Zelal AYDIN, Elif Selcen YABANCI ERTEN, Feray KAYA, Elif KÜÇÜK, Lütfiye KORU, Eda Nur DİZMAN, Hatice Kübra DURSUN, Merve Özen BALCI, Ufuk Furkan ÖZDEMİR, Fatih HASLAK, Kübra ÖZTÜRK
Türkiye Çocuk Hastalıkları Dergisi - 2026;20(3):166-170
Objective: Periodic Fever, Aphthous Stomatitis, Pharyngitis, and Adenitis (PFAPA) syndrome is one of the most common autoinflammatory diseases of childhood. Although gastrointestinal system (GIS) complaints are reported, bowel habits have not been objectively evaluated in these patients. This study investigated changes in bowel habits before and after treatment in children with PFAPA using the Bristol Stool Scale and daily stool frequency. Materials and Methods: We included 101 children diagnosed with PFAPA according to the EUROFEVER/PRINTO criteria. Clinical, laboratory, daily stool frequency, and stool form were evaluated during febrile attacks before and after treatment. Stool form was evaluated using the Bristol Stool Scale and classified as hard (types 1-3), normal (type 4), and loose (types 5-7). Results: Following treatment, median daily stool frequency during attacks decreased (2 [0.25-10] vs. 1 [0.25-6]; p=0.008), while stool form assessed by the Bristol Stool Scale remained unchanged (4 [1-7] vs. 4 [1-7]; p=0.943). No significant difference was observed in stool consistency categories (p=0.174). In the probiotic group, patients with normal stool form increased from 53.6% (n=15) pre-treatment to 57.1% (n=16) post-treatment. Conclusion: To our knowledge, this study is the first to objectively evaluate bowel habits in children with PFAPA syndrome. Following treatment, stool frequency during episodes decreased significantly, while stool form remained unchanged. These results indicate that post-treatment alterations in bowel habits are primarily related to stool frequency. Future studies incorporating fecal biomarkers may provide further insights into gastrointestinal involvement and potential subclinical intestinal inflammation in PFAPA.
