Post-Infectious Functional Gastrointestinal Disorders in Children

Objective

To investigate the development of functional gastrointestinal disorders (FGIDs) after an episode of acute bacterial gastroenteritis (AGE) in children.

Study design

A cohort study of children 3 to 19 years old with a positive result on a bacterial stool culture. 44 patients in each arm (unidirectional α of 0.05, power of 0.80). Children presenting at two pediatric hospitals (United States and Italy) for AGE who tested positive for bacteria on stool culture (2001-2005) were contacted at least 6 months after the episode. Exposed children were matched with control subjects of similar age and sex consulting to the same hospitals for trauma or well-child visit within 4 weeks of the index case. Symptoms were evaluated with a validated questionnaire for FGIDs assessing pain, diarrhea, and disability.

Results

88 patients (46 boys; mean age, 8.1 years; age range, 3-19 years) were recruited. Bacteria included Salmonella (54%), Campylobacter (32%), and Shigella (14%). 36% of exposed patients and 11% of control subjects complained of abdominal pain (P < .01). 87% had irritable bowel syndrome and 24% had dyspepsia. 56% reported onset of pain following the AGE.

Conclusion

There is a significant increase in cases of FGIDs after bacterial infections in children.

Abbreviations: AGE, Acute bacterial gastroenteritis, AP, Abdominal pain, FGID, Functional gastrointestinal disorder, IBS, Irritable bowel syndrome, PI-IBS, Post-infectious irritable bowel syndrome, PI-FGID, Post-infectious functional gastrointestinal disorder, QPGS, Questionnaire on Pediatric Gastrointestinal Symptoms