• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제20권1호
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• pp.1-13
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• 2017

Functional gastrointestinal disorders (FGIDs) are common worldwide and cover a wide range of disorders attributable to the gastrointestinal tract that cannot be explained by structural or biochemical abnormalities. The diagnosis of these disorders relies on the symptom-based Rome criteria. In 2016 the Rome criteria were revised for infants/toddlers and for children and adolescents. In this review, we discuss the novel Rome IV criteria for infants and toddlers. The criteria for infant colic were drastically changed, whereas only minor changes were made for regurgitation, cyclic vomiting syndrome, functional diarrhea, infant dyschezia and functional constipation. In addition to this, the new Rome IV discusses underlying mechanisms of pain in infants and toddlers, including the neurodevelopment of nociceptive and pain pathways, the various factors that are involved in pain experience, and methods of pain assessment in infants and toddlers is essential for the clinician who encounters functional pain in this age group. Overall, the Rome IV criteria have become more distinctive for all disorders in order to improve the process of diagnosing pediatric FGIDs.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제27권2호
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• pp.125-135
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• 2024

Purpose: The updated ROME IV criteria for functional constipation (FC) in children were published in 2016. However, information on the use of these criteria is scarce. This study aimed to report the frequency of the use of the ROME IV criteria by Indonesian pediatricians and general practitioners (GPs) in FC management in infants and toddlers. Methods: An anonymous cross-sectional online survey was conducted between November 2021 and March 2022. Results: A total of 248 respondents (183 pediatricians and 65 GPs) from 24 Indonesian provinces completed the survey. Most respondents reported an estimated prevalence of FC to be less than 5% both in infants and toddlers. On average, only 64.6% of respondents frequently used the ROME IV criteria. Pediatricians used the ROME IV criteria more often than GPs did (p<0.001). The most frequently used criteria were painful or hard bowel movements (75.0%) and ≤2 defecations/week (71.4%). Lactulose as a laxative was the preferred treatment choice, followed by changing the standard formula to a specific nutritional formula. Most of the respondents carried out parenteral reassurance and education. Normal growth, as a marker of good digestion and absorption function, and normal stool consistency and frequency were the most reported indicators of gut health. Conclusion: The ROME IV criteria for functional constipation are not extensively used by pediatricians and GPs in Indonesia. Laxatives and specific nutritional formulas were the most used management approaches in infants and toddlers. Medical education, especially for general practitioners, should be updated.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제25권5호
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• pp.376-386
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• 2022

Functional gastrointestinal disorders (FGIDs) are classified as a combination of persistent gastrointestinal symptoms. The Rome IV criteria can elucidate several factors in the pathogenesis of FGIDs. The frequency of FGIDs can differ between clinical and nonclinical settings and between geographic regions. To determine the global prevalence of FGIDs in neonates and toddlers according to the Rome IV criteria. We included cohort and descriptive observational studies reporting the prevalence of FGIDs according to the Rome IV criteria in children aged 0-48 months. We searched the Medline, Embase, Lilacs, and CENTRAL databases from May 2016 to the present day. Furthermore, unpublished literature was searched to supplement this information. The Strengthening the Reporting of Observational Studies in Epidemiology statement was used to evaluate the risk of bias. A meta-analysis of the proportions was performed using MetaProp in R. The results are reported in forest plots. We identified and analyzed 15 studies comprising 48,325 participants. Six studies were conducted in Europe, three in Latin America, two in North America, and four in Asia. Most participants were 12-48 months old (61.0%) and were recruited from the community. The global prevalence of FGIDs was 22.0% (95% confidence interval, 15-31%). The most common disorder was functional constipation (9.0%), followed by infant regurgitation syndrome (8.0%). Its prevalence was higher in the Americas (28.0%). FGIDs, as defined by the Rome IV criteria, are present in 22% of children, and the most common primary disorder is functional constipation. A higher prevalence of FGIDs has been reported in America.

• 대한한방소아과학회지
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• 제31권3호
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• pp.1-13
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• 2017

Objectives The purpose of this study is to investigate how irritable bowel syndrome (IBS) affects fatigue scales and eating habits in children and adolescents using Rome IV criteria. Methods Questionnaires and The $PedsQL^{TM}$ Multidimensional Fatigue Scale (MFS) have been given to 211 children and adolescents aged 8 to 18 years old who were admitted to ${\bigcirc}{\bigcirc}$ university Korean medicine hospital pediatric departments, from 29th, July, 2016 to 12th, August, 2016 to evaluate their eating habits and fatigue. Additionally, PASW statistics 18.0 were used to analyze influence of irritable bowel syndrome on eating habits and fatigue in children and adolescents by using chi-square test, independent t-test and linear regression. Results In total of 211 subjects, 29 (13.7%) were diagnosed with IBS according to the Rome IV criteria. 1. There was a statistically significant difference (p<0.05) between IBS group and non-IBS group on a specific question in the eating habit questionnaire: the amount of sugar intake and the prevalence of IBS. 2. There was a statistically significant difference in general fatigue and cognitive fatigue categories when comparing the MFS subscores according to the prevalence of IBS. Conclusions Considering patients eating habits and fatigue is a necessary process for the successful treatment of irritable bowel syndrome. Korean medicine that maximizes quality of life while minimizing the potential risks to the patients of gastrointestinal disease should also include administrative interventions that may be helpful in the daily life of IBS patients.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제27권3호
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• pp.186-195
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• 2024

Purpose: Infantile colic diagnostic criteria were established by Rome IV. A universally accepted management remains to be established. We aimed to evaluate diagnostic criteria, management strategies, and perceived regional prevalence of infantile colic in Pakistan, as well as its effect on physicians and parents. Methods: A questionnaire was distributed amongst 1,256 physicians. Results: We received 800 replies. Wessel and Rome IV criteria were used by most physicians for diagnosis; however, the response "any infant who cries a lot" was selected by older physicians (48% of those over 60 years), physicians in rural areas (32%), physicians practicing in private clinics (27%), and general physicians (30%). Estimated prevalence of infantile colic ranges from 21-40%. Reassurance was the most widely recommended management strategy followed by herbal teas (51%), switching to a different formula (49%), probiotics (28%) and antibiotics (26%), discontinuation of breastfeeding (14%), elimination of dairy products from the breastfeeding mothers' diet (6%), and the administration of colic drops (1%). Most physicians considered the negative impact of colic on their personal lives and the parents as mild-to-moderate. Notably, 38% of percent of physicians routinely screened for maternal depression, and 45% of physicians were aware of the association between infantile colic and shaken baby syndrome. Conclusion: Most physicians in Pakistan diagnose and manage infantile colic according to the established guidelines. However, the guidelines pertaining to treatment planning are not followed. Educational efforts directed toward general physicians and doctors practicing in rural areas and clinics must be implemented to avoid unnecessary testing and treatment burden.

• 한국임상약학회지
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• 제29권3호
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• pp.156-165
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• 2019

Objective: The purpose of this study was to provide a database for making better decisions of the treatment of the irritable bowel syndrome (IBS) patient, and for improving the recognition of IBS in the Korean society. Methods: The survey was conducted on 174 female college students in Korea from January 2017 to January 2018. Out of the total students surveyed, 160 questionnaires were analyzed after excluding 14 uncompleted questionnaires. Results: Based on the survey, the prevalence of IBS among female college students in Korea was found to be 13.8%. Statistically, the results proved that there were significant differences in the stress levels between the students with IBS and non-IBS diagnosed by ROME IV criteria. Students with IBS had higher stress levels than students without the ailment. Conclusions: Based on this study, stress management related treatment should be actively considered. Furthermore, it is necessary to develop more efficient and updated guidelines for the treatment of IBS and new patient care programs.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제26권2호
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• pp.116-126
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• 2023

Purpose: This study aimed to evaluate the prevalence and risk factors of infant dyschezia as well as pediatrician awareness regarding this disease in Indonesia. Methods: This is a two-part cross-sectional study, which was divided into study A and B. Study A: Parents whose infants were under 9 months old and attended well-baby clinics were recruited at two randomly selected primary health centers. Parents also provided information on the infant's previous medical history, and socio-demographic and family details. The Rome IV criteria was translated and validated to be used for diagnosis of infant dyschezia. Study B: Randomly selected pediatricians were surveyed by using a questionnaire to evaluate their knowledge regarding infant dyschezia. Results: The prevalence of infant dyschezia based on the result of this study was 11.8%. Three risk factors had a significant relationship with infant dyschezia i.e., the number of children in the family (odds ratio [OR], 5.619; 95% confidence interval [CI], 2.194-14.390; p<0.001), complementary food diet (OR, 4.238; 95% CI, 1.902-9.443; p<0.001), and social-emotional disturbance (OR, 5.670; 95% CI, 2.550-12.609; p<0.001). The percentage of pediatricians correctly diagnosed infant dyschezia was 71.5%. Most pediatricians agreed that they did not perform any diagnostic testing (79.7%) and only provided education in cases of infant dyschezia (58.5%). Conclusion: The prevalence of infant dyschezia identified in our study was higher than that in other neighboring Asian countries, with the highest prevalence observed in infants 7-9 months old. Being an only child, receiving complementary food diet, and sociao-emotional disturbances were significant risk factors of infant dyschezia.

• 한국학교보건학회지
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• 제32권1호
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• pp.1-9
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• 2019

Purpose: The purpose of this study was to identify the prevalence, subtypes and risk factors of Irritable Bowel Syndrome (IBS) among male adolescents. Methods: The survey was conducted on male adolescents (n=441) attending a high school. Rome IV criteria was used to diagnose IBS. Data on health promoting behaviors, psychological distress, sleep hygiene practices were collected using self-administered structured questionnaires. Results: The prevalence of IBS was 11.1% and the subtypes were mixed (77.5%), unclassified (10.2%), diarrhea-predominant (8.2%), and constipation-predominant (4.1%). Risk factors influencing IBS were sleeping time (Odds Ratio [OR]=1.00, 95% Confidence Interval [CI]: 0.99~1.00), anxiety, a subfactor under psychological distress (OR=1.12, 95% CI: 1.02~1.22), and arousal-related behaviors, a subfactor under sleep hygiene practices (OR=1.10, 95% CI: 1.03~1.17). Conclusion: Our findings indicated that IBS is a common problem in male adolescents. It is necessary to develop school-based intervention strategies addressing sleeping time, anxiety and arousal-related behaviors in order to prevent and improve IBS in male adolescents.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제25권3호
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• pp.276-282
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• 2022

Purpose: Infantile colic, a common functional gastrointestinal condition, causes distress and frustration in families. Its prevalence and incidence vary from community to community. The purpose of our study was to demonstrate the incidence of and factors associated with infantile colic in Thai infants. Methods: We conducted a prospective analytic study to explore the incidence and factors associated with infantile colic in 386 Thai infants aged between one month and six months. Caregivers were interviewed using a questionnaire about infants' symptoms of colic based on the definition from the Rome IV criteria. Family background and potential precipitating factors of colic were also evaluated. Results: The incidence of colic in infants younger than 6 months was 6.5%. All infants' colic started within 12 weeks of life and lasted approximately 6 weeks. Sex, gestational age, birth weight, delivery route, birth order, family factors, and parental factors were not correlated with the occurrence of colic. Infants who were exclusively breastfed for the first 2 months of life had a lower incidence of infantile colic than those who were mixed- or formula-fed (odds ratio=3.0; 95% confidence intervals=1.3 to 7.2). Conclusion: The incidence of infantile colic in Thai infants in our study was 6.5%, which is similar to that in other reports. Being exclusively breastfed for the first two months was the only risk factor in our cohort.

• 한국산학기술학회논문지
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• 제21권7호
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• pp.487-495
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• 2020

본 연구는 기능성 변비를 가진 여대생을 대상으로 이압요법을 적용하여 변비 완화에 미치는 효과를 확인하기 위해 수행되었으며, 무작위 배정, 단일 맹검, Sham 대조군 비교 설계를 이용한 실험연구이다. 로마 기준 IV의 기능성 변비에 해당하는 여대생 44명이 참여하였으며, 이압요법은 왕불류행 씨앗을 이용한 이압 스티커를 귀에 부착하고 자극하는 방법으로 1주일 단위로 6회, 즉 6주 동안 시행하였다. 처치군(n=23)에게는 변비와 관련된 귀 반응구역(점)인 직장, 대장, 폐, 삼초, 신문에, Sham 대조군(n=21)에게는 변비와 관련이 없는 귀 반응구역(점)인 발목, 이륜, 치아, 턱, 외이에 이압스티커를 부착하였다. 이압스티커 부착 부위를 하루에 3회, 한 개의 귀 반응구역(점)마다 한 번에 30초 동안, 얼얼한 느낌이 들 정도로 손으로 눌러 자극하도록 대상자를 교육하였다. 이압 스티커는 5일 후에 대상자가 스스로 제거하고 귀를 가볍게 마사지하고 2일간 쉬는 시간을 갖도록 하였다. 6주간 이압요법 적용을 통해 이압요법이 기능성 변비가 있는 여대생의 변비의 정도, 대변 형태, 변비 관련 삶의 질 향상에 효과가 있음을 확인하였다.