Objective: To test the hypothesis that allergic proctocolitis, a cause of self-limiting rectal bleeding in infants, can predispose to the development of functional gastrointestinal disorders (FGIDs) later in childhood. Study design: We studied a cohort of 80 consecutive patients diagnosed with allergic proctocolitis. Their sibling or matched children presenting to the same hospital for minor trauma served as controls. Parents of the patients with allergic proctocolitis and controls participated in a telephone interview every 12 months until the child was at least 4 years old. At that time, they were asked to complete the parental Questionnaire on Pediatric Gastrointestinal Symptoms, Rome III version. Results: Sixteen of the 160 subjects (10.0%) included in the study met the Rome III criteria for FGIDs. Among the 80 patients with allergic proctocolitis, 12 (15.0%) reported FGIDs, compared with 4 of 80 (5.0%) controls (P =.035). After adjustment for age and sex, the OR for FGIDs in allergic proctocolitis group was 4.39 (95% CI, 1.03-18.68). FGIDs were significantly associated with iron deficiency anemia, duration of hematochezia, and younger age at presentation. In a multivariate analysis, only the duration of hematochezia was significantly associated with the development of FGIDs (OR, 3.14; 95% CI,1.72-5.74). Conclusions: We have identified allergic proctocolitis as a new risk factor for the development of FGIDs in children. Our data suggest that not only infection, but also a transient early-life allergic inflammatory trigger may induce persistent digestive symptoms, supporting the existence of “postinflammatory” FGIDs.

Allergic Proctocolitis Is a Risk Factor for Functional Gastrointestinal Disorders in Children / Di Nardo, Giovanni; Cremon, Cesare; Frediani, Simone; Lucarelli, Sandra; Villa, Maria Pia; Stanghellini, Vincenzo; La Torre, Giuseppe; Martemucci, Luigi; Barbara, Giovanni. - In: THE JOURNAL OF PEDIATRICS. - ISSN 0022-3476. - ELETTRONICO. - 195:Apr(2018), pp. 128-133. [10.1016/j.jpeds.2017.10.073]

Allergic Proctocolitis Is a Risk Factor for Functional Gastrointestinal Disorders in Children

Di Nardo, Giovanni
Primo
Writing – Review & Editing
;
Frediani, Simone;Lucarelli, Sandra;Villa, Maria Pia;La Torre, Giuseppe;
2018

Abstract

Objective: To test the hypothesis that allergic proctocolitis, a cause of self-limiting rectal bleeding in infants, can predispose to the development of functional gastrointestinal disorders (FGIDs) later in childhood. Study design: We studied a cohort of 80 consecutive patients diagnosed with allergic proctocolitis. Their sibling or matched children presenting to the same hospital for minor trauma served as controls. Parents of the patients with allergic proctocolitis and controls participated in a telephone interview every 12 months until the child was at least 4 years old. At that time, they were asked to complete the parental Questionnaire on Pediatric Gastrointestinal Symptoms, Rome III version. Results: Sixteen of the 160 subjects (10.0%) included in the study met the Rome III criteria for FGIDs. Among the 80 patients with allergic proctocolitis, 12 (15.0%) reported FGIDs, compared with 4 of 80 (5.0%) controls (P =.035). After adjustment for age and sex, the OR for FGIDs in allergic proctocolitis group was 4.39 (95% CI, 1.03-18.68). FGIDs were significantly associated with iron deficiency anemia, duration of hematochezia, and younger age at presentation. In a multivariate analysis, only the duration of hematochezia was significantly associated with the development of FGIDs (OR, 3.14; 95% CI,1.72-5.74). Conclusions: We have identified allergic proctocolitis as a new risk factor for the development of FGIDs in children. Our data suggest that not only infection, but also a transient early-life allergic inflammatory trigger may induce persistent digestive symptoms, supporting the existence of “postinflammatory” FGIDs.
allergic proctocolitis; children; functional gastrointestinal disorders; pediatrics; perinatology and child health
01 Pubblicazione su rivista::01a Articolo in rivista
Allergic Proctocolitis Is a Risk Factor for Functional Gastrointestinal Disorders in Children / Di Nardo, Giovanni; Cremon, Cesare; Frediani, Simone; Lucarelli, Sandra; Villa, Maria Pia; Stanghellini, Vincenzo; La Torre, Giuseppe; Martemucci, Luigi; Barbara, Giovanni. - In: THE JOURNAL OF PEDIATRICS. - ISSN 0022-3476. - ELETTRONICO. - 195:Apr(2018), pp. 128-133. [10.1016/j.jpeds.2017.10.073]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1078725
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