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Post-Infectious Functional Gastrointestinal Disorder in Children: What You Need To Know?
Dwi Prasetyo

Division of Pediatric Gastrohepatology, Department of Child Health Faculty of Medicine. Universitas Padjadjaran - Dr. Hasan Sadikin General Hospital Bandung, Indonesia.
Recurrent gastrointestinal complaints constitute one of the most common reasons for medical consultation in day care and school age children. A population-based study demonstrated that 60% of school-age children experienced at least one gastroenterological symptom weekly, and 10% of all children complained weekly of abdominal pain (AP) for at least 8 weeks. Functional AP greatly affects children in quality of life, socialization, and school absenteeism and can have long-term psychological implications. 
     Functional gastrointestinal disorders (FGIDs) are defined as a variable combination of chronic or recurrent gastrointestinal symptoms not explained by structural or biochemical abnormalities. Irritable bowel syndrome (IBS) is one of the most common FGIDs in children. Irritable bowel syndrome (IBS) is consist of chronic and recurrent symptoms such as constipation, diarrhea, abdominal pain without any structural abnormalities.
     Functional gastrointestinal disorders can occur after gastrointestinal infections known as post infectious functional gastrointestinal disorders (PI-FGIDs). Acute gastroenteritis (AGE) is more common in children than in any other age group. Acute bacterial gastroenteritis become the most common infection that evolve into PI-FGIDs. This phenomenon is reported in study published in 1962, their symptoms began following an episode of bacillary or amoebic dysentery. Another study suggested that rotavirus infection does not place children at increased risk for abdominal pain-related FGIDs (AP-FGIDs) at long-term follow-up. Research in pediatric began at 2007 and has not been widely reported. 
     A study published in 2015 reported a significant increase of prevalence abdominal pain-related FGID in children 4-17 years after acute diarrhea within 1 month and 3 until 6 month later. In adult, irritable bowel syndrome (IBS) and functional dyspepsia (FD) are the most frequent and studied FGID.4 In children, there are some different results from studies. A study reported that 87% children suffer from post infectious irritable bowel syndrome (PI-IBS) and 24% post infectious functional dyspepsia (PI-FD), and another reported constipation constitute 15,7% as FGID in children. Published studies have reported incidence of PI-IBS to range between 5% and 32%. A recent systematic review and meta-analysis demonstrated that the risk of developing IBS increases six-fold after gastrointestinal infection and remains elevated for at least 2-3 years post-infection.
Keywords: children, functional dyspepsia, irritable bowel syndrome, post infectious functional gastrointestinal disorders
Refference:
1. Saps M, Pensabene L, Martino L, Staiano A, Wechsler, Zheng X, et al. Postinfectious functional gastrointestinal disorder in children. J Pediatr, 2008;152:812?6.
2. Pensabene L, Talarico V, Concolino D, Ciliberto D, Campanozzi A, Gentile T, et al. Post infectious functional gastrointestinal disorder in children: a multi centre prospective study. J Pediatr. 2015;166(4):903?7.
3. Spiller R, Lam C. An update onpostinfectius irritable bowel syndrome: role of genetics, immune activation, serotonin and altered microbiome. J Neurogastroenterol. 2012;18:258?68.
4. Mearin F. Postinfectious functional gastrointestinal disorder. J Clin Gastroenterol. 2011;45:102?5.
5. Ghoshal UC, Ranjan P. Postinfectious irritable bowel syndrome: the past, the present and the future. J Gastroenterol Hepatol. 2011;26(3):94?101.
6. Thabane M, Kottachchi DT, Marshall JK. Systematic review and meta-analysis: The incidence and prognosis of post-infectious irritable bowel syndrome. Aliment Pharmacol Ther. 2007;26:535?544.

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