Prevalence of disorders of gut-brain-interaction in pediatric patients with in-remission inflammatory bowel disease: An Italian multicenter study.
Pediatric patients with in-remission inflammatory bowel disease (IBD) often report persistent gastrointestinal symptoms, suggesting a potential overlap with disorders of gut-brain-interaction (DGBIs). While DGBIs affect up to 40% of the general population, their prevalence in quiescent IBD children remains limited. We aimed to evaluate the prevalence and distribution of DGBIs, based on Rome-IV criteria, in children with quiescent IBD compared to healthy controls, identifying demographic, clinical and therapeutic factors associated with DGBIs.
In this multicenter, prospective, controlled study, in-remission IBD pediatric patients and healthy controls were enrolled completing the Rome IV-Questionnaire. IBD-remission was defined by pediatric ulcerative colitis activity index (PUCAI)/pediatric Crohn's disease activity index scores < 10, normal inflammatory markers and recent endoscopic mucosal healing.
Forty-one pediatric patients with IBD in remission and 179 healthy controls were enrolled. DGBIs were found in 41.46% of IBD-patients versus 27.93% of controls (p = 0.089). Functional Dyspepsia was significantly more prevalent in IBD patients (p < 0.001), while irritable bowel syndrome was more frequent among controls, though not significantly (p = 0.466). No differences in DGBI prevalence emerged between Crohn's disease and ulcerative colitis (p = 0.54). At the multivariate analysis, psychological comorbidities (odds ratio [OR] 40.767, p < 0.001) and low weight (0.953, p ≤ 0.001) were significantly associated with DGBIs. Notably, 5-aminosalicylic-acid (ASA) administration was associated with reduced DGBIs likelihood (OR 0.139, p = 0.005).
In our cohort, the overall DGBIs prevalence was numerically but not significantly higher in quiescent-IBD patients compared to controls, while upper gastrointestinal DGBIs were significantly more frequent in IBD patients. Psychological and nutritional factors emerged as strong predictors of DGBIs, while 5-ASA may be associated with lower likelihood of DGBIs.
In this multicenter, prospective, controlled study, in-remission IBD pediatric patients and healthy controls were enrolled completing the Rome IV-Questionnaire. IBD-remission was defined by pediatric ulcerative colitis activity index (PUCAI)/pediatric Crohn's disease activity index scores < 10, normal inflammatory markers and recent endoscopic mucosal healing.
Forty-one pediatric patients with IBD in remission and 179 healthy controls were enrolled. DGBIs were found in 41.46% of IBD-patients versus 27.93% of controls (p = 0.089). Functional Dyspepsia was significantly more prevalent in IBD patients (p < 0.001), while irritable bowel syndrome was more frequent among controls, though not significantly (p = 0.466). No differences in DGBI prevalence emerged between Crohn's disease and ulcerative colitis (p = 0.54). At the multivariate analysis, psychological comorbidities (odds ratio [OR] 40.767, p < 0.001) and low weight (0.953, p ≤ 0.001) were significantly associated with DGBIs. Notably, 5-aminosalicylic-acid (ASA) administration was associated with reduced DGBIs likelihood (OR 0.139, p = 0.005).
In our cohort, the overall DGBIs prevalence was numerically but not significantly higher in quiescent-IBD patients compared to controls, while upper gastrointestinal DGBIs were significantly more frequent in IBD patients. Psychological and nutritional factors emerged as strong predictors of DGBIs, while 5-ASA may be associated with lower likelihood of DGBIs.
Authors
Quatrale Quatrale, Chirico Chirico, Colecchia Colecchia, Stella Stella, Proli Proli, Pisano Pisano, Romeo Romeo, De Angelis De Angelis, Pensabene Pensabene, Marasco Marasco, Di Nardo Di Nardo, Barbara Barbara, Gasbarrini Gasbarrini, Scaldaferri Scaldaferri, Giorgio Giorgio
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