{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T19:15:56Z","timestamp":1790709356736,"version":"4.1.0"},"reference-count":50,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,7,14]],"date-time":"2025-07-14T00:00:00Z","timestamp":1752451200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,7,14]],"date-time":"2025-07-14T00:00:00Z","timestamp":1752451200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. pediatr. gastroenterol. nutr."],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To evaluate the frequency and number of vulnerability factors for the development of pain\u2010predominant disorders of gut\u2013brain interaction (p\u2010DGBI) in a well\u2010defined cohort of pediatric patients and examine associations with pain severity and functional impairment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Retrospective cross\u2010sectional study of patients evaluated in a multidisciplinary abdominal pain program at a pediatric tertiary care center.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Two hundred and fifty\u2010two patients were included, 70.6% female, mean age 13.6\u2009\u00b1\u20093.1 years; 37.3% had functional abdominal pain (FAP), 31.7% irritable bowel syndrome (IBS), and 31.0% functional dyspepsia (FD). At least one vulnerability was reported by 91.3%, with a mean of 2.2\u2009\u00b1\u20091.1 per patient, including early life events (42.9%), mental health problems (51.2%), a family history of mental health (52.4%), or chronic pain (55.2%) conditions. Functional disability scores were higher in patients with more vulnerability factors (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004). There was no association of increased number of vulnerability factors with pain intensity A triggering event precipitating p\u2010DGBI symptoms was reported by 63.9% of patients: gastrointestinal infections (41.0%), extra\u2010intestinal infections (16.1%), psychological stress (15.5%), concussion (8.7%), onset of organic disease (7.5%), medication reaction (5.0%), surgery (4.3%), or physical injury (3.7%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Results support the biopsychosocial model suggesting that patients with p\u2010DGBI are inherently susceptible to developing chronic pain due to biologic vulnerabilities and environmental factors. While infections remain the most reported trigger of p\u2010DGBI symptoms, this study newly identifies other triggers. The association of increased number of vulnerability factors with worse functioning raises the question if there may be a cumulative adverse effect of multiple vulnerability factors.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jpn3.70155","type":"journal-article","created":{"date-parts":[[2025,7,15]],"date-time":"2025-07-15T05:38:59Z","timestamp":1752557939000},"page":"540-550","source":"Crossref","is-referenced-by-count":5,"title":["Vulnerability factors for pediatric disorders of gut\u2013brain interaction and implications for functional impairment"],"prefix":"10.1002","volume":"81","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9303-3474","authenticated-orcid":false,"given":"Beate","family":"Beinvogl","sequence":"first","affiliation":[{"name":"Center for Motility and Functional Gastrointestinal Disorders, Division of Pediatric Gastroenterology Boston Children's Hospital Boston Massachusetts 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