Prevalence of Symptoms, Blood Marker Positivity, and FCal Positivity by Final Diagnosis
| Diagnosis | No. (%) | Symptom Positive,a No. | Blood Marker Positive,b No. | FCal >50 μg/g, No. | Range of FCal, μg/g |
|---|---|---|---|---|---|
| Primary care cohort | |||||
| Functional gastrointestinal disorder | 108 (95) | 24 | 9 | 12 | 20–257 |
| Gastroenteritisc | 5 (45) | 0 | 0 | 1 | 20–88 |
| Declined endoscopy | 1 (1) | 1 | 0 | – | – |
| Referred cohort | |||||
| IBD | |||||
| Crohn disease | 7 (8) | 7 | 7 | 6 | 152–2,823 |
| Ulcerative colitis | 8 (9) | 7 | 4 | 8 | 53–916 |
| IBD unclassified | 2 (2) | 2 | 1 | 2 | 79–778 |
| Non-IBD | |||||
| Functional gastrointestinal disorder | 66 (73) | 40 | 12 | 10 | 20–185 |
| Gastroenteritisc | 3 (3) | 1 | 0 | 0 | 20–45 |
| Reflux esophagitis | 1 (1) | 0 | 0 | 0 | 22 |
| Celiac disease | 1 (1) | 1 | 0 | 0 | 20 |
| Solitary rectal ulcer | 1 (1) | 1 | 0 | 1 | 299 |
FCal = fecal calprotectin; IBD = inflammatory bowel disease.
↵a Presence of 1 or more of the following: growth failure, involuntary weight loss, rectal blood loss, extraintestinal symptoms, perianal lesions, family history of IBD.
↵b Hemoglobin (4–12 years old <7.1 mmol/L; 12–18 years old: boys <8.1 mmol/L, girls <7.4 mmol/L), C-reactive protein (>10 mg/L), erythrocyte sedimentation rate (>20 mm/h), platelet count(>450 × 109/L).
↵c Due to Salmonella enterica (0 cases included by primary care physician; 2 cases included by pediatrician), Shiga toxin–producing Escherichia coli (STEC) (1 and 0), and Giardia lamblia (4 and 1).
Note: One child declined endoscopy and evaluation of red flags at 12 months’ follow-up, so the diagnosis was unknown. Nine children without IBD, including 1 child with a solitary rectal ulcer, underwent upper and lower endoscopy, including ileal intubation. The remaining 3 children did not undergo complete endoscopic evaluation for various reasons: the colonoscopy was prematurely terminated because of mucosal bleeding in 1 child with a functional gastrointestinal disorder, but was not repeated because symptoms subsided; 1 child with a functional gastrointestinal disorder underwent colonoscopy only, but not esophagogastroduodenoscopy; and 1 child received a diagnosis of celiac disease by esophagogastroduodenoscopy only.