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Title: Child and parent perceived food-induced gastrointestinal symptoms and quality of life in children with functional gastrointestinal disorders

Author
item CARLSON, MICHELLE - Texas Children'S Hospital
item MOORE, CAROLYN - Texas Woman'S University
item TSAI, CYNTHIA - Baylor College Of Medicine
item SHULMAN, ROBERT - Children'S Nutrition Research Center (CNRC)
item CHUMPITAZI, BRUNO - Texas Children'S Hospital

Submitted to: Journal of the Academy of Nutrition and Dietetics
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 10/2/2013
Publication Date: 12/19/2013
Citation: Carlson, M.J., Moore, C.E., Tsai, C.M., Shulman, R.J., Chumpitazi, B.P. 2013. Child and parent perceived food-induced gastrointestinal symptoms and quality of life in children with functional gastrointestinal disorders. Journal of the Academy of Nutrition and Dietetics. 114(3):403-413.

Interpretive Summary: Many children and adults have a lot of problems with stomachaches and other intestinal problems which are not caused by known diseases. These are called functional gastrointestinal (belly) pain disorders (FGIDs). Although adults and children may say that certain foods cause stomachaches and other intestinal problems, it is not known if this is common in children with FGIDs; and, if it is true, what foods most commonly cause the problems. In this study we met with children who have FGIDs and their parents. We asked them whether foods seemed to make their pain worse; if so, what foods were responsible; and whether these problems with food affected the quality of their lives. We learned that children with FGIDs have a number of foods that seem to cause problems, including spicy foods, cow's milk, and pizza. Parents said that the larger the number of foods causing problems, the worse the quality of life of their children. Children and parents agreed to a great degree on what foods caused problems. The children described the strategies they used to deal with the foods that caused problems. This research is important as we attempt to improve the quality of life of children.

Technical Abstract: It is unknown whether children with functional gastrointestinal (GI) disorders identify specific foods that exacerbate their GI symptoms. The objectives of this study were to determine the perceived role of food on GI symptoms and to determine the impact of food-induced symptoms on quality of life (QOL) in children with functional GI disorders. Between August and November 2010, 25 children ages 11 to 17 years old with functional GI disorders and a parent completed a food symptom association questionnaire and validated questionnaires assessing FGID symptoms and QOL. In addition, children completed a 24-hour food recall, participated in focus groups to identify problematic foods and any coping strategies, and discussed how their QOL was affected. Statistical analyses were conducted using X 2, t test, Mann-Whitney U test, Wilcoxon signed rank, and Spearman's p. Children identified a median of 11 (range=2 to 25) foods as exacerbating a GI symptom, with the most commonly identified foods being spicy foods, cow's milk, and pizza. Several coping strategies were identified, including consuming smaller portions, modifying foods, and avoiding a median of 8 (range=1 to 20) foods. Children reported that food-induced symptoms interfered with school performance, sports, and social activities. Although the parent's assessment of their child's QOL negatively correlated with the number of perceived symptom-inducing foods in their child, this relationship was not found in the children. Findings suggest that specific foods are perceived to exacerbate GI symptoms in children with functional GI disorders. In addition, despite use of several coping strategies, food-induced symptoms can adversely impact children's QOL in several important areas