G26 Detailed analysis of PEDSQL results can more accurately assess impact of functional gastrointestinal disorders on quality of life in paediatric patients and their families. (12th September 2022)

• Record Type: Journal Article
• Authors: Walker, R; Cornish, M; Knott, G; Kammermeier, J; Vora, R; Mutalib, M
• Is Part Of: Frontline gastroenterology. Volume 13(2022)Supplement 1
• Page Start: A33
• Page End: A34
• Publication Date: 2022-09-12
• Subjects: Gastroenterology -- Periodicals; 616.33005
• DOI: 10.1136/flgastro-2022-bspghan.46
• Languages: English
• ISSNs: 2041-4137

Abstract

Abstract : Background: Functional gastrointestinal disorders (FGID) are a heterogeneous group of disorders defined as a variable combination of chronic or recurrent gastrointestinal symptoms that occur in the absence of structural or biochemical abnormalities. This group of conditions are common in the paediatric population with an estimated prevalence from 27.1% to 38.0%, and almost 21% of patients presenting with more than one FGID. Indeed, FGID are a familiar challenge for any paediatric gastroenterologist, with functional constipation alone accounting for up to 25% of workload. Although life-threatening complications and outcomes are rare, FGIDs and accompanying symptom profiles cause significant morbidity and impact on the quality of life (QOL) of patient and their families. In many paediatric gastroenterology departments psychological support is not routinely available as part of the treatment package for management of FGID's. Aim: In this article we compare impact on QOL of FGID's when compared with organic gastrointestinal disorders (OGID's), and demonstrate how to achieve greater insight into this impact using a more detailed analysis of the PEDSQL questionnaire results. Subject + Methods: Data was collected from the PEDSQL questionnaires completed by the patient and their caregiver as part of the psychology assessment, for patients identified as having FGID as per the Rome IV criteria. Results: 54 patients (50% male) with gastrointestinal disorders were included, age range 5–17 years: Functional abdominal pain not otherwise specified (FAPNOS) n=24, constipation n=13, inflammatory bowel disease (IBD) n=12, rumination syndrome n=3, eosinophilic oesophagitis n=2. In the FGID group the average child-reported total score was 56.4 (±17.2) compared with 66.13 (±12.6) in the OGID group. The average child-reported psychosocial and physical scores in the FGID group were 56.6 (±16.04) and 57.62 (±23.1) compared with 63.91 (±13.2) and 70.31 (±19.7) in the OGID group. Analysis of parent-reported scores revealed that parents in the FGID and OGID groups rated QOL differently to their children in all 3 domains (psychosocial, physical and total overall score), as demonstrated in table 1 . The average total parent-reported score in the FGID was 53.49 (±17.6) and 54.69 in the OGID group, both of which are lower than the child-reported scores. Discrepancies between child-reported and parent-reported scores were noted across the majority of disease sub-groups. Please see table 1 for further breakdown of results. Summary and Conclusion: Our data shows that patients with FGID's have lower QOL when compared with other OGID's. In addition, there were frequent discrepancies observed between the child and their parent, reflecting a different experience or perception of QOL. We suggest that a detailed analysis of the PEDSQL questionnaire result provides a deeper insight into the experience of the patient and their caregiver, and that subsequent sharing of these results can be used as a useful aid for management in a resource limited setting. In order to adequately and holistically support these patients and their families we also advocate for the provision of psychological support as a mandatory part of the treatment package for patients with FGID and their caregivers.