Predictors of Hospital Admission for Pediatric Cyclic Vomiting Syndrome.

OBJECTIVES: To identify predictors of hospitalization in pediatric patients presenting to an emergency department (ED) for a cyclic vomiting syndrome (CVS) attack. STUDY DESIGN: We retrospectively reviewed patients with CVS seen at our institution between 2015 and 2018 and included those who met the Rome IV criteria for CVS. We identified all CVS-related ED visits and subsequently performed a case-control analysis, utilizing multivariate logistic regression, to identify clinical and demographic factors that may predict hospitalization. RESULTS: In total, 219 patients with CVS (using International Statistical Classification of Diseases and Related Health Problems, 10th Revision) were identified, of which 65% met the inclusion criteria (median age 11 years). We identified 152 CVS-related ED visits, of which 62% resulted in hospitalization. Factors found to predict hospitalization using multivariate analyses included male sex (P = .04), younger age (P = .027), delayed presentation (>24 hours) to the ED (P < .001), and longer wait time prior treatment with antiemetics (P = .029). CONCLUSION: One-quarter of all patients with CVS had presented to the ED and nearly two-thirds of these ED visits resulted in hospitalization. A delayed presentation to the ED following the onset of symptoms was the strongest independent predictor of hospital admission, alongside male sex, younger age, and longer ED wait times before treatment with antiemetics. These findings suggest that early intervention may be key to successfully mitigating the risk of hospitalization for a CVS attack.

Colombian School Children With Functional Gastrointestinal Disorders Respond Differently to Family Stress Than Healthy Children.

Our objective is to compare coping methods, stress responses, and resilience in children with and without functional gastrointestinal disorders (FGIDs) in response to common sources of stress. We performed a case-control study. Children meeting criteria for FGIDs and matched controls completed measures of response to stress (Peer Stress, Family Stress, Academic Problems, and Recurrent Abdominal Pain versions of the Response to Stress Questionnaire) and resilience (Connor-Davidson Resilience Scale 10). We included 134 children with an FGID (57 with functional constipation and 74 with an abdominal pain-predominant FGID) and 135 controls. Children with FGIDs were more likely to take action (P < 0.001) and less likely to remain involuntarily engaged (P < 0.001) in response to family stress. Response to peer and academic stress and measures of resilience were similar between groups. Further research is needed to better understand the role that family stress and a child's response play in the pathophysiology of pediatric FGIDs.

Sex, Age, and Prevalence of Pediatric Irritable Bowel Syndrome and Constipation in Colombia: A Population-based Study.

OBJECTIVES: Our objective was to evaluate the role of sex and age in the prevalence of irritable bowel syndrome (IBS) and functional constipation (FC) in Colombian children. We hypothesized that the prevalence of IBS and FC would be higher in female adolescents than in younger female children, with no corresponding difference in boys. METHODS: We performed a cross-sectional study of Colombian children. Subjects completed the Questionnaire on Pediatric Gastrointestinal Symptoms-Rome III. Subjects were divided into child and adolescent age groups using 2 different cutoffs. Cutoffs were established at 12 and 13 years (CH-1 = 8-12 years, AD-1 = 13-18 years, CH-2 = 8-13 years, AD-2 = 14-18 years). RESULTS: A total of 3891 subjects (47.0% F, mean age 12.0 years) participated. One hundred eighty-seven (4.8%) met criteria for IBS. There was no difference in sex composition between CH-1/AD-1 (56.0%, 43.5% F) and CH-2/AD-2 (53.4%, 46.8% F). Prevalence of IBS among girls was higher in CH-1 than that in AD-1 (6.4%, 3.7%, P < 0.05) and overall prevalence was higher in CH-1 than in AD-1 (5.4%, 4.0%, P < 0.05). Four hundred ninety-four (12.7%) children met criteria for FC. There was no difference in sex composition between CH-1/AD-1 (47.6%, 48.7% F) and CH-2/AD-2 (47.7%, 49.0% F). Prevalence of FC among girls was higher in CH-1/CH-2 (14.6%, 14.1%) than in AD-1/AD-2 (10.4%, P < 0.01; 9.9%, P < 0.05). Prevalence of FC overall was higher in CH-1/CH-2 (14.5%, 14.0%) than in AD-1/AD-2 (10.0%, P < 0.0001; 9.3%, P < 0.0001). CONCLUSIONS: We did not find a significant female predominance among Colombian children with IBS or FC. Contrary to our hypothesis, IBS and FC prevalence was generally higher in younger children compared with adolescents regardless of sex.

The prevalence of functional gastrointestinal disorders in children in Panama: a school-based study.

AIM: Functional gastrointestinal disorders (FGIDs) are common in children, but the epidemiology of FGIDs is incompletely understood. Our aim was to perform a population-based study using Rome III criteria to describe the prevalence of FGIDs in children in Panama. METHODS: We performed a cross-sectional study of children attending three schools in Panama City, Panama. Children with organic medical diseases were excluded. Subjects provided demographic information and completed the Questionnaire on Pediatric Gastrointestinal Symptoms - Rome III Spanish version. RESULTS: A total of 321 subjects (61.1% female, median age 10 years, range 8-14 years) completed our study. A total of 92 subjects (28.7%) met criteria for an FGID. Gender, age and school type did not differ significantly between subjects with and without FGIDs. The most common FGIDs included functional constipation (15.9%), irritable bowel syndrome (5.6%), and functional abdominal pain or functional abdominal pain syndrome (4.0%). Abdominal pain-related FGIDs were present in 12.1%. CONCLUSION: FGIDs are common in school-aged children in Panama. The prevalence of abdominal pain-related FGIDs in children in Panama is similar to that described in other parts of the world. Further population-based studies utilising Rome III criteria to measure FGID prevalence in children are needed to advance our understanding of the pathogenesis of FGIDs.