Increased Gastrointestinal Permeability and Gut Inflammation in Children with Functional Abdominal Pain and Irritable Bowel Syndrome

Objectives

To determine gastrointestinal (GI) permeability and fecal calprotectin concentration in children 7 to 10 years of age with functional abdominal pain and irritable bowel syndrome (FAP/IBS) versus control subjects and ascertain potential relationships with pain symptoms and stooling.

Study design

GI permeability and fecal calprotectin concentration were measured. Children kept a 2-week diary of pain episodes and stooling pattern.

Results

Proximal GI permeability was greater in the FAP/IBS group (n = 93) compared with control subjects (n = 52) (0.59 ± 0.50 vs 0.36 ± 0.26, respectively; mean ± SD; P < .001) as was colonic permeability (1.01 ± 0.67 vs 0.81 ± 0.43, respectively; P < .05). Gastric and small intestinal permeability were similar. Fecal calprotectin concentration was greater in children with FAP/IBS compared with control children (65.5 ± 75.4 μg/g stool vs 43.2 ± 39.4, respectively; P < .01). Fecal calprotectin concentration correlated with pain interference with activities (P = .01, r² = 0.36). There was no correlation between GI permeability and pain related symptoms. Neither permeability nor fecal calprotectin correlated with stool form.

Conclusions

Children with FAP/IBS have evidence of increased GI permeability and low-grade GI inflammation, with the latter relating to the degree to which pain interferes with activities.

Abbreviations: GI, Gastrointestinal, FAP/IBS, Functional abdominal pain and irritable bowel syndrome