Analysis of the impact of COVID-19 pandemic on functional gastrointestinal disorders among paediatric population.

OBJECTIVE: Functional gastrointestinal disorders are common gastrointestinal diseases. The pathophysiology is multifactorial and psychosocial distress worsens symptoms severity. Since the end of 2019 the world has been facing COVID-19 pandemic. The associated control measures have affected the psychological health of people. The aim of the present study is to evaluate the impact of the COVID-19 pandemic on the prevalence of functional gastrointestinal disorders among Italian children and adolescents. PATIENTS AND METHODS: The study sample is composed of 407 patients (187 males, 220 females), aged from 10 to 17 years. The mean age is 14.27 ± 2.24 years. The study was conducted through the Italian version of the Questionnaire on Pediatric Gastrointestinal Symptoms-Rome III Version.  The prevalence of each disorder has been calculated as the ratio of affected subjects for each disease and the total number of effective cases for that specific disease. RESULTS: The study demonstrates that the prevalence of Functional Gastrointestinal Disorder in Italian children, during the COVD-19 pandemic, is higher, compared with the one reported in the previous studies. The most frequent disorders are Abdominal Migraine and Irritable Bowel Syndrome. CONCLUSIONS: Our study is the first one which provides data of the prevalence of Functional gastrointestinal disorders in sample of Italian adolescents, during the COVID-19 pandemic. The study underlines the need to focus on stress management, in order to reduce the effects of the lockdown on the psychological wellness of the youngest.

Outcomes of Treating Rumination Syndrome with a Tricyclic Antidepressant and Diaphragmatic Breathing.

BACKGROUND: Rumination syndrome is a functional gastrointestinal disorder characterized by effortless postprandial regurgitation and accompanied by gastric visceral hypersensitivity. Almost invariably, the onset of symptoms is preceded by a psychologically stressful situation, and anxiety is often an accompanying complaint. In this background of gastric visceral hypersensitivity, anxiety and psychological stress, we investigated the effectiveness of combining a tricyclic antidepressant (TCA) with diaphragmatic breathing/relaxation techniques for the treatment of rumination syndrome. MATERIALS AND METHODS: Patients who fulfilled the Rome IV criteria for rumination syndrome received hands-on instructions and/or coaching on diaphragmatic breathing techniques, were given relaxing auditory media, started on a TCA, and completed a follow-up symptoms questionnaire after undergoing a minimum of 3 months of this therapy. RESULTS: A total of 44 patients, 35 women; mean age 40.4 (range 20-71) were identified. Mean time from onset of symptoms to diagnosis was 36.0 months (range 6-180). Weight loss ranged from 1.4 to 39.5 kg. Approximately 65.9% had a history of anxiety and/or depression, and a separate 65.9% reported the onset of symptoms were chronologically related to an inciting event and/or psychological stressor. After a mean follow-up period of 8.8 months, 90.9% of patients reported improvement in their symptoms, with a mean subjective improvement from baseline of 68.9%, and specifically, 45.5% of patients reported ≥80% improvement. Weight increased or stabilized in 80.6% of those initially reporting weight loss. CONCLUSIONS: The combination of a TCA with diaphragmatic breathing/relaxation techniques is an effective treatment modality for the management of rumination syndrome as it addresses the underlying factors identified in this entity.