Risk factors for the development of functional gastrointestinal disorders in children
DOI:
https://doi.org/10.15574/SP.2022.126.62Keywords:
children, functional constipation, functional dyspepsia, risk factors, predictors, functional gastrointestinal disordersAbstract
The purpose is to analyze the risk factors for functional gastrointestinal disorders (FGID) in children, which will prevent their development and optimize therapy.
The article presents an analysis of the literature on risk factors for the most common disorders: functional dyspepsia and irritable bowel syndrome. Among all potential predictors of FGID, chronic psychological stress is the most significant. The main triggers for its occurrence are sleep disturbance, excessive mental stress, dissatisfaction with family relationships with friends and parents, abuse of gadgets, smartphones, etc.
Among the predictors of FGID, scientists consider malnutrition, starting from an early age, namely artificial feeding, to be no less important. In older adults, excessive lipid intake, adherence to FODMAPs diets, and consumption of ultra-processed foods are considered risk factors for FGID. In addition, a violation of the diet, the use of cold dishes also contribute to the occurrence of dysfunctions of the gastrointestinal tract.
An important aspect of studying risk factors for FGID is the level of physical activity of children, as well as their nutritional status.
Functional gastrointestinal disorders are conditions characterized by recurrent abdominal pain not explained by structural or biochemical disorders. The interest in functional pathology is quite justified and understandable: despite the fact that functional diseases of the gastrointestinal tract do not pose an immediate threat to the patient's life, they significantly reduce its quality: they affect all segments of society, regardless of socioeconomic status, gender or race, violate the microclimate in the family, which leads to anxiety of the child and parents, form long-term consequences in the future, contribute to a long diagnostic search, repeated consultations, unjustified appointments and expenses.
Such a subject of discussion cannot remain without research interest due to the fact that the identification of the main risk factors for FGID will prevent their development, improve the quality of life, reduce the time and cost of examining a patient, and optimize therapy.
No conflict of interests was declared by the authors.
References
Anderson E, Shivakumar G. (2013). Effects of Exercise and Physical Activity on Anxiety. Frontiers in Psychiatry: 4. URL: https://www.frontiersin.org/article/10.3389/fpsyt.2013.00027. ISSN 1664-0640. https://doi.org/10.3389/fpsyt.2013.00027; PMid:23630504 PMCid:PMC3632802
Assa A, Ish-Tov A, Rinawi F, Shamir R. (2015). School attendance in children with functional abdominal pain and inflammatory bowel diseases. J Pediatr Gstroenterol Nutr. 61: 553-557. https://doi.org/10.1097/MPG.0000000000000850; PMid:25950089
Basso JC, Suzuki WA. (2017, Jan 1). The Effects of Acute Exercise on Mood, Cognition, Neurophysiology, and Neurochemical Pathways: A Review. Brain Plast. 2 (2): 127-152. URL: https://content.iospress.com/articles/brain-plasticity/bpl16004025. https://doi.org/10.3233/BPL-160040; PMid:29765853 PMCid:PMC5928534
Benninga MA, Faure C, Hyman PE, Roberts IStJ, Schechter NL, Nurko S. (2016). Childhood Functional Gastrointestinal Disorders: Neonate/Toddler. Gastroenterology. S00165085(16)00182-7. https://doi.org/10.1053/j.gastro.2016.02.016; PMid:27144631
Carlson MJ, Moore CE, Tsai CM, Shulman RJ, Chumpitazi BP. (2014). Child and parent perceived food-induced gastrointestinal symptoms and quality of life in children with functional gastrointestinal disorders. J Acad Nutr Diet. 114: 403-413. https://doi.org/10.1016/j.jand.2013.10.013; PMid:24360501 PMCid:PMC4267718
Chey WD. (2013). The role of food in the functional gastrointestinal disorders: introduction to a manuscript series. Am J Gastroenterol. 108 (5): 694-697. Epub 2013 Apr 2. https://doi.org/10.1038/ajg.2013.62; PMid:23545712
Cinquetti M, Biasin M, Ventimiglia M, Balanzoni L et al. (2020). Functional gastrointestinal disorders and smartphone use in adolescents. Clinical and Experimental Pediatrics. 64 (9): 494-496. https://doi.org/10.3345/cep.2020.01326; PMid:33171037 PMCid:PMC8426096
Costa RJ, Snipe RM, Kitic CM et al. (2017). Systematic review: exercise-induced gastrointestinal syndrome-implications for health and intestinal disease. Aliment Pharmacol Ther. 46: 246-265. https://doi.org/10.1111/apt.14157; PMid:28589631
Demirci K, Akgönül M, Akpinar A. (2015, Jun). Relationship of smartphone use severity with sleep quality, depression, and anxiety in university students. J Behav Addict. 4 (2): 85-92. https://doi.org/10.1556/2006.4.2015.010; PMid:26132913 PMCid:PMC4500888
Devanarayana NM, Rajindrajith S, Benninga MA. (2014). Quality of life and health care consultation in 13 to 18 year olds with abdominal pain predominant functional gastrointestinal diseases. BMC Gastroenterol. 14: 150. https://doi.org/10.1186/1471-230X-14-150; PMid:25145589 PMCid:PMC4236590
Bouchoucha M, Girault-Lidvan N, Hejnar M, Mary F, Airinei G, Benamouzig R. Clinical and psychological characteristics of patients with globus. Clin Res Hepatol Gastroenterol 2019;43: 614-622. https://doi.org/10.1016/j.clinre.2019.01.006; PMid:30772327
Di Lorenzo C. (2013). Other functional gastrointestinal disordersin infants and young children. J Pediatr Gastroenterol and Nutr. 57 (1): S36-S38. https://doi.org/10.1097/01.mpg.0000441933.15093.c3
Dong TS, Gupta A. (2019, Jan). Influence of Early Life, Diet, and the Environment on the Microbiome. Clin Gastroenterol Hepatol. 17 (2): 231-242. Epub 2018 Sep 7. https://doi.org/10.1016/j.cgh.2018.08.067; PMid:30196160 PMCid:PMC6422042
Drossman DA, Tack J, Ford AC, Szigethy E et al. (2018). Neuromodulators for Functional Gastrointestinal Disorders (Disorders of Gut Brain Interaction): A Rome Foundation Working Team Report. Gastroenterology. 154: 1140-1171. https://doi.org/10.1053/j.gastro.2017.11.279; PMid:29274869
Duncanson KR, Talley NJ, Walker MM, Burrows TLJ. (2018, Jun). Food and functional dyspepsia: a systematic review. Hum Nutr Diet. 31 (3): 390-340. https://doi.org/10.1111/jhn.12506; PMid:28913843
Enck P, Azpiroz F, Boeckxstaens G, Elsenbruch S et al. (2017, Nov 3). Functional dyspepsia. Nat Rev Dis Primers. 3: 17081. https://doi.org/10.1038/nrdp.2017.81; PMid:29099093
Feinle-Bisset C, Azpiroz F. (2013). Dietary lipids and functional gastrointestinal disorders. Am J Gastroenterol. 108: 737-747. https://doi.org/10.1038/ajg.2013.76; PMid:23567355
Galai T, Moran-Lev H, Cohen S, Ben-Tov A et al. (2020, May 6). Higher prevalence of obesity among children with functional abdominal pain disorders. BMC Pediatr. 20 (1): 193. https://doi.org/10.1186/s12887-020-02106-9; PMid:32375714 PMCid:PMC7201594
Güven B, Gülerman F, Akyüz E, Aydın G. (2020). Emotional dysregulation in adolescents with functional gastrointestinal disorders. Arab J Gastroenterol. 21 (1): 24-27. https://doi.org/10.1016/j.ajg.2020.02.002; PMid:32179047
Holtmann G, Shah A, Morrison M. (2017). Pathophysiology of Functional Gastrointestinal Disorders: A Holistic Overview. Dig Dis. 35 (1): 5-13. https://doi.org/10.1159/000485409; PMid:29421808
Jagiashvili OV. (2019). Age-related features of syntropic pathology in functional disorders of the digestive organs in children dissertation 01.14.10 - pediatrics 222 - Medicine: 200.
Karamanolis G, Tack J. (2006). Promotility medications-now and in the future. Dig Dis. 24: 297-307. https://doi.org/10.1159/000092883; PMid:16849857
Kee Seang Chew, Jun Min Em, Zhong Lin Koay, Muhammad Yazid Jalaludin et al. (2021). Low prevalence of infantile functional gastrointestinal disorders (FGIDs) in a multi-ethnic Asian population. Pediatrics & Neonatology. 62 (1): 49-54. ISSN 1875-9572. https://doi.org/10.1016/j.pedneo.2020.08.009; PMid:32891528
Keshteli A, Feizi A, Esmaillzadeh A, Zaribaf F et al. (2015). Patterns of dietary behaviours identified by latent class analysis are associated with chronic uninvestigated dyspepsia. British Journal of Nutrition. 113 (5): 803-812. https://doi.org/10.1017/S0007114514004140; PMid:25686505
Koloski NA, Jones M, Kalantar J et al. (2012). The brain - gut pathway in functional gastrointestinal disorders is bidirectional: a 12-year prospective population-based study. Gut. 61: 1284-1290. https://doi.org/10.1136/gutjnl-2011-300474; PMid:22234979
Koloski NA, Jones M, Weltman M, Kalantar J, Bone C et al. (2015). Identification of early environmental risk factors for irritable bowel syndrome and dyspepsia. Neurogastroenterol Motil. 27: 1317-1325. https://doi.org/10.1111/nmo.12626; PMid:26202154
Koloski NA, Jones MP, Talley NJ. (2016). Confirmation of bidirectional gut to brain pathways in irritable bowel syndrome and functional dyspepsia: a one-year population-based prospective study. Gastroenterology. 150: S737. https://doi.org/10.1016/S0016-5085(16)32505-7
Lewis ML, Palsson OS, Whitehead WE, van Tilburg MA. (2016). Prevalence of Functional Gastrointestinal Disorders in Children and Adolescents. J. Pediatr. 177: 39-43.e3. https://doi.org/10.1016/j.jpeds.2016.04.008; PMid:27156185
Lysytsia YuM, Bulat LM, Pypa LV, Svistilnyk RV et al. (2019). Clinical masks of somatoform disorders of the gastrointestinal tract and urinary system in children associated with affective states. Bulletin of Vinnytsia National Medical University. 23: 3. https://doi.org/10.31393/reports-vnmedical-2019-23(3)-17
Maidannyk VG. (2015). Problematic issues of natural feeding of children in Ukraine. Health-ua.com. URL: https://health-ua.com/article/16248-problemn-pitannya-prirodnogo-vigodovuvannya-dtej-v-ukran.
Marc B, Oozeer R, Gerardi-Temporel G, Faure Ch, Vandenplas Y. (2018). Multiple functional gastrointestinal disorders are frequent in formula-fed infants and decrease their quality of life. Acta Pædiatrica. 107: 1276-1282. https://doi.org/10.1111/apa.14348; PMid:29604128 PMCid:PMC6055647
Matkovska TM. (2015). Peculiarities of the mental state of adolescents as a risk factor for the adverse course of diffuse nontoxic goiter. Psychiatry, neurology and medical psychology. 2 (1): 36-41.
Matsuzaki J, Suzuki H, Masaoka T et al. (2016). Influence of regular exercise on gastric emptying in healthy men: a pilot study. J Clin Biochem Nutr. 59: 130-133. https://doi.org/10.3164/jcbn.16-29; PMid:27698540 PMCid:PMC5018576
Mayer EA, Savidge T, Shulman RJ. (2014, May). Brain-gut microbiome interactions and functional bowel disorders. Gastroenterology. 146 (6): 1500-1512. https://doi.org/10.1053/j.gastro.2014.02.037; PMid:24583088 PMCid:PMC4114504
Monda V, Villano I, Messina A et al. (2017). Exercise modifies the gut microbiota with positive health effects. Oxid Med Cell Longev. 2017: 3831972. https://doi.org/10.1155/2017/3831972; PMid:28357027 PMCid:PMC5357536
Monzon AD, Cushing CC, Friesen CA, Schurman JV. (2020, Jan 1). The Association Between Affect and Sleep in Adolescents With and Without FGIDs. J Pediatr Psychol. 45 (1): 110-119. https://doi.org/10.1093/jpepsy/jsz092; PMid:31769842
O'Sullivan A, Farver M, Smilowitz JT. (2015, Dec 16). The Influence of Early Infant-Feeding Practices on the Intestinal Microbiome and Body Composition in Infants. Nutr Metab Insights. 8 (1): 1-9. https://doi.org/10.4137/NMI.S29530; PMid:26715853 PMCid:PMC4686345
Palii IG. (2013). Functional dyspepsia: modern concepts of mechanisms of occurrence and tactics of patient management. Practitioner: 3.
Pesce M, Cargiolli M, Cassarano S, Polese B, De Conno B, Aurino L, Mancino N, Sarnelli G. (2020, Feb 7). Diet and functional dyspepsia: Clinical correlates and therapeutic perspectives. World J Gastroenterol. 26 (5): 456-465. https://doi.org/10.3748/wjg.v26.i5.456; PMid:32089623 PMCid:PMC7015717
Phatak UP, Pashankar DS. (2014, Oct). Prevalence of functional gastrointestinal disorders in obese and overweight children. Int J Obes (Lond). 38 (10): 1324-1327. Epub 2014 May 2. https://doi.org/10.1038/ijo.2014.67; PMid:24781857
Rusu F. (2018, Jun). Obesity and irritable bowel syndrome: coincidence or association? J Gastrointestin Liver Dis. 27 (2): 205. https://doi.org/10.15403/jgld.2014.1121.272.ibs; PMCid:PMC6340102
Schnabel L, Buscail C, Sabate J-M, Bouchoucha M, Kesse-Guyot E, Alles B et al. (2018). Association between ultra-processed food consumption and functional gastrointestinal disorders: results from the french nutrinet-sante cohort. Am J Gastroenterol. 113: 1217-1228. https://doi.org/10.1038/s41395-018-0137-1; PMid:29904158
Shau JP, Chen PH, Chan CF, Hsu YC, Wu TC, James FE, Pan WH. (2016). Fast foods - are they a risk factor for functional gastrointestinal disorders? Asia Pac J Clin Nutr. 25 (2): 393-401. doi: 10.6133/apjcn.2016.25.2.28. PMID: 27222424.
Sorokman TV, Lozyuk IYa. (2021). Eating behavior and nutrition characteristics of preschool children. Modern Pediatrics. Ukraine. 5 (117): 29-34. https://doi.org/10.15574/SP.2021.117.29
Specht IO, Rohde JF, Olsen NJ, Heitmann BL. (2018, Jul 11). Duration of exclusive breastfeeding may be related to eating behaviour and dietary intake in obesity prone normal weight young children. PLoS One. 13 (7): e0200388. https://doi.org/10.1371/journal.pone.0200388; PMid:29995949 PMCid:PMC6040730
Sprouse-Blum AS, Smith G, Sugai D, Parsa FD. (2010, Mar). Understanding endorphins and their importance in pain management. Hawaii Med J. 69 (3): 70-71. PMID: 20397507; PMCID: PMC3104618.
Wang RF, Wang ZF, Ke MY et al. (2013). Temperature can infuence gastric accommodation and sensitivity in functional dyspepsia with epigastric pain syndrome. Dig Dis Sci. 58 (9): 2550-2555. https://doi.org/10.1007/s10620-012-2363-5; PMid:22945476
Wei Z, Yang X, Xing X, Dong L, Wang J, Qin B. (2021, May 12). Risk factors associated with functional dyspepsia in Chinese children: a cross-sectional study. BMC Gastroenterol. 21 (1): 218. https://doi.org/10.1186/s12876-021-01800-x; PMid:33980172 PMCid:PMC8114539
Yamamoto Y, Furukawa S, Watanabe J, Kato A et al. (2022). Association Between Body Mass Index and Functional Dyspepsia in Young Japanese People. J Neurogastroenterol Motil. 28: 276-282. https://doi.org/10.5056/jnm21076; PMid:35362453 PMCid:PMC8978132
Zhong L, Zhong L, Shanahan ER, Raj A et al. (2017). Dyspepsia and the microbiome: time to focus on the small intestine. Gut. 66: 1168-1169. https://doi.org/10.1136/gutjnl-2016-312574; PMid:27489239
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