Henoch–Schonlein Purpura Leads to Functional Gastrointestinal Disorders

Background Pain predominant functional gastrointestinal disorders such as irritable bowel syndrome may develop as sequelae to acute infectious gastroenteritis. Henoch–Schonlein purpura is a vaculitis that causes an inflammatory insult to the intestinal mucosa. Objective To assess whether patients with Henoch–Schonlein purpura are more likely to develop functional gastrointestinal disorders in long-term follow-up than controls. Patients and Methods Families of children diagnosed with Henoch–Schonlein purpura from 2002 to 2009 were contacted at least 6 months after an acute episode. Parents completed a validated questionnaire to diagnose functional gastrointestinal disorders according to Rome III criteria. Results Thirty-eight patients (mean 9.9 years, range 3–22 years, 19 males) and 38 controls (mean 9.5 years, range 1–24 years, 21 males) were recruited. Of the patients, 81% had abdominal pain with Henoch–Schonlein purpura presentation. Initial abdominal pain had resolved in all cases. At the time of study, 60.5% patients and 2.6% controls had abdominal pain. Children in Henoch–Schonlein purpura group were diagnosed with various functional gastrointestinal disorders: Irritable bowel syndrome in 11%, functional abdominal pain syndrome in 8%, and functional abdominal pain in 2.8%. Steroid usage was associated with higher incidence of abdominal pain (87.5%) at the time of the study as compared to no steroid usage (40.9%), p = 0.0065. Conclusions Patients with Henoch–Schonlein purpura are at an increased risk of developing pain predominant functional gastrointestinal disorders. The presence of abdominal pain and use of steroids at presentation of Henoch–Schonlein purpura are associated with higher incidence of pain predominant functional gastrointestinal disorders.