Digestive Diseases and Sciences

, Volume 56, Issue 6, pp 1789–1793

Henoch–Schonlein Purpura Leads to Functional Gastrointestinal Disorders

Original Article

DOI: 10.1007/s10620-010-1499-4

Cite this article as:
Saps, M., Dhroove, G. & Chogle, A. Dig Dis Sci (2011) 56: 1789. doi:10.1007/s10620-010-1499-4

Abstract

Background

Pain predominant functional gastrointestinal disorders such as irritable bowel syndrome may develop as sequelae to acute infectious gastroenteritis. Henoch–Schonlein purpura is a vaculitis that causes an inflammatory insult to the intestinal mucosa.

Objective

To assess whether patients with Henoch–Schonlein purpura are more likely to develop functional gastrointestinal disorders in long-term follow-up than controls.

Patients and Methods

Families of children diagnosed with Henoch–Schonlein purpura from 2002 to 2009 were contacted at least 6 months after an acute episode. Parents completed a validated questionnaire to diagnose functional gastrointestinal disorders according to Rome III criteria.

Results

Thirty-eight patients (mean 9.9 years, range 3–22 years, 19 males) and 38 controls (mean 9.5 years, range 1–24 years, 21 males) were recruited. Of the patients, 81% had abdominal pain with Henoch–Schonlein purpura presentation. Initial abdominal pain had resolved in all cases. At the time of study, 60.5% patients and 2.6% controls had abdominal pain. Children in Henoch–Schonlein purpura group were diagnosed with various functional gastrointestinal disorders: Irritable bowel syndrome in 11%, functional abdominal pain syndrome in 8%, and functional abdominal pain in 2.8%. Steroid usage was associated with higher incidence of abdominal pain (87.5%) at the time of the study as compared to no steroid usage (40.9%), p = 0.0065.

Conclusions

Patients with Henoch–Schonlein purpura are at an increased risk of developing pain predominant functional gastrointestinal disorders. The presence of abdominal pain and use of steroids at presentation of Henoch–Schonlein purpura are associated with higher incidence of pain predominant functional gastrointestinal disorders.

Keywords

Henoch–Schonlein purpura Post-infectious functional gastrointestinal disorder Pain predominant functional gastrointestinal disorder Irritable bowel syndrome Functional abdominal pain Functional abdominal pain syndrome 

Abbreviations

HSP

Henoch–Schonlein purpura

QPGS

Questionnaire on Pediatric Gastrointestinal Symptoms

AP

Abdominal pain

FGID

Functional gastrointestinal disorder

PI-FGID

Post-infectious functional gastrointestinal disorder

PP-FGID

Pain predominant functional gastrointestinal disorder

IBS

Irritable bowel syndrome

FAP

Functional abdominal pain

FAPS

Functional abdominal pain syndrome

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  1. 1.Department of Pediatric Gastroenterology, Hepatology & Nutrition, Gastrointestinal Motility and Functional Bowel Disorders Program, Children’s Memorial HospitalNorthwestern UniversityChicagoUSA

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