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Title: Gastrointestinal symptoms predictors of health-related quality of life in pediatric patients with functional gastrointestinal disorders

item VARNI, JAMES - Texas A&M University
item SHULMAN, ROBERT - Children'S Nutrition Research Center (CNRC)
item SELF, MARIELLA - Baylor College Of Medicine
item NURKO, SAMUEL - Boston Children'S Hospital
item SAPS, MIGUEL - Northwestern University
item SAEED, SHEHZAD - Cincinnati Children'S Research Hospital
item PATEL, ASHISH - University Of Texas Southwestern Medical Center
item DARK, CHELSEA - Texas A&M University
item BENDO, CRISTIANE - Federal University Of Minas Gerais
item POHL, JOHN - Primary Children'S Medical Center

Submitted to: Quality of Life Research
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 10/6/2016
Publication Date: 10/14/2016
Citation: Varni, J.W., Shulman, R.J., Self, M.M., Nurko, S., Saps, M., Saeed, S.A., Patel, A.S., Dark, C.V., Bendo, C.B., Pohl, J.F. 2016. Gastrointestinal symptoms predictors of health-related quality of life in pediatric patients with functional gastrointestinal disorders. Quality of Life Research. doi:10.1007/S11136-016-1430-3.

Interpretive Summary: Functional gastrointestinal disorders affect approximately 15% of all children worldwide. Overall quality of life in these children is worse than in children with many other types of gastrointestinal problems. Using a questionnaire, we identified specific symptoms that could be targeted to improve the quality of life of these children. Through this research intervention to relieve concerns will help individuals improve their daily functions.

Technical Abstract: To investigate the patient-reported multidimensional gastrointestinal symptoms predictors of generic health-related quality of life (HRQOL) in pediatric patients with functional gastrointestinal disorders (FGIDs). The Pediatric Quality of Life Inventory (PedsQL) Gastrointestinal Symptoms Scales and PedsQL 4.0 Generic Core Scales were completed in a 9-site study by 259 pediatric patients with functional constipation, functional abdominal pain (FAP), or irritable bowel syndrome (IBS). 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 identified as clinically important symptom differentiators from healthy controls based on prior findings, and subsequently tested for bivariate and multivariate linear associations with overall HRQOL. Gastrointestinal symptoms were differentially associated with decreased HRQOL in bivariate analyses for the three FGIDs. In predictive models utilizing hierarchical multiple regression analyses controlling for age, gender, and race/ethnicity, gastrointestinal symptoms differentially accounted for an additional 47, 40, and 60 % of the variance in patient-reported HRQOL for functional constipation, FAP, and IBS, respectively, reflecting large effect sizes. Significant individual gastrointestinal symptoms predictors were identified after controlling for the other gastrointestinal symptoms in the FGID-specific predictive models. Gastrointestinal symptoms represent potentially modifiable predictors of generic HRQOL in pediatric patients with FGIDs. Identifying the condition-specific gastrointestinal symptoms that are the most important predictors from the patient perspective facilitates a patient-centered approach to targeted interventions designed to ameliorate impaired overall HRQOL.