J Pediatr. 2020 Jul;222:134-140.e2. doi: 10.1016/j.jpeds.2020.03.033.Epub 2020 May 4.

Robert J Shulman ¹, Mariella M Self ², Danita I Czyzewski ², Jerry Goldberg ³, Margaret Heitkemper ⁴

Author information

• ¹Department of Pediatrics, Baylor College of Medicine, Houston, TX; Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX; Texas Children's Hospital, Houston, TX.
• ²Department of Pediatrics, Baylor College of Medicine, Houston, TX; Texas Children's Hospital, Houston, TX.
• ³Marshfield, WI.
• ⁴Department of Biobehavioral Nursing and Health Informatics, University of Washington, Seattle, WA.

Abstract

Objectives: To test the hypothesis that the prevalence of joint hypermobility is greater in children with irritable bowel syndrome and functional abdominal pain than in healthy control children and is related to gastrointestinal symptoms and psychosocial distress (anxiety, depression, and somatization).

Study design: Children (irritable bowel syndrome, n = 109; functional abdominal pain, n = 31; healthy control, n = 69), 7-12 years of age completed prospective 2-week pain and stooling diaries and child- and parent-reported measures of anxiety, depression, and somatization. Joint hypermobility was determined using Beighton criteria (score of ≥4 or 6). We also examined possible relationships between Beighton score, race, body mass index, gastrointestinal symptoms, and psychosocial distress.

Results: Beighton scores were similar between groups, as was the proportion with joint hypermobility. Scores were higher in girls (3.1 ± 2.4) than boys (2.3 ± 1.8; P = .004) and decreased with age (P < .001; r = -0.25). Race and body mass index did not impact joint hypermobility prevalence. Beighton scores were not related to abdominal pain or stooling characteristics. Participants with a score of ≥4 and ≥6 had greater somatization and depression by child report (P = .017 and P = .048, respectively). No association was seen for anxiety. There was no significant association between joint hypermobility and psychosocial distress measures per parent report.

Conclusions: Contrary to the adult literature, the prevalence of joint hypermobility does not differ among children with irritable bowel syndrome, functional abdominal pain, or healthy control children. The presence or severity of joint hypermobility does not correlate with abdominal pain or stooling characteristics. Somatization and depression by child report appear to have a relationship with joint hypermobility.