Epidemiology of functional gastrointestinal disorders in children and adolescents: A systematic review

Table 4 Prevalence or frequency of functional gastrointestinal disorders: Defecations problems in children and adolescents

Author, year, country	Study design, setting	Sample size (participation %)	Age bracket yr	Case definition	Case ascertainment	Score1	FGID subtype prevalence % (95%CI)
							Constipation	Nonretentive fecal incontinence
Bhatia et al[6], 2016, India	Cross-sectional, school-based	1200 (93.3)	10-17	Rome III	Self-reported QPGS-RIII	5	0.5	0.4
					Medical records
					Physical examination
Burgers et al[31], 2012, Netherlands	Cross-sectional (retrospective), tertiary care	176 (NR)	6-18	Rome II	Clinical evaluation	3	5.7
				Rome III	Medical records		86.9
					Physical examination
Caplan et al[18], 2005, Canada	Cross-sectional, tertiary care	315 (NR)	4-18	Rome II	Self-reported QPGS	3	p 4-9 yr = 19.2	p 4-9 yr = 0.6
					Parental QPGS		p 10-18 yr = 13.8	p 10-18 yr = 0.7
					Clinical evaluation		c/a 10-18 yr = 15.2	c/a 10-18 yr = 0.7
Devanarayana et al[36], 2010, Sri Lanka	Cross-sectional, school-based	464 (92)	12-16	Rome II	Self-reported QPGS	4	1.4	0.2
				Rome III			4.2	0.2
Helgeland et al[35], 2009, Norway	Cross-sectional, tertiary care	192 (NR)	4-15	Rome III	Parental QPGS-III	3	6.0
					Clinical evaluation
					Medical records
					Physical examination
					Laboratory exams
Játiva et al[30], 2016, Ecuador	Cross-sectional, school-based	420 (99.3)	8-15	Rome III	Self-reported QPGS-RIII	3	11.8	0.2
					Parental standard questionnaire
Lewis et al[25], 2016, United States	Cross-sectional, online painel community	1447 (NR)	4-18	Rome III	Parental QPGS-RIII	2	12.9	1.8
					PedsQL4.0
Lu et al[29], 2016, Colombia	Cross-sectional, school-based	4751 (89.8)	8-18	Rome III	Self-reported QPGS-RIII	3	12.7
					Parental standard questionnaire
Lu et al[28], 2016, Panama	Cross-sectional, school-based	436 (82.8)	8-14	Rome III	Rome III	4	15.9 (11.9-19.9)	0 (0.0-0.0)
					Self-reported QPGS-RIII
					Parental standard questionnaire
Rajindrajith et al[39], 2013, Sri Lanka	Cross-sectional, school-based	1855 (96.7)	13-18	Rome III	Self-reported QPGS-RIII	5	7.7
					Self-reported PedsQL4.0
Sagawa et al[16], 2012, Japan	Cross-sectional, school-based	3976 (NR)	10-17	Rome III	Rome III	6	0.3	0.2
					Self-reported QPGS-RIII
					Self-reported PedsQL4.0
					Clinical evaluation
Saps et al[26], 2014, Colombia	Cross-sectional, school-based	488 (83.2)	10.0 (mean age)	Rome III	Self-reported QPGS-RIII	4	14.0 (12.0-19.3)	1.5 (0.7-3.6)
					Parental standard questionnaire
Uc et al[22], 2006, United States	Cross-sectional, primary care	243 (100)	4-17	Rome II	Parental QPGS	4	16.1	0.4
					Clinical evaluation
Zablah et al[27], 2015, El Salvador	Cross-sectional, school-based	434 (NR)	8-15	Rome III	Self-reported QPGS-RIII	3	10.0	0.0
					Parental standard questionnaire
Zhou et al[38], 2011, China	Cross-sectional, school-based	3671 (NR)	12-18	Rome III	Self-reported standard questionnaire	5	24.9 (23.5-26.3)

¹Score: Methodological strength of study (maximum 8) by Loney’s criteria. NR: Not reported; w: With; p: Parents; c: Children; a: Adolescents; ph: Physician; QPGS-RIII: Questionnaire on Pediatric Gastrointestinal Symptoms - Rome III; QPGS: Questionnaire on Pediatric Gastrointestinal Symptoms - Rome II; PedsQL4.0 Pediatric Quality of Life version Inventory 4.0.