Symptomatic Treatment of Pain-Related Pediatric Functional Gastrointestinal Disorders in a Biopsychosocial Construct, and a Validity Study of Rome III Criteria

Author:

Madani Shailender1,Madani Rohit2,Parikh Suchi3,Manivannan Ahila4ORCID,Orellana Wilma R.2,Thomas Ron1,Di Lorenzo Carlo5

Affiliation:

1. Children’s Hospital of Michigan, Troy, MI, USA

2. Children’s Healthcare of Atlanta, Emory University, Atlanta, GA, USA

3. Cook Children’s Physician Network, Fort Worth, TX, USA

4. Wayne State University School of Medicine, Detroit, MI, USA

5. Nationwide Children’s Hospital, Columbus, OH, USA

Abstract

Our study aims to assess improvement with symptomatic treatment of pain-related functional gastrointestinal disorders (FGIDs) in a biopsychosocial construct and evaluate validity of Rome III criteria. Children with chronic abdominal pain diagnosed with an FGID or organic disease were followed for 1 year: 256/334 were diagnosed with an FGID and 78/334 were diagnosed with a possible organic disease due to alarm signs or not meeting Rome III criteria. After 1 year, 251 had true FGID and 46 had organic diseases. Ninety percent of FGID patients improved with symptomatic treatment over an average of 5.4 months. With a 95% confidence interval, Rome criteria predicted FGIDs with sensitivity 0.89, specificity 0.90, positive predictive value 0.98, and negative predictive value 0.59. We conclude that symptomatic treatment of pain-related FGIDs results in clinical improvement and could reduce invasive/expensive testing. Rome III criteria’s high specificity and positive predictive value suggest they can rule in a diagnosis of FGID.

Publisher

SAGE Publications

Subject

Pediatrics, Perinatology, and Child Health

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