Submitted to: Children's Health Care
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 10/20/2006
Publication Date: 2/14/2007
Citation: Czyzewski, D.I., Eakin, M.N., Lane, M.M., Jarrett, M., Shulman, R.J. 2007. Recurrent abdominal pain in primary and tertiary care: differences and similarities. Children's Health Care. 36(2):137-153. Interpretive Summary: This study wanted to understand why some children with recurrent abdominal pain go to their pediatricians (RAP Peds) while other go to a gastroenterologist (RAP GI). Children (7-10 years) and mothers in three groups (RAP GI, RAP Peds, and Controls) completed mother and child reports measuring psychological factors. The children’s psychological reports were similar among the three groups. In contrast, the mother’s psychological factors differed among the three groups. Psychological factors in the mothers may partly explain why children go to a pediatric gastroenterologist for recurrent abdominal pain.
Technical Abstract: This study sought to identify child and parent characteristics differentiating children with recurrent abdominal pain seen by a pediatrician (RAP-Peds) from those seen by a gastroenterologist (RAP-GI). Children (7-10 years) and mothers in three groups (RAP-GI, RAP-Peds, and Controls) completed mother and child reports of child’s functional disability, internalizing symptoms, and somatic complaints, and mother report of her anxiety and somatization. Child report did not differentiate groups. RAP mothers were more likely than Control mothers to focus on somatic complaints in themselves and their children. Mother report of child disability was strongly related to tertiary care for child’s recurrent abdominal pain. Pediatric researchers have been exploring the topic of recurrent abdominal pain (RAP) for 40 years since Apley (1975) first described the condition. Refinements in medical assessment and treatment, as well as methodological rigor have shaped and focused this research. No longer is the question “What causes the pain?” because the answer to that is clearly multifaceted. More targeted questions such as “What factors are associated with increased pain and disability?” and “For what portion of the abdominal pain population are these factors relevant?” are the kinds of questions that continue to expand our knowledge of recurrent abdominal pain.