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The Prevalence of Hypermobility in Children with Irritable Bowel Syndrome and Functional Abdominal Pain Is Similar to that in Healthy Children - 27/01/21

Doi : 10.1016/j.jpeds.2020.03.033 
Robert J. Shulman, MD 1, 2, 3, Mariella M. Self, PhD 1, 3, Danita I. Czyzewski, PhD 1, 3, Jerry Goldberg, MD 4, Margaret Heitkemper, PhD 5
1 Department of Pediatrics, Baylor College of Medicine, Houston, TX 
2 Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX 
3 Texas Children's Hospital, Houston, TX 
4 Marshfield, WI 
5 Department of Biobehavioral Nursing and Health Informatics, University of Washington, Seattle, WA 

Abstract

Objectives

To test the hypothesis that the prevalence of joint hypermobility is greater in children with irritable bowel syndrome and functional abdominal pain than in healthy control children and is related to gastrointestinal symptoms and psychosocial distress (anxiety, depression, and somatization).

Study design

Children (irritable bowel syndrome, n = 109; functional abdominal pain, n = 31; healthy control, n = 69), 7-12 years of age completed prospective 2-week pain and stooling diaries and child- and parent-reported measures of anxiety, depression, and somatization. Joint hypermobility was determined using Beighton criteria (score of ≥4 or 6). We also examined possible relationships between Beighton score, race, body mass index, gastrointestinal symptoms, and psychosocial distress.

Results

Beighton scores were similar between groups, as was the proportion with joint hypermobility. Scores were higher in girls (3.1 ± 2.4) than boys (2.3 ± 1.8; P = .004) and decreased with age (P < .001; r = −0.25). Race and body mass index did not impact joint hypermobility prevalence. Beighton scores were not related to abdominal pain or stooling characteristics. Participants with a score of ≥4 and ≥6 had greater somatization and depression by child report (P = .017 and P = .048, respectively). No association was seen for anxiety. There was no significant association between joint hypermobility and psychosocial distress measures per parent report.

Conclusions

Contrary to the adult literature, the prevalence of joint hypermobility does not differ among children with irritable bowel syndrome, functional abdominal pain, or healthy control children. The presence or severity of joint hypermobility does not correlate with abdominal pain or stooling characteristics. Somatization and depression by child report appear to have a relationship with joint hypermobility.

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Keywords : irritable bowel syndrome, functional abdominal pain, gastrointestinal, functional abdominal pain disorder, joint hypermobility

Abbreviations : FAP, GI, IBS


Plan


 Supported by the National Institutes of Health (R01 NR013497), the Daffy’s Foundation, the USDA/Agricultural Research Service under Cooperative Agreement (58-3092-0-001) and P30 DK56338, which funds the Texas Medical Center Digestive Disease Center. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. This work is a publication of the USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital. The contents do not necessarily reflect the views or policies of the USDA, nor does mention of trade names, commercial products, or organizations imply endorsement by the US Government. The authors declare no conflicts of interest.


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Vol 222

P. 134 - juillet 2020 Retour au numéro
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