Functional Gastrointestinal Disorders in African American Children in Primary Care

Abstract

Objective: To determine the prevalence of functional gastrointestinal disorders (FGIDs) in a primary care setting and to assess the usefulness of pediatric Rome criteria. Methods: The Questionnaire on Pediatric Gastrointestinal Symptoms (QPGS) assessing the pediatric Rome criteria was administered to 243 school-age children visiting a general pediatric clinic for annual school physicals. Pearson χ² statistics were used to determine the association of various demographic factors with FGIDs. Results: All children were African American, 47.7% were girls, and the mean ± standard deviation age of the group was 10.7 ± 3.9 years. QPGS detected 52 children (21.4%) with FGID. Diagnoses included aerophagia (6), abdominal migraine (1), cyclic vomiting syndrome (2), functional dyspepsia (2), functional abdominal pain syndrome (1), functional constipation (39) and functional fecal retention (1). Thorough clinical evaluation identified 47 (19.3%) children with FGIDs. Five of the children (2.1%) identified as having FGID on QPGS were felt not to have FGID by the examining physician. Children with FGIDs were not different from healthy children in age, insurance, parent's education, employment or number of children in the family. FGIDs were more common in girls (29/47 girls, P = 0.028). Children with FGIDs tended to live in single-parent households and miss school more often than children without FGIDs (P = 0.08). Conclusions: Functional gastrointestinal disorders are common among African American children and adolescents in a primary care setting and predominantly affect girls. Symptom-based criteria are useful in the diagnosis of pediatric FGIDs.