Pediatric Gastroenterology Fellow Lehigh Valley Reilly Children's Hospital Allentown, Pennsylvania, United States
Background: Acute gastroenteritis (AGE) is the most common disease predisposing to the development of Disorders of Gut-Brain Interactions (DGBI) in adults (post-infection DGBI: PI-DGBI). There is paucity of data on incidence and risk factors for the development of PI-DGBI in children. Objective: Aim 1) assess whether AGE predispose children to the development of PI-DGBI. Aim 2) assess whether the severity of AGE is associated to the development of PI-DGBI. Design/Methods: This is a prospective, controlled, cohort study. Children with recent AGE (cases) and siblings (controls) were followed for 6 months. We assessed DGBIs using a validated questionnaire (QPGS IV) per Rome criteria. After gathering baseline information, we followed the cases and controls at 10 days post-AGE and again at 3- and 6- months to assess the course of illness. At 10 days follow-up caretakers completed a survey for the assessment of the severity of AGE based on the Modified Vesikari Score and risk factors previously found to be associated with the development of PI-DGBI. At 3- and 6-month follow-ups caretakers were asked to again complete the QPGS-IV for cases and controls. Statistical analysis was done with Student’s t-test, Fisher’s exact test and the Point-Biserial Correlation. Results: Fifty cases and 58 controls were enrolled; 4 cases (8%) and 1 control (1.7%) had a previous diagnosis of DGBI. At 3-months, 10 cases (20%) were diagnosed with DGBI vs. 1 (1.7%) control (p = 0.002). Among children without a history of DGBI prior to the AGE, 6 (12%) cases vs. 0 control were diagnosed with DGBI (p = 0.007) at follow up. At 6 months, 5 cases (1 lost to follow-up) vs. 0 control had persistent DGBI (p= 0.021). Severity of AGE was correlated with PI-DGBI (r =.645, p= .001).
Conclusion(s): AGE is a risk factor for developing DGBI, and the severity of the episode further increases this risk. Children with PI-DGBI are likely to continue to experiment with symptoms at 6 months of age. This is the first study outside of an outbreak of AGE to investigate risk factors in children. While larger studies are needed to confirm our findings, if confirmed, this can open an opportunity for potential preventative measures. Providing education about the prognosis of AGE and the possible development of PI-DGBI during ER visits and doctor appointments could equip parents with a deeper understanding of DGBI, enhancing its management within the community.
