J Pediatr. 2021 May 12;S0022-3476(21)00440-6. doi: 10.1016/j.jpeds.2021.05.017.Online ahead of print.

Patrick Short ¹, Carolyn Sullivan Burklow ², Cade M Nylund ², Apryl Susi ³, Elizabeth Hisle-Gorman ³

Author information

• ¹Department of Pediatrics. Walter Reed National Military Medical Center. Bethesda, MD; Department of Pediatrics. Uniformed Services University of the Health Sciences. Bethesda, MD. Electronic address: Patrick.L.Short2.mil@mail.mil.
• ²Department of Pediatrics. Walter Reed National Military Medical Center. Bethesda, MD; Department of Pediatrics. Uniformed Services University of the Health Sciences. Bethesda, MD.
• ³Department of Pediatrics. Uniformed Services University of the Health Sciences. Bethesda, MD.

Abstract

Objective: To evaluate the relationship between parental injury and illness and disorders of gut brain interaction (DGBI) in children.

Study design: A self-controlled case series using data from the Military Health System Data Repository compared ICD-9 identified DGBI related outpatient visits and prescriptions in 442,651 children ages 3-16 years in the two-years before and the two-years after the injury and/or illness of their military parent. Negative binomial regression was used to compare visit rates for constipation, fecal incontinence, abdominal pain, irritable bowel syndrome, and a composite of these before and after parental injury and/or illness. Logistic regression, clustered by child, compared the odds of stooling agent and antispasmodic prescription before and after PII.

Results: In the two years following PII children had increased visits for DGBIs [adjusted incidence rate ratio (aIRR): 1.09; 95% CI: 1.07-1.10], constipation (aIRR: 1.07; 95% CI: 1.04-1.10), abdominal pain (aIRR: 1.09; 95% CI 1.07-1.12), and irritable bowel syndrome (IBS) (aIRR: 1.37; 95%CI 1.19-1.58). Following PII, the odds of stooling agent prescription decreased [adjusted odds ratio (aOR): 0.95; 95% CI 0.93-0.97] and the odds of antispasmodic prescription increased (aOR: 1.26; 95% CI 1.18-1.36).

Conclusions: PII is associated with increased healthcare utilization for DGBIs. Parental health should be considered by clinicians when assessing DGBIs, counselling patients, and formulating treatment plans.