Elsevier

The Journal of Pediatrics

Volume 166, Issue 1, January 2015, Pages 85-90.e2
The Journal of Pediatrics

Original Article
Health-Related Quality of Life in Pediatric Patients with Functional and Organic Gastrointestinal Diseases

https://doi.org/10.1016/j.jpeds.2014.08.022Get rights and content

Objective

To compare health-related quality of life (HRQOL) in pediatric patients with functional gastrointestinal disorders (FGIDs) and organic gastrointestinal (GI) diseases with an age-, sex-, and race/ethnicity-matched healthy sample across GI diagnostic groups and with one another.

Study design

The Pediatric Quality of Life Inventory 4.0 Generic Core Scales were completed in a 9-site study by 689 families. Patients had 1 of 7 physician-diagnosed GI disorders: chronic constipation, functional abdominal pain, irritable bowel syndrome, functional dyspepsia, Crohn's disease, ulcerative colitis, and gastroesophageal reflux disease. The healthy control sample included 1114 families. School days missed, days in bed and needing care, parent missed workdays, work impact, and healthcare utilization were compared as well.

Results

Patients with an FGID or organic GI disease demonstrated lower HRQOL than the healthy controls across all dimensions (physical, emotional, social, and school; P < .001 for all), with larger effect sizes for patients with an FGID. Patients with an FGID manifested lower HRQOL than those with an organic GI disease. Patients with an FGID or organic GI disease missed more school, spent more days in bed and needing care, had greater healthcare utilization, and had parents who missed more workdays with greater work impact (P < .001 for most), with larger effect sizes for the patients with an FGID.

Conclusion

Patients with an FGID or organic GI disease demonstrate impaired HRQOL compared with healthy children. HRQOL can be used as a common metric to compare patient outcomes in clinical research and practice both within and across groups of patients with FGIDs and organic GI diseases.

Section snippets

Methods

Pediatric patients aged 5-18 years and parents of pediatric patients aged 2-18 years with a physician-diagnosed GI disorder using International Classification of Disease, Ninth Revision, Clinical Modification diagnosis codes and/or Rome III criteria for FGIDs for 7 GI diagnostic groups, including both functional (chronic constipation [CC], functional abdominal pain [FAP], irritable bowel syndrome [IBS], and functional dyspepsia [FD]) and organic diseases (Crohn's disease [CD], ulcerative

Results

A total of 689 patient families (584 children aged 5-18 years and 682 parents of children aged 2-18 years) participated in the field test study. The average age of the 318 boys (46.2%) and 371 girls (53.8%) was 11.43 years (SD, 4.58; range, 2.0-18.9). The racial/ethnic distribution was 517 (75.0%) white non-Hispanic, 68 (9.9%) Hispanic, 63 (9.1%) black non-Hispanic, 13 (1.9%) Asian/Pacific Islander, 1 Native American (0.1%), and 27 (3.9%) other. With respect to parent education, 6.1% of mothers

Discussion

The results of this multicenter study demonstrate that pediatric patients with FGIDs and organic GI diseases have significantly lower generic HRQOL compared with healthy children, with the majority of effects sizes in the medium to large range. In addition, these children missed more days from school, had more days in bed/too ill to play, and required greater healthcare utilization, and their parents reported more days missed from work and a greater impact on their daily work routine and

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    • Cited by (0)

    J.F. is currently at the Division of Gastroenterology, Hepatology, and Nutrition, Nemours Children's Hospital, Orlando, FL.

    J.V. holds the copyright and the trademark for the PedsQL and receives financial compensation from the Mapi Research Trust, a nonprofit research institute that charges distribution fees to for-profit companies that use the PedsQL. The other authors declare no conflicts of interest.

    ∗

    A list of PedsQL Gastrointestinal Symptoms Module Testing Study Consortium sites is available at www.jpeds.com (Appendix).

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