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Research Project: Pediatric Clinical Nutrition

Location: Children's Nutrition Research Center

Title: Health-related quality of life in pediatric patients with functional and organic gastrointestinal diseases

Author
item VARNI, J - Texas A&M University
item BENDO, C - Federal University Of Minas Gerais
item NURKO, S - Boston Children'S Hospital
item SHULMAN, R - Children'S Nutrition Research Center (CNRC)
item SELF, M - Baylor College Of Medicine
item FRANCIOSI, J - Cincinnati Children'S Research Hospital
item SAPS, M - Northwestern University
item POHL, J - Primary Children'S Medical Center

Submitted to: Journal of Pediatrics
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 8/12/2014
Publication Date: 1/1/2015
Citation: Varni, J.W., Bendo, C.B., Nurko, S., Shulman, R.J., Self, M.M., Franciosi, J.P., Saps, M., Pohl, J.F. 2015. Health-related quality of life in pediatric patients with functional and organic gastrointestinal diseases. Journal of Pediatrics. 166:85-90.

Interpretive Summary: The quality of life of patients is receiving increasing attention. In order to find out if healthy children differ from those with gastrointestinal problems in regard to symptoms and worry – factors that greatly affect quality of life – we carried out a study. We found that children with unexplained chronic abdominal pain (although sometimes it may be related in part, to diet) had a worse quality of life than healthy children and even those with known gastrointestinal disorders. This measurement can be used amongest a broad aray of groups with gastrointestinal issues.

Technical Abstract: The objective of our study was to compare health-related quality of life (HRQOL) in pediatric patients with functional gastrointestinal disorders (FGIDs) and organic gastrointestinal (GI) diseases with an age-, sex-, and race/ethnicity-matched healthy sample across GI diagnostic groups and with one another. The Pediatric Quality of Life Inventory 4.0 Generic Core Scales were completed in a 9-site study by 689 families. Patients had 1 of 7 physician-diagnosed GI disorders: chronic constipation, functional abdominal pain, irritable bowel syndrome, functional dyspepsia, Crohn's disease, ulcerative colitis, and gastroesophageal reflux disease. The healthy control sample included 1114 families. School days missed, days in bed and needing care, parent missed workdays, work impact, and healthcare utilization were compared as well. Patients with an FGID or organic GI disease demonstrated lower HRQOL than the healthy controls across all dimensions (physical, emotional, social, and school; P < .001 for all), with larger effect sizes for patients with an FGID. Patients with an FGID manifested lower HRQOL than those with an organic GI disease. Patients with an FGID or organic GI disease missed more school, spent more days in bed and needing care, had greater healthcare utilization, and had parents who missed more workdays with greater work impact (P < .001 for most), with larger effect sizes for the patients with an FGID. Patients with an FGID or organic GI disease demonstrate impaired HRQOL compared with healthy children. HRQOL can be used as a common metric to compare patient outcomes in clinical research and practice both within and across groups of patients with FGIDs and organic GI diseases.