Post-infectious functional gastrointestinal disorders in children.

OBJECTIVE: To investigate the development of functional gastrointestinal disorders (FGIDs) after an episode of acute bacterial gastroenteritis (AGE) in children.

STUDY DESIGN: A cohort study of children 3 to 19 years old with a positive result on a bacterial stool culture. 44 patients in each arm (unidirectional alpha of 0.05, power of 0.80). Children presenting at two pediatric hospitals (United States and Italy) for AGE who tested positive for bacteria on stool culture (2001-2005) were contacted at least 6 months after the episode. Exposed children were matched with control subjects of similar age and sex consulting to the same hospitals for trauma or well-child visit within 4 weeks of the index case. Symptoms were evaluated with a validated questionnaire for FGIDs assessing pain, diarrhea, and disability.

RESULTS: 88 patients (46 boys; mean age, 8.1 years; age range, 3-19 years) were recruited. Bacteria included Salmonella (54%), Campylobacter (32%), and Shigella (14%). 36% of exposed patients and 11% of control subjects complained of abdominal pain (P < .01). 87% had irritable bowel syndrome and 24% had dyspepsia. 56% reported onset of pain following the AGE.

CONCLUSION: There is a significant increase in cases of FGIDs after bacterial infections in children.