Disorders of Gut–Brain Interaction like symptoms in Children with Inflammatory Bowel Disease: A Multicenter Prospective Study from the Pediatric IBD Porto Group of the ESPGHAN.

Background & Aims: Disorders of gut–brain interaction (DGBI) are frequently reported in patients with inflammatory bowel disease (IBD), but pediatric data are scarce. We aimed to determine the prevalence of DGBI-like symptoms in children with quiescent IBD compared with healthy controls (HC), and to evaluate their impact on health-related quality of life (HR-QoL), anxiety and symptoms burden. Methods: This multicenter, prospective, observational study enrolled children aged 10–18 years with biochemically quiescent IBD, with or without endoscopic confirmation of remission from seven European ESPGHAN centers (January 2021–August 2023). Age and sex-matched HC were recruited through primary care pediatricians and screened for subclinical inflammation using fecal calprotectin. DGBI were assessed using Rome IV criteria. HR-QoL and psychological burden were evaluated using IMPACT III, PROMIS Anxiety, Visceral Sensitivity Index–Child, and Behavioral Response Questionnaire–Child. Results: A total of 253 children were enrolled (IBD: n=131; HC: n=122). The prevalence of DGBI-like symptoms did not differ between IBD and HC [34.4% vs 41.8%, p=0.30]. Functional abdominal pain disorders were present in 24.4% of children with IBD. Children with IBD and DGBI-like symptoms showed significantly lower IMPACT III scores compared with those without DGBI [median 74 (IQR 62.5–81) vs 84 (70–90); p=0.001], with the greatest impairment in IBD symptoms, energy, and social domains. PROMIS Anxiety scores were higher in the DGBI group [31 (20–44) vs 21.5 (16–28); p<0.001], with a greater proportion exceeding the clinical threshold (>50) (17.8% vs 3.5%; p=0.008). Female sex was the only independent predictor of DGBI (OR 5.2, 95% CI 1.6–16.1; p=0.005). Conclusions: DGBI-like symptoms are common in children with quiescent IBD and are associated with a substantial psychological and quality-of-life burden.