The Turkish Journal of Pediatrics 2021 , Vol 63 , Num 2
Is there a relationship between joint hypermobility and gastrointestinal disorders in children?
Paolo Quitadamo 1-2 ,Nikhil Thapar 3 ,Giovanni Di Nardo 4 ,Matilde Pescarin 3-5 ,Luca Bertelli 5 ,Clelia Tortora 1 ,Osvaldo Borrelli 3 ,Roberto De Giorgio 6 ,Annamaria Staiano 1
1 Department of Translational Medical Science, Section of Pediatrics, University of Naples “Federico II”
2 Department of Pediatrics, A.O.R.N. Santobono-Pausilipon, Naples, Italy
3 Gastroenterology Unit, Great Ormond Street Hospital, London, United Kingdom
4 Pediatric Unit, NESMOS Department, Faculty of Medicine & Psychology, Sapienza University of Rome, S. Andrea University Hospital, Rome, Italy
5 Department of Medicine-DIMED, University of Padova, Padova, Italy
6 Internal Medicine Unit, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
DOI : 10.24953/turkjped.2021.02.015 Background. The main aim of the study was to assess the association between joint hypermobility (JH) and gastrointestinal (GI) disorders in children.

Methods. All children aged 4-17 years attending the clinics of the participating Pediatric Gastroenterology Centres for functional GI disorders (FGIDs) and inflammatory bowel disease (IBD) were screened for joint laxity. JH diagnosis was inferred using the Beighton Score. JHS diagnosis was inferred based on the Brighton Criteria. Rome III Diagnostic Criteria were used to diagnose possible FGIDs. Ulcerative colitis and Crohn`s disease diagnoses were made according to the Porto Criteria. Age and sex- matched healthy children were enrolled as controls.

Results. One-hundred-seventy children with GI disorders (70 with FGIDs, 50 with Crohn`s disease, and 50 with ulcerative colitis) and 100 healthy controls were enrolled in the study. JH was reported in 7/70 (10%) children with FGIDs (p=0.26 compared to controls), 4/50 (8%) children with Crohn`s disease (p=0.21 compared to controls) and 15/50 (30%) children with ulcerative colitis (p=0.09 compared to controls; p=0.01 compared to FGIDs; p=0.01 compared to Crohn`s).

Conclusions. JH is more prevalent in patients suffering from ulcerative colitis compared to the healthy general population, yet the difference did not reach statistical significance. Likely, a proportion of children with ulcerative colitis and JH may show connective tissue abnormalities. However, whether JH can be considered a possible feature of pediatric GI disorders deserves further investigation. Keywords : joint hypermobility, joint hypermobility syndrome, inflammatory bowel disease, ulcerative colitis, children

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