The relationship between adverse childhood experiences and disorders of the gut-brain interaction.

Autor: Fritz J; Maine Medical Partners Pediatric Gastroenterology, Portland, Maine, USA.; Department of Pediatrics, Maine Medical Center, Portland, Maine, USA.; Tufts University School of Medicine, Boston, Massachusetts, USA., Coffey R; Department of Pediatrics, Maine Medical Center, Portland, Maine, USA., Bloch J; Maine Medical Partners Pediatric Gastroenterology, Portland, Maine, USA., Cutler A; MaineHealth Institute for Research Center for Interdisciplinary Population and Health Research, Portland, Maine, USA., Gabrielson S; The Barbara Bush Children's Hospital at Maine Medical Center, Portland, Maine, USA., DiGiovanni S; Department of Pediatrics, Maine Medical Center, Portland, Maine, USA.; Tufts University School of Medicine, Boston, Massachusetts, USA., Faherty LJ; Department of Pediatrics, Maine Medical Center, Portland, Maine, USA.; Tufts University School of Medicine, Boston, Massachusetts, USA.; RAND Corporation, Boston, Massachusetts, USA.
Jazyk: angličtina
Zdroj: Journal of pediatric gastroenterology and nutrition [J Pediatr Gastroenterol Nutr] 2024 Nov 25. Date of Electronic Publication: 2024 Nov 25.
DOI: 10.1002/jpn3.12422
Abstrakt: Objectives: Disorders of the gut-brain interaction (DGBI) arise from a complex interplay of psychosocial factors, altered physiology, and early life factors. In adults, adverse childhood experiences (ACEs) have been associated with DGBI. While both ACEs and DGBI are prevalent among children, the relationship between ACEs and DGBI in childhood is not well understood.
Methods: Retrospective review of patients aged 3-18 years with ACE scores documented between October 1, 2019 and April 30, 2022 who were divided into three comparison groups: (1) not referred to pediatric gastroenterology (GI); (2) referred to GI and diagnosed with a DGBI; and (3) referred to GI and not diagnosed with a DGBI.
Results: Of 29,490 patients with ACE scores documented during the study period, 897 completed a GI consultation. Four hundred one (44.7%) were diagnosed with a DGBI. With each additional adverse experience, patients were 1.09 times more likely to have a DGBI diagnosis (95% confidence interval [CI] = 1.056-1.163; p ≤ 0.001). An anxiety diagnosis mediated 73% of this relationship (p = 0.012).
Conclusions: Among patients receiving pediatric GI specialty care, higher ACE scores were associated with a higher likelihood of a DGBI diagnosis. Anxiety largely mediates this relationship, suggesting potential avenues for targeted, multidisciplinary interventions in both primary and specialty care settings.
(© 2024 European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition.)
Databáze: MEDLINE
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