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Background/Aims To assess the effectiveness and feasibility of a brief session of hypnosis to reduce distress in children with functional constipation undergoing anorectal manometry (ARM). Methods A partially-blinded randomized controlled pilot trial was conducted in children 4-18 years old scheduled for ARM. Children were randomized to receive a brief session of hypnosis prior to ARM or standard care. Non-blinded and blinded observers rated the child's level of distress using the Observation Scale of Behavioral Distress and a 4-point-Likert scale, respectively. Differences between groups were analyzed using Fisher's exact test or Mann-Whitney U test as appropriate. Results Data from 32 children (15 hypnosis and 17 standard care) were analyzed. Prior to insertion of the catheter, the observed mean levels of distress were lower in the hypnosis group according to both the non-blinded observer (median 0.0 [interquartile range {IQR} 0.0-0.3] vs 1.4 [IQR 0.3-2.4]; P = 0.009) and the blinded observer (median 0.0 [IQR 0.0-0.0] vs 0.5 [IQR 0.0-1.0]; P = 0.044). During ARM, observed and reported levels of distress did not differ significantly. In the hypnosis group, 92.9% of parents and children reported that hypnosis helped the child to relax. There were no significant differences in resting pressure, squeeze pressure, or duration of the procedure between both groups. Conclusion A brief session of hypnosis for children before ARM is an easily incorporable intervention that lowers distress levels prior to the procedure and is positively perceived by children and parents. [ABSTRACT FROM AUTHOR]

Background/Aims To investigate the intra-rater (test-retest) reliability of the diagnosis of functional gastrointestinal disorders (FGIDs) as measured by the Questionnaire on Pediatric Functional Gastrointestinal Disorders, Rome IV version (QPGS-IV) in children. Methods A prospective cohort study was conducted in a public school in Cali, Colombia. Children and adolescents between 11 and 18 years of age were given the self-report Spanish version of the QPGS-IV at day 0 (baseline) and at day 2 (48 hours later). Results The study protocol was completed by 215 children, of which 97 (45%) were excluded from analysis due to the inability to follow the questionnaire's instructions. The final analysis included data of 118 children (mean age 15.0 ± SD 1.8 years old, 58.5% boys). The most common diagnoses were functional dyspepsia, functional constipation, and irritable bowel syndrome. We found a moderate intra-rater reliability (κ = 0.61-0.65) for diagnosing an FGID in general, a functional abdominal pain disorder, and the diagnosis of functional dyspepsia. We found a weak intra-rater reliability (κ = 0.46-0.54) for diagnosing a functional defecation disorder, functional constipation, irritable bowel syndrome, and the postprandial distress syndrome subtype of functional dyspepsia. Conclusions Our study shows that a large proportion of children cannot adequately complete the QPGS-IV and that the intra-rater reliability among those who did adequately follow the instructions is moderate. We advise to test the children's understanding of the instructions prior to completion of questionnaires and recommend to not rely exclusively on a self-reported questionnaire to select, recruit, or evaluate pediatric patients for FGIDs for research purposes. [ABSTRACT FROM AUTHOR]

Childhood obesity is spreading across the world very fast. Although initial data showed it as a problem of affluence, both developed and developing countries are almost equally affected with the epidemic. It is well known that obesity predisposes both children and adults to several serious disease conditions that can be life threatening. However, in addition to that, data are emerging that obesity predisposes children to develop an array of functional gastrointestinal diseases (FGIDs). Recently, Phatak and Pashankar1 have published an eye opening article to establish the relationship between obesity in children and FGIDs. They have recruited 450 children from 3 paediatric and adolescent clinics in Yale, USA. Children and their parents were interviewed using the standard Rome III questionnaire for children/adolescents. Medical records of these children were comprehensively reviewed to obtain information regarding data on demography and growth indices. Their data show an alarmingly high prevalence of obesity/overweight (42%). Functional abdominal pain syndrome (FAPS) (OR, 2.1; 95% CI, 1.21-3.64; P = 0.007), functional constipation (FC) (OR, 1.83; 95% CI, 1.12-2.98; P = 0.01) and irritable bowel syndrome (IBS) (OR, 2.59; 95% CI, 1.40-4.79; P = 0.003) were noted to be significantly more prevalent in the obese/overweight children. Of the obese/overweight children, 47% had at least one functional gastrointestinal disorder compared with 27% of the normal weight children (P < 0.001). [ABSTRACT FROM AUTHOR]