Multinational prevalence and burden of paediatric disorders of gut-brain interaction: results of the Rome Foundation paediatric global study.

BACKGROUND: Global prevalence estimates of paediatric disorders of gut-brain interaction (DGBI) are largely unknown and published studies are hindered by heterogeneous methodology. OBJECTIVE: To determine the multinational prevalence and burden of paediatric DGBI as defined by Rome V. DESIGN: Caregivers of 8000 children aged 0-17 years from China, Italy, Mexico and the USA completed an online Rome V survey assessing gastrointestinal symptoms, illness burden and comorbid health conditions. Prevalence was calculated by DGBI category, country, sex and age. RESULTS: Paediatric DGBI were highly prevalent, affecting 28.0% (95% CI 27.0% to 29.0%) of children. Upper DGBI were present in 8.7% (95% CI 8.2% to 9.5%) and lower DGBI in 23.7% (95% CI 22.8% to 24.7%). The most common lower DGBI were defecation and anorectal disorders (20.2%) followed by abdominal pain disorders (4.4%) and discomfort disorders (1.8%). The most common upper DGBI were gastroduodenal disorders (6.6%), followed by functional feeding disorders (3.4%) and oesophageal disorders (0.6%). Significant geographic differences were observed with the highest prevalence in Mexico and the lowest in China. There was a female predominance in gastroduodenal and discomfort disorders. Overall prevalence declined with age, from approximately 41% in children aged 0-3 years to 22% in adolescents. DGBI were associated with significant anxiety, depression, functional disability and healthcare utilisation, as well as parental time spent in care and coordination particularly when upper and lower DGBI overlapped. CONCLUSIONS: This global Rome V study demonstrates the high multi-national prevalence, burden and heterogeneity of paediatric DGBI, supporting improved recognition, classification, research and clinical care.