Pediatric Rheumatology Online Journal → June 2003 → Health-Related Quality of Life, Disease Activity and Outcome Assessments→ Abstract #29

GASTROINTESTINAL (GI) SYMPTOMS AND HEALTH-RELATED QUALITY OF LIFE (HRQL) IN JUVENILE IDIOPATHIC ARTHRITIS (JIA)

H. I. Brunner, A. C. Barron, T. M. Moore, M. H. Passo, D. J. Lovell

¹Rheumatology, Cincinnati Children

Objective: 1. To quantify GI symptoms of children with JIA using the Gastrointestinal Symptom Scale for Pediatrics (GIPS); 2. To verify for the GIPS reliability, construct validity and quality of parent proxy reporting; 3. To evaluate the relationship of GI symptoms severity and HRQL in JIA.
Methods: A convenience sample of 54 families of JIA patients was interviewed twice (patients (pts) GIPS (7 item scale with yes/no answers; score 0 - 7; 0 = no GI symptoms) and a visual analog scale (VAS-GI). Information on other outcomes was obtained, incl. the Childhood Health Assessment Questionnaire (CHAQ); the Pediatric Quality of Life Inventory Rheumatology Module (PedsQL-R) and Generic Core Scale (PedsQL-G).
Results: 46% of the pts (mean age: 10.3 yrs) had some GI symptoms. Treatments included NSAIDs (n=45), methotrexate (MTX; n=33) and GI protectants (n=21). Intrarater reliability and internal consistency of the GIPS (parent report: weighted kappa= .7; Crohnbachs-GIPS, GI-VAS, PedsQL-R and PedsQl-G (r= .5-.8) were strongly correlated. The mean GIPS score of pts having GI symptoms was 2, with nausea and epigastric pain being most common. Use of MTX (pGIPS scores pGIPS)
Conclusion: The GIPS is a reliable and valid measure of GI symptom severity. GI symptoms are frequent among children with JIA and, if moderate or severe, have a significant negative impact on the HRQL. GI side effects require special consideration for patient management and medication choices in JIA.