The Mediterranean Pediatric
FGIDs Project
Dr. Elena Scarpato
M.D. “Federico II” University of Naples
FGIDs

Functional Gastrointestinal Disorders (FGIDs) include
a variable combination of age-dependent, chronic or
recurrent gastrointestinal symptoms not otherwise
explained by structural or biochemical abnormalities

Diagnosis and therapy of the FGIDs in children are
not standardized and may vary between countries.
FGIDs Project: PRELIMINARY DATA

We have already performed, via an informal network including Pediatric
Gastroenterological centers located in several European-Mediterranean
Countries, a survey on prevalence, diagnosis and treatment of FGIDs or
Irritable Bowel Syndrome (IBS) alone.

A standardized questionnaire was submitted to nine Paediatric
Gastroenterological Centres (PC) located in Mediterranean countries:
- Staiano Annamaria (coordinator), University Federico II, Naples, ITALY
- Attard Thomas, University of Malta, Med School, Guardamangia, MALTA
- Durmaz Ozlem, Istanbul University, Istanbul, TURKEY
- Irastorza Inaki, Hospital Universitario de Cruces, Bilbao, SPAIN
- Kolaček Sanja, Children's Hospital, Zagreb, CROATIA
- Koleilat Aziz, Makassed University General Hospital, Beirut, LEBANON
- Papadopoulou Alexandra, Children's Hospital P & A Kyriakou, Athens, GREECE
- Roma Eleftheria, Aghia Sophia Children’s Hospital, Athens, GREECE
- Shamir Raanan, Schneider Children's Medical Center of Israel, Tel Aviv, ISRAEL
The Questionnaire
The questionnaire
included different items
assessing:
- Cultural, psychosocial
and dietary factors
- Epidemiology
- Clinical diagnosis and
use of Rome Criteria
- Treatment
Preliminary Data

Our preliminary data indicate that IBS prevalence is not
known and diagnostic approach and treatment varies
widely from Country to Country, and particularly so in
pediatric patients.

Even less is known on prevalence, diagnosis and
treatment of all the other FGIDs.
Preliminary Data

Our data indicate that FGIDs represent a real
problem also in the Balkans and in Africa.

For this reason it is essential to correctly
diagnose these disorders in order to optimize the
use of economic resources and avoid
unnecessary investigations (Eg: EGDS)
FGIDs Project: AIMS
1) To Assess
- FGIDs prevalence
- Modality of diagnosis and use of Rome Criteria
- Way of treatment of these disorders in different Countries
2) To Standardize diagnostic algorithms and treatments of FGIDs
3) To Establish a European- Mediterranean network to share know-how
and technology for the diagnosis and management of FGIDs
Expected Results
To obtain
 clear definition of FGIDs prevalence
 dissemination of knowledge and practical skills
for the identification and management of FGIDs
 establishment of a network, expanded in the
field outside the reference hospitals
Organization

Prevalence studies will be performed in the different centers.
For each country, a coordinator will identify the first level health
professionals fairly distributed across the entire national territory, in order
to have the more reliable data on prevalence

A survey will be conducted to evaluate current implementation of guidelines
in clinical practice. A representative from each involved center will be asked
to complete a one page questionnaire investigating his approach to patients
with FGIDs suggestive symptoms

The ‘hub & spoke’ methodology will be adopted for the progressive training
at national level.
Organization

A multi-lingual project web site helps to share diagnostic guidelines,
online consultations, data sharing and analysis, teleconferences

Training materials, for different levels and cultures, will be available
on line

The applicability of guidelines will be evaluated based on the number
of patients managed in full compliance with guidelines by trained
pediatricians.
Gustav Klimt, Le tre età della donna - 1905