Document Detail


Gastrointestinal complaints and diagnosis in children: a population-based study.
MedLine Citation:
PMID:  15303801     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: To find out the extent to which children at 10-11 y of age suffer from various gastrointestinal complaints and how often a food-induced or other diagnostic disorder might be assessed behind them, we carried out a population-based survey of 404 children in a rural Finnish town. METHODS: A questionnaire filled in retrospectively by their parents was used to describe the frequency of various abdominal symptoms during the previous 2 y and to select the symptomatic subjects for closer clinical examination. In the clinical investigation of the children, an elimination challenge with milk protein and lactose intolerance tests, as well as endoscopic examinations in selected cases and blood tests, were performed. RESULTS: In all, 110 (27%) subjects reported some gastrointestinal (GI) complaints during the last 2 y; 64 (16%) meeting the Apley criteria for recurrent abdominal pain. A specific organic or functional disorder was found in 26 subjects (6%), two having no GI symptoms. Milk protein intolerance was the most common specific disorder diagnosed in nine subjects (2.2%), followed by lactose intolerance in eight (2%), coeliac disease in five (1.2%) and Helicobacter pylori infection in three (0.7%). An endoscopic examination performed on 17 subjects (4.2%) and a colonoscopy on three revealed significant findings in 11; lymphonodular changes being most common, occurring in five subjects. Subjects with milk protein-induced disorders showed significantly lower IgA-class antibodies to milk and its fractions than the non-symptomatic controls. Chronic diseases, short breastfeeding, GI problems and food intolerance during the first year of life were observed as significant risk factors in determining whether a subject belonged to the group experiencing any GI complaints. CONCLUSION: We conclude that in one in five of those with any, even mild, GI complaints we were able to assess a specific organic disease; milk-induced disorders being most common. A milk protein and/or lactose load test, completed in some cases with an endoscopic examination, would help in assessing a proper individual diagnosis.
Authors:
J Kokkonen; M Haapalahti; S Tikkanen; R Karttunen; E Savilahti
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Acta paediatrica (Oslo, Norway : 1992)     Volume:  93     ISSN:  0803-5253     ISO Abbreviation:  Acta Paediatr.     Publication Date:  2004 Jul 
Date Detail:
Created Date:  2004-08-11     Completed Date:  2004-10-21     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9205968     Medline TA:  Acta Paediatr     Country:  Norway    
Other Details:
Languages:  eng     Pagination:  880-6     Citation Subset:  IM    
Affiliation:
Department of Paediatrics, Oulu University Hospital, Oulu, Finland. jorma.kokkonen@ppshp.fi
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MeSH Terms
Descriptor/Qualifier:
Abdominal Pain / etiology
Child
Diarrhea / etiology
Endoscopes, Gastrointestinal
Finland / epidemiology
Food Hypersensitivity / complications*
Gastrointestinal Diseases / diagnosis*,  epidemiology,  etiology
Humans
Immunoglobulin G / blood
Milk Hypersensitivity / complications
Questionnaires
Retrospective Studies
Risk Factors
Chemical
Reg. No./Substance:
0/Immunoglobulin G
Comments/Corrections
Comment In:
Acta Paediatr. 2004 Jul;93(7):869-71   [PMID:  15303799 ]

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