Increased Gastrointestinal Permeability and Gut Inflammation in Children with Functional Abdominal Pain and Irritable Bowel Syndrome

Objectives To determine gastrointestinal (GI) permeability and fecal calprotectin concentration in children 7 to 10 years o age with functional abdominal pain and irritable bowel syndrome (FAP/IBS) versus control subjects and ascertain potentia relationships with pain symptoms and stooling. Study design GI permeability and fecal calprotectin concentration were measured. Children kept a 2-week diary of pair episodes mid 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 protection concentration correlated with pain interference with activities (P = .01. r(2) = 0.36). There was no correlation between G 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 die degree to which pain interferes with acthities. (J Pediatr 2008.153:646-50)