Pediatric functional constipation gastrointestinal symptom profile compared with healthy controls

Authors: VARNI, JAMES - Texas A&M University; NURKO, SAMUEL - Boston Children'S Hospital; SHULMAN, ROBERT - Children'S Nutrition Research Center (CNRC); SELF, MARIELLA - Baylor College Of Medicine; SAPS, MIGUEL - Northwestern University; BENDO, CRISTIANE - Federal University Of Minas Gerais; DARK, CHELSEA - Texas A&M University; POHL, JOHN - University Of Utah

Submitted to: Journal of Pediatric Gastroenterology and Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 5/15/2015
Publication Date: 10/1/2015
Citation: Varni, J.W., Nurko, S., Shulman, R.J., Self, M.M., Saps, M., Bendo, C.B., Dark, C.V., Pohl, J.F. 2015. Pediatric functional constipation gastrointestinal symptom profile compared with healthy controls. Journal of Pediatric Gastroenterology and Nutrition. 61(4):424-430.

Interpretive Summary: More importance is being placed on how patients report whether a treatment is effective or not. This study investigated whether the Pediatric Quality of Life Inventory Gastrointestinal Symptoms and Gastrointestinal Worry Scales can be used for patients to describe their quality of life when they have constipation, a very common stomach complaint. We found that children with constipation could use the Pediatric Quality of Life Inventory Gastrointestinal Symptoms and Gastrointestinal Worry Scales. Compared to healthy children, children with constipation reported stomach pain, discomfort when eating, and worry about constipation.

Technical Abstract: Patient-reported outcomes are necessary to evaluate the gastrointestinal symptom profile of patients with functional constipation. Study objectives were to compare the gastrointestinal symptom profile of pediatric patients with functional constipation with matched healthy controls with the Pediatric Quality of Life Inventory Gastrointestinal Symptoms and Gastrointestinal Worry Scales and to establish clinical interpretability in functional constipation through identification of minimal important difference (MID) scores. The secondary objective compared the symptom profile of patients with functional constipation with patients with irritable bowel syndrome (IBS). Gastrointestinal Symptoms and Worry Scales were completed in a 9-site study by 116 pediatric patients with functional constipation and 188 parents. Gastrointestinal Symptoms Scales measuring stomach pain, stomach discomfort when eating, food and drink limits, trouble swallowing, heartburn and reflux, nausea and vomiting, gas and bloating, constipation, blood in poop, and diarrhea were administered along with Gastrointestinal Worry Scales. A total of 341 families with healthy children and 43 families with patients with IBS completed the scales. A broad profile of gastrointestinal symptoms and worry were reported by patients with functional constipation in comparison with healthy controls (P < 0.001) with large effect sizes (>0.80) across the majority of symptom domains. Patients with IBS manifested a broader symptom profile than functional constipation, with differences for stomach pain, stomach discomfort when eating, and worry about stomachaches, with similar constipation scores. Pediatric patients with functional constipation report a broad gastrointestinal symptom profile in comparison with healthy controls and only somewhat fewer symptoms than patients with IBS, highlighting the critical need for more efficacious interventions to achieve healthy functioning.