J Clin Outcomes Manage
Recurrent abdominal pain symptoms in childhood: a population-based study
Malaty HM, Tkachenko M, Fraley JK, Abudayyeh S, O'Malley K, Graham DY, Gilger MA
Abstract: Objectives: To characterize the course of children with recurrent abdominal pain (RAP) and to compare patient responses on a newly developed measure for RAP across the different diagnostic categories of RAP. Methods: We enrolled children diagnosed with RAP during their first visit to the pediatric gastroenterology clinic at Texas Children’s Hospital. At their initial visit, the eligible child/parent completed a multidimensional measure for RAP (MM-RAP) consisting of 4 scales (pain intensity scale, nonpain symptoms scale, disability scale, and satisfaction scale). The final diagnosis was defined as the diagnosis at their last visit. Diagnoses were classified as either functional RAP, organic RAP, or predominant gastroesophageal reflux disease (GERD) symptoms. The responses on the MM-RAP were analyzed by 1-way analysis of variance. Results: 141 children aged 4 to 18 years (44% boys) participated. The mean follow-up period was 50 weeks. The final diagnoses were functional RAP in 46%, organic RAP in 24%, and GERD symptoms in 30%. Neither age nor sex predicted the outcome. The total scores for the pain intensity scale were significantly higher among children with functional RAP than organic RAP or GERD symptoms (19.7 ± 3.5 vs. 14.2 ± 4.7 and 13.1 ± 4.2, respectively; P = 0.001). Although the nonpain symptoms total score did not differ between the 3 outcome groups, independent items within the scale (ie, diarrhea, vomiting, and heartburn) were significantly higher among children with organic RAP and GERD symptoms compared with functional RAP. The scores for pain disability and health satisfaction scales were similar among the 3 groups. Conclusions: The MM-RAP discriminated between functional and organic RAP across the studied population. Children with functional RAP report more intense pain than children with organic RAP or GERD symptoms.
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