Hogervorst, Esmee (2020) Course of the diagnosis, symptoms and health-related quality of life perception of children with chronic gastrointestinal symptoms in primary care. thesis, Medicine.
Full text available on request.Abstract
Purpose: It can be challenging for general practitioners (GPs) to early recognize children who will develop persistent abdominal complaints, as much is still unknown about the prognosis of children with chronic gastrointestinal symptoms in primary care. This study aimed to assess the course of the diagnosis (based on the Rome III criteria), symptoms and health-related quality of life (HRQoL) perception of these children during 12 months follow-up. Methods: Data were obtained from the database of the Darmonderzoek bij kinderen study (July 2011-September 2014), in which 114 children of 4-18 years with chronic abdominal pain and/or chronic diarrhoea in primary care were included. The children or their parents completed the Questionnaire on Pediatric Gastrointestinal Symptoms-Rome III version and Child Health Questionnaire-Parent Form 50 at baseline and after 12 months, and completed a symptom questionnaire every three months. In addition to the course of the diagnosis, symptoms (chronic abdominal pain, chronic diarrhoea and red flag symptoms) and HRQoL during 12 months follow-up, the influence of factors on the presence of symptoms and low HRQoL was assessed by performing generalized linear mixed model analyses and logistic regression analyses. Results: At baseline 94 children (87.0%) had a functional gastrointestinal disorder (FGID) according to the Rome criteria, which decreased to 42 (44.2%) after 12 months. Only 8.3% of children with irritable bowel syndrome according to the Rome criteria also received this diagnosis from the GP at baseline. The percentage of children with chronic abdominal pain or chronic diarrhoea mostly decreased within the first three months, and only slightly decreased thereafter. The percentage of children with at least 1 red flag symptom, however, increased during follow-up. After 12 months, percentages of children with a physical (PhS) or psychosocial (PsS) HRQoL score <50 were decreased compared with baseline (27.3% v.s. 55.7% and 26.1% v.s. 33.0%, respectively). At nearly each follow-up moment the percentages of children with chronic abdominal pain or diarrhoea were highest, and HRQoL scores lowest, for children with multiple FGIDs at baseline, compared with 1 FGID and no FGID. Age was significantly positively associated with a PhS score <50 after 12 months (OR 1.15; 95% CI, 1.01-1.30; P=0.03). Conclusion: The course of the diagnosis, symptoms and HRQoL perception of children with chronic gastrointestinal symptoms in primary care is favourable during 12 months follow-up. The prognosis differed between children with multiple FGIDs, a single FGID and no FGID according to the Rome criteria, which suggests that GPs could use these criteria in practice for early recognition of children with persistent symptoms.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | prof. dr. Berger, M.Y. and dr. Holtman, G.A. and Ms. Ganzevoort (MSc), I.N. |
| Faculty: | Medical Sciences |
| Date Deposited: | 23 Oct 2023 11:46 |
| Last Modified: | 23 Oct 2023 11:46 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3710 |
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