engleski

Functional gastrointestinal disorders in a tertiary outpatient setting – a three-year period outcome

Goal The aim of this study was to evaluate children with functional gastrointestinal disorders (FGIDs) seen by the paediatric gastroenterologist (PG) and their outcome during a three-year period. Method The study included children with FGIDs who visited the PG at the UHC Zagreb from January 1st 2017 to December 31st 2017 (N=328). This retrospective cohort was followed until December 31st 2019, data was extracted retrospectively from clinical records and their outcomes were assessed. Descriptive statistics and McNemar’s test were used, statistical significance was determined as p < 0.05. Results About 2/3 of outpatients (222/328) dropped out during the year 2017. The leading diagnosis was functional constipation (90/222 or 40.5%) and more than half of these patients were younger than 11 years (106/222). Most drop-outs visited the PG only once in 2017 (134/222), but for 33 patients this was a control visit, meaning that 101/222 (45.5%) needed no further subspecialist’s follow-ups after the index visit. During the year 2018 the number of patients who dropped out was 63/106 (59.4%) or 1/5 of the initial group. Finally, 43/328 or 13.1% of children from the initial cohort were still supervised by PG during the year 2019. About half of them had functional constipation (20/43), followed by irritable bowel syndrome (IBS) (12/43) and other functional abdominal pain disorders. Majority of patients were in the adolescent group (28/43). Further, we assessed the severity of symptoms at their last appointment in a subgroup of 227 patients who had one or more check-ups in the three-year period. About half of the patients claimed some improvement (115/227 patients), while 1/5 stated they were symptom-free (49/227). About 1/4 of children reported no change in the severity of symptoms (58/227). The vast majority of patients were correctly diagnosed with FGID, although the type of FGID changed in 13/328 subjects. In one patient, however, the diagnosis of IBS was reversed to ulcerative colitis. A significant number of children was included in a child psychologist/psychiatrist treatment (74/328 or 22.5%). Conclusion This survey reveals that almost half of children referred to the PG because of FGID needs only one subspecialist consultation. Less than 15% of children with FGID have persistent complaints lasting three years and requiring prolonged PG follow-ups. Adolescents tend to have more pronounced symptoms difficult to treat, as they were more prevalent in the subgroup followed to 2019 than in the initial 2017 cohort (28/43 vs. 143/328, p <0.001).

functional gastrointestinal disorders ; children

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