TY - JOUR
TI - Functional Gastrointestinal Disorders in Children: A Survey on Clinical Approach in the Mediterranean Area
AU - Scarpato, E.
AU - Quitadamo, P.
AU - Roman, E.
AU - Jojkic-Pavkov, D.
AU - Kolacek, S.
AU - Papadopoulou, A.
AU - Roma, E.
AU - Shamir, R.
AU - Lev, M.R.B.
AU - Lutovac, B.
AU - Djurisic, V.
AU - Orel, R.
AU - Koleilat, A.
AU - Mneimneh, S.
AU - Coppola, V.
AU - Corazziari, E.
AU - Staiano, A.
JO - Journal of Pediatric Gastroenterology and Nutrition,
PY - 2017
VL - 64
TODO - 6
SP - e142-e146
PB - Lippincott Williams and Wilkins
SN - 0277-2116
TODO - 10.1097/MPG.0000000000001550
TODO - analgesic agent;  antidiarrheal agent;  bisacodyl;  docusate sodium;  enema;  glycerol;  histamine H2 receptor antagonist;  lactulose;  macrogol;  magnesium hydroxide;  mineral oil;  picosulfate sodium;  probiotic agent;  proton pump inhibitor;  spasmolytic agent, abdominal pain;  adolescent;  adult;  child;  constipation;  Croatia;  diarrhea;  diet therapy;  digestive system function disorder;  gastroesophageal reflux;  Greece;  human;  infant;  irritable colon;  Israel;  Italy;  Lebanon;  major clinical study;  Montenegro (republic);  newborn;  pediatrician;  personal experience;  practice guideline;  priority journal;  Review;  Serbia;  Slovenia;  Southern Europe;  Spain;  clinical practice;  clinical trial;  constipation;  female;  gastroesophageal reflux;  gastrointestinal disease;  health care disparity;  health care survey;  irritable colon;  male;  multicenter study;  pediatrics;  preschool child;  prospective study;  protocol compliance;  statistics and numerical data, Adolescent;  Child;  Child, Preschool;  Constipation;  Female;  Gastroesophageal Reflux;  Gastrointestinal Diseases;  Guideline Adherence;  Health Care Surveys;  Healthcare Disparities;  Humans;  Infant;  Infant, Newborn;  Irritable Bowel Syndrome;  Male;  Mediterranean Region;  Pediatrics;  Practice Guidelines as Topic;  Practice Patterns, Physicians';  Prospective Studies
TODO - Objectives: Childhood functional gastrointestinal disorders (FGIDs) are common conditions associated with significant morbidity and high healthcare costs. This multicenter study aimed at assessing the clinical approach to infants (0-6 months) and children/adolescents (4-18 years) with suspected FGIDs by pediatricians from the Mediterranean Area. Methods: A survey evaluating the diagnostic approach, including the use of Rome II and III criteria, and the therapeutic management of some of the most prevalent FGIDs, such as irritable bowel syndrome (IBS), functional constipation (FC), and functional regurgitation (FR), was distributed to a sample of pediatricians. Results: We collected 278 questionnaires from 9 countries (Croatia, Greece, Israel, Italy, Lebanon, Montenegro, Serbia, Slovenia, and Spain). Rome III criteria are used to diagnose FC by 28.8%. Treatment of FC is based on dietary modifications (97.5%) and osmotic laxatives (93.5%). Rome III criteria are used to diagnose FR by 22.3% of the responders, in contrast to 79.5% who rely on personal experience for diagnosis. Reported treatments mainly consist of reassurance (96.8%) and thickened feedings (77.3%). Nevertheless, 21.2% prescribe proton pump inhibitors or H2-blockers to infants with FR. Rome III criteria are used to diagnose IBS by only 25.9%. Moreover, 86% of the pediatricians base IBS therapy on the predominant symptom. The most prescribed treatments are analgesics (36.6%) for pain control, dietary advice (41.5%) for diarrhea-predominant IBS, and dietary advice (47.8%) for constipation-predominant IBS. Conclusions: Our data show that the use of Rome III diagnostic criteria is not sufficiently widespread among pediatricians, and that large variability remains in the management of FGIDs within the different Mediterranean countries surveyed. Copyright © 2017 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition.
ER -