A systematic review and meta-analysis in schoolchildren and adolescents with functional gastrointestinal disorders according to Rome IV criteria

Abstract

Objective – To determine the prevalence of functional gastrointestinal disorders (FGIDs) in children according to Rome IV criteria. Methods – We included cohorts and observational descriptive studies, including information for the prevalence of FGIDs according to Rome IV criteria in children 4 to 18 years old. We searched the MEDLINE (Ovid), EMBASE, LILACS, and CENTRAL databases from May 2016 to nowadays. Gray literature and other databases were also consulted. The risk of bias was assessed using the STROBE Statement. The results were reported in forest plots of the estimated effects of the included studies with a 95% confidence interval (95%CI). Results – We included 14 studies involving a total of 17427 participants. Three studies were conducted in Europe, two in North America, and nine in Latin America. Most studies were school-based (n=14670, 84.18%), participants were mostly female (55.49%), white (51.73%), 8 to 18 years old (77.64%), and assisted to a public school (81.53%). Thirteen studies used the Questionnaire on Pediatric Gastrointestinal Symptoms (QPGS-RIV) to assess FGIDs. We found a global prevalence for FGIDs of 23% (95%CI 21–25%, I2 99%). Main disorders were functional constipation (FC) with 12% (95%CI 11–15%) followed by functional dyspepsia (FD) (5%, 95%CI 11–15%) and irritable bowel syndrome (IBS) (3%, 95%CI 2–4%). The prevalence of FGIDs was higher in the Americas, representing 23.67% (95%CI 21.2–26.2%, I2 91.3%). Conclusion – FGIDs are present in one of four children and adolescents, representing a common condition in this age group the central disorders were FC, FD, and IBS.