• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.12 no.2
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• pp.111-119
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• 2009

Purpose: Chronic abdominal pain is a common complaint encountered in pediatric clinics. This study aimed to investigate chronic functional abdominal pain in Korean children and adolescents by applying the Rome III criteria. Methods: A prospective study on chronic abdominal pain in 194 patients was conducted between July 2006 and August 2007. The parents of the subjects were asked to respond to a questionnaire based on the Rome III criteria. These responses were evaluated by pediatricians, and subsequently, the patients were clinically evaluated. Results: On the basis of the results of the medical evaluation, 167 of the 194 patients (86.1%) were diagnosed with functional gastrointestinal disorders, i.e., no organic causes of chronic abdominal pain were detected during the medical evaluation. Of these 167 patients, 89.8% of the patients satisfied one of the Rome III criteria, while 10.2% of the patients did not satisfy any of the Rome III criteria for chronic abdominal pain-related functional gastrointestinal disorders (functional dyspepsia, 29.3%; irritable bowel syndrome, 25.7%; abdominal migraine, 7.8%; childhood functional abdominal pain, 27.0%; and childhood functional abdominal pain syndrome, 12.6%). Compared to other symptom subtypes, children with childhood functional abdominal pain experienced an earlier onset and a shorter duration of symptoms. Conclusion: The Rome III criteria are more comprehensive; the use of these criteria will provide more accurate information and better diagnoses for children and adolescents with chronic abdominal pain.

• Clinical and Experimental Pediatrics
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• v.49 no.2
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• pp.129-135
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• 2006

Chronic recurrent abdominal pain is a common manifestation in children. Functional abdominal pain is the most common cause of chronic abdominal pain and can be diagnosed properly by the physician without the requirement of specific evaluation when there are no alarm symptoms or signs. Functional abdominal pain is categorized as functional dyspepsia, irritable bowel syndrome, functional abdominal pain, abdominal migraine, and aerophagia, according to the Rome II criteria for pediatric functional gastrointestinal disorders. New concepts on the pathogenesis of functional abdominal pain include brain-gut interaction, visceral hypersensitivity, gastrointestinal dysmotility, inflammation, autonomic dysfunction, genetic predisposition, and triggering factors including psycho-social stress.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.25 no.5
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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.

• Journal of the Korean Society for Precision Engineering
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• v.24 no.9
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• pp.130-139
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• 2007

The disaster from functional gastrointestinal disorders (FGID) has detrimental impact on the quality of life of the affected population. There are, however, rare diagnostic methods for FGID. Our research group identified recently that the gastrointestinal tract well of the patients with FGID became more rigid than that of healthy people when palpating the abdominal regions overlaying the gastrointestinal tract. The objective of the current study is, therefore, to identify feasibility of a diagnostic system for FGID based on ultrasound technique, which can quantify the characteristics above. Two-dimensional finite difference (FD) models (one normal and two rigid models) were developed to analyze the reflective characteristic (displacement) on each soft-tissue layer responded after application of ultrasound signals. Based on the results from FD analysis, the ultrasound system for diagnosis of the FGID was developed and clinically tested via application of it to 40 human subjects with/without FGID who were assigned to Normal and Patient Groups. The results from FD analysis showed that the maximum displacement amplitude in the rigid models (0.12 and 0.16) at the interface between the fat and muscle layers was explicitly less than that in the normal model (0.29). The results from actual specimens showed that the maximum amplitude of the ultrasound reflective signal in the rigid models $(0.2{\pm}0.1Vp-p)$ at the interface between the fat and muscle layers was explicitly higher than that in the normal model $(0.1{\pm}0.0Vp-p)$. Clinical tests using our customized ultrasound system showed that the maximum amplitudes of the ultrasound reflective signals near to the gastrointestinal tract well for the patient group $(2.6{\pm}0.3Vp-p)$ were generally higher than those in normal group $(0.1{\pm}0.2Vp-p)$. These findings suggest that our customized ultrasound system using the ultrasound reflective signal may be helpful to the diagnosis of the FGID.

• Korean Journal of Psychosomatic Medicine
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• v.6 no.2
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• pp.210-220
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• 1998

The relationships between emotion, stress and gastro-intestinal dysfunction were briefly reviewed. Until now, several kinds of theories on about pathophysiology, such as motility dysfunction, changes of pain perception on the lumen, dysregulations on the central nervous system associated with psychosocial factors were reported. However, none of those factors could'nt give any clues for the causes of the functional bowel disorders. For understanding the meaning of the symptoms and for the treatment approach, clinicians should give attention to the comprehensive point of view, i.e., not only biological but also psychological aspects of the patients with non-organic bowel dysfunctions. Giving warm and kind explanations to the patient about symptom formation and progression and understanding the patient's illness behaviors, and good and strong doctor-patient relationship is essentials for the treatment.

• Journal of Korea Association of Health Promotion
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• v.3 no.1
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• pp.46-54
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• 2005

The functional dyspepsia is a complex disease reaction that ocurs due to the presence of various factors and its pathophysiology has not been clearly verified until now. This disease is diagnosed after the organic diseases are ruled out. Therefore, the main treatments are limited down to compensating for revealed symptoms through exercising the supportive care. The international prevalence of the functional dyspepsia under the Rome I criterior is approximately 25%. For the cases of Koreans, there are very omnifarious symptoms in gastrointestinal disorders and the medical vocabularies which describe the diagnostic standard are not closely associated with the daily vocabularies, thus there would be a lot of restrictions to directly apply the Rome II criterior. However, the Korean Society of Gastrointestinal motility had decided to promote the use of the international standardized Rome II criterior in order for Korea to be comparable to the clinical studies from the other nations. There should be more extensive studies to differentiate the definitions of symptom descriptions from Korea to foreign countries. The extended researches concerning the pathophysiology are highly recommended which in return, would help enabling the reliable treatment techniques for this disease.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.19 no.3
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• pp.153-161
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• 2016

This paper covers algorithms for the management of regurgitation, constipation and infantile colic in infants. Anti-regurgitation formula may be considered in infants with troublesome regurgitation, while diagnostic investigations or drug therapy are not indicated in the absence of warning signs. Although probiotics have shown some positive evidence for the management of functional gastrointestinal disorders (FGIDs), the evidence is not strong enough to make a recommendation. A partially hydrolyzed infant formula with prebiotics and ${\beta}$-palmitate may be considered as a dietary intervention for functional constipation in formula fed infants. Lactulose has been shown to be effective and safe in infants younger than 6 months that are constipated. Macrogol (polyethylene glycol, PEG) is not approved for use in infants less than 6 months of age. However, PEG is preferred over lactulose in infants >6 months of age. Limited data suggests that infant formula with a partial hydrolysate, galacto-oligosaccharides/fructo-oligosaccharides, added ${\beta}$-palmitate may be of benefit in reducing infantile colic in formula fed infants in cases where cow's milk protein allergy (CMPA) is not suspected. Evidence suggests that the use of extensively hydrolyzed infant formula for a formula-fed baby and a cow's milk free diet for a breastfeeding mother may be beneficial to decrease infantile colic if CMPA is suspected. None of the FGIDs is a reason to stop breastfeeding.

• Journal of Neurogastroenterology and Motility
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• v.24 no.4
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• pp.512-527
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• 2018

This review provides a comprehensive overview of brain imaging studies of the brain-gut interaction in functional gastrointestinal disorders (FGIDs). Functional neuroimaging studies during gut stimulation have shown enhanced brain responses in regions related to sensory processing of the homeostatic condition of the gut (homeostatic afferent) and responses to salience stimuli (salience network), as well as increased and decreased brain activity in the emotional response areas and reduced activation in areas associated with the top-down modulation of visceral afferent signals. Altered central regulation of the endocrine and autonomic nervous responses, the key mediators of the brain-gut axis, has been demonstrated. Studies using resting-state functional magnetic resonance imaging reported abnormal local and global connectivity in the areas related to pain processing and the default mode network (a physiological baseline of brain activity at rest associated with self-awareness and memory) in FGIDs. Structural imaging with brain morphometry and diffusion imaging demonstrated altered gray- and white-matter structures in areas that also showed changes in functional imaging studies, although this requires replication. Molecular imaging by magnetic resonance spectroscopy and positron emission tomography in FGIDs remains relatively sparse. Progress using analytical methods such as machine learning algorithms may shift neuroimaging studies from brain mapping to predicting clinical outcomes. Because several factors contribute to the pathophysiology of FGIDs and because its population is quite heterogeneous, a new model is needed in future studies to assess the importance of the factors and brain functions that are responsible for an optimal homeostatic state.

• The Journal of Internal Korean Medicine
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• v.29 no.3
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• pp.666-674
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• 2008

Objectives : The aim of this study was to evaluate gastrointestinal parasympathetic nerve activation and pyloric valve function in patients with functional dyspepsia through analysis of bowel sounds and to investigate clinical characteristics associated with the parameters of bowel sounds. Method : We surveyed clinical characteristics of patients by using a questionnaire about functional dyspepsia. Bowel sounds were recorded for 15 minutes during fasting state and for 40 minutes during postprandial state. We then classified the patients into 3 groups by abnormal states of bowel sounds, specifically by the percentage of B.S. and dominenet frequency, and studied clinical characteristics in each group. Results : Among the 182 subjects, patients who had low activity of parasympathetic nerve were 25.8% and showed a tendency of female-dominant, family history and more frequent abdominal pain. Those who had pyloric valve disturbance were 24.1% and showed no tendency by sex distribution, family history and complained of indigestion sensation. Patients who had both disorders were 10.9%, and their clinical characteristics were non-specific. Conclusion : Analysis of bowel sounds may be useful in evaluating pathophysiological factors of functional dyspepsia.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.26 no.1
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• pp.59-86
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• 2023

Purpose: Information regarding functional gastrointestinal disorders (FGIDs) in infants is currently lacking in Indonesia. This study aimed to describe the prevalence and risk factors of FGIDs in infants aged 6 weeks to 4 months in Indonesia. Methods: This cross-sectional study of 433 infants was conducted between September 2018 and February 2020. Information on FGIDs was collected using the Infant Gastrointestinal Symptom Questionnaire and the Feeding Practice and Gut Comfort Questionnaire. Adapted Rome IV criteria were used to define the FGIDs. Results: The prevalence of regurgitation was 26.3%; 16.8% of the infants presented cryingrelated symptoms and 5.5% exhibited constipation. The statistical analyses revealed that constipation was associated with sex (odds ratio [OR], 2.74; 95% confidence interval [CI], 1.07-7.71; p=0.043), employment of the father (OR, 0.3; 95% CI, 0.12-0.77; p=0.01), and education of the mother (OR, 1.92; 95% CI, 1.07-3.51; p=0.031). Length at birth (OR, 0.74; 95% CI, 0.55-0.99; p=0.042) was associated with constipation. Length at visit (OR, 0.83; 95% CI, 0.76-0.91; p<0.001) was associated with regurgitation, and the weight at visit (OR, 0.58; 95% CI, 0.35-0.96; p=0.038) was associated with crying and/or colic. A history of parental FGIDs was associated with crying-related symptoms (OR, 2.12; 95% CI, 1.23-3.68; p=0.007). Conclusion: Regurgitation, crying, and constipation are common FGIDs in infants. Some parental and infant characteristics may be predictors for FGIDs. Further investigations are needed to evaluate the clinical relevance of our findings. Understanding the determinants of FGIDs will benefit healthcare professionals and parents to improve infant's quality of life and better manage these condition.