14 estudos envolvendo um total de 17.427 participantes. Três estudos foram realizados na Europa, dois na América do Norte e nove na América Latina. A maioria dos estudos foi de base escolar (n=14.670, 84,18%), os participantes eram em sua maioria do sexo feminino (55,49%), brancos (51,73%), de 8 a 18 anos (77,64%) e atendidos em escola pública (81,53%). Treze estudos usaram o Questionário de Sintomas Gastrointestinais Pediátricos (QPGS-RIV) para avaliar DGF. Encontramos uma prevalência global de DGF de 23% (95%IC 21-25%, I2 99%). Os principais distúrbios foram constipação funcional (CF) com 12% (95%IC 11-15%) seguido de dispepsia funcional (DF) (5%, 95%IC 11-15%) e síndrome do intestino irritável (SII) (3%, 95%IC 2-4%). A prevalência de DGF foi maior nas Américas, representando 23,67% (95%IC 21, 2-26,2%, I2 91,3%). Conclusão: DGF estão presentes em uma de quatro crianças e adolescentes, representando uma condição comum nessa faixa etária. Os distúrbios centrais foram CF, DF e SII.