Disorders of Gut-Brain Interaction in a Pediatric Cystic Fibrosis Cohort

Abstract

Introduction: Disorders of gut-brain interaction (DGBI), such as irritable bowel syndrome, occur at a higher prevalence in adults with cystic fibrosis (CF), compared to the general population. DGBI are associated with impaired quality of life and significant health-system costs. This study aimed to assess the proportion of cwCF with DGBI, compared to non-CF controls.

Methods: Validated for the assessment of DGBI, ROME IV surveys were distributed to cwCF and non-CF controls aged 0-18 years as part of the Evaluating the Alimentary Tracts in Health and Disease (EARTH) observational study. CF participants were recruited from the Sydney Children's Hospital (SCH) CF outpatient clinic between 2018 and 2022. Non-CF controls were recruited from outpatient clinics, advertisements, and word-of-mouth.

Results: Forty-four cwCF (female = 22 [50%], median [IQR] age = 7.04 [2.25-11.06] years) and 48 non-CF controls (female = 22 [45.83%], median (IQR) age = 8.04 [3.57-12.77] years) completed baseline surveys. Symptoms consistent with at least one DGBI were observed more frequently in cwCF compared to non-CF controls (36.36% vs. 10.42%%, p = 0.01). Functional abdominal pain was experienced at a higher prevalence in cwCF compared to non-CF controls (13.79% vs. 0%, p = 0.02). No significant differences in the prevalence of other specific disorders were observed between cwCF and non-CF controls.

Conclusion: Compared to non-CF, cwCF were significantly more likely to experience functional abdominal pain, and at least one DGBI collectively. Further large-scale studies are needed to validate our findings and ascertain the role of routine screening of DGBI in pediatric CF cohorts.

Keywords: DGBI; cystic fibrosis; disorders of gut‐brain interaction; functional gastrointestinal disorder.