Multinational prevalence and burden of paediatric disorders of gut-brain interaction: results of the Rome Foundation paediatric global study.

BACKGROUND

Global prevalence estimates of paediatric disorders of gut-brain interaction (DGBI) are largely unknown and published studies are hindered by heterogeneous methodology.

OBJECTIVE

To determine the multinational prevalence and burden of paediatric DGBI as defined by Rome V.

DESIGN

Caregivers of 8000 children aged 0-17 years from China, Italy, Mexico and the USA completed an online Rome V survey assessing gastrointestinal symptoms, illness burden and comorbid health conditions. Prevalence was calculated by DGBI category, country, sex and age.

RESULTS

Paediatric DGBI were highly prevalent, affecting 28.0% (95% CI 27.0% to 29.0%) of children. Upper DGBI were present in 8.7% (95% CI 8.2% to 9.5%) and lower DGBI in 23.7% (95% CI 22.8% to 24.7%). The most common lower DGBI were defecation and anorectal disorders (20.2%) followed by abdominal pain disorders (4.4%) and discomfort disorders (1.8%). The most common upper DGBI were gastroduodenal disorders (6.6%), followed by functional feeding disorders (3.4%) and oesophageal disorders (0.6%). Significant geographic differences were observed with the highest prevalence in Mexico and the lowest in China. There was a female predominance in gastroduodenal and discomfort disorders. Overall prevalence declined with age, from approximately 41% in children aged 0-3 years to 22% in adolescents. DGBI were associated with significant anxiety, depression, functional disability and healthcare utilisation, as well as parental time spent in care and coordination particularly when upper and lower DGBI overlapped.

CONCLUSIONS

This global Rome V study demonstrates the high multi-national prevalence, burden and heterogeneity of paediatric DGBI, supporting improved recognition, classification, research and clinical care.