Increased Gastrointestinal Permeability and Gut Inflammation in Children with Functional Abdominal Pain and Irritable Bowel Syndrome.
Shulman, Robert J. MD a,c,d,e; Eakin, Michelle N. PhD f; Czyzewski, Danita I. PhD a,b,c,d; Jarrett, Monica PhD g; Ou, Ching-Nan PhD a,c,d
[Article]
Journal of Pediatrics.
153(5):646-650, November 2008.
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Objectives: To determine gastrointestinal (GI) permeability and fecal calprotectin concentration in children 7 to 10 years of age with functional abdominal pain and irritable bowel syndrome (FAP/IBS) versus control subjects and ascertain potential relationships with pain symptoms and stooling.
Study design: GI permeability and fecal calprotectin concentration were measured. Children kept a 2-week diary of pain episodes and stooling pattern.
Results: Proximal GI permeability was greater in the FAP/IBS group (n = 93) compared with control subjects (n = 52) (0.59 /- 0.50 vs 0.36 /- 0.26, respectively; mean /- SD; P < .001) as was colonic permeability (1.01 /- 0.67 vs 0.81 /- 0.43, respectively; P < .05). Gastric and small intestinal permeability were similar. Fecal calprotectin concentration was greater in children with FAP/IBS compared with control children (65.5 /- 75.4 [mu]g/g stool vs 43.2 /- 39.4, respectively; P < .01). Fecal calprotectin concentration correlated with pain interference with activities (P = .01, r2 = 0.36). There was no correlation between GI permeability and pain related symptoms. Neither permeability nor fecal calprotectin correlated with stool form.
Conclusions: Children with FAP/IBS have evidence of increased GI permeability and low-grade GI inflammation, with the latter relating to the degree to which pain interferes with activities.
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