Location: Children's Nutrition Research CenterTitle: Complementary and alternative medicine (CAM) use in children with functional abdominal pain (FAP) and irritable bowel syndrome (IBS) differs in tertiary vs. primary care and is related to mother's view of child disability Author
Submitted to: Gastroenterology
Publication Type: Abstract Only
Publication Acceptance Date: 4/1/2009
Publication Date: 5/1/2009
Citation: Weidler, E., Lane, M., Czyzewski, D.I., Shulman, R.J. 2009. Complementary and alternative medicine (CAM) use in children with functional abdominal pain (FAP) and irritable bowel syndrome (IBS) differs in tertiary vs. primary care and is related to mother's view of child disability [abstract]. Gastroenterology. 136(5 Suppl.1):A215-A216. Interpretive Summary:
Technical Abstract: We sought to determine if CAM use was greater in children in tertiary vs. primary care, and whether child or parent report of pain characteristics, and/or child and mother's psychological characteristics differed between those who did/did not use CAM. We identified children 7-10 years of age with FAP or IBS using Pediatric Rome II criteria. Children were managed solely in primary care by their pediatrician (PED, n= 43) or were receiving tertiary care from a pediatric gastroenterologist (GI, n= 40). Parents were contacted and further screening by phone was done to ensure that children met the criteria. Children completed a 2-wk daily pain diary (pain frequency, severity, pain interference with activities). Children and mothers completed the Behavior Assessment System for Children (BASC) and the Symptoms Checklist version 90-R (SCL-90-R) to measure anxiety, depression, and somatization. Mothers rated the child's pain severity and interference with activities. Mothers also completed a validated questionnaire regarding the use of CAM in the treatment of their child's FAP/IBS. There was no difference between the groups with regard to the child's gender, child's ethnicity, mother's education level, or socioeconomic status based on the family's insurance carrier. Overall, 65% of parents of FAP/IBS children (combining GI and PED groups) reported having used at least one form of CAM, with many using more than one form of treatment (100 treatments in 54 children). The most common form of CAM used was spiritual healing or prayer (29%; n=24). Use of herbal remedies was more prevalent in the GI group (P = 0.01), but there was no difference in overall frequency of CAM use for children in the GI vs. PED group. The mother's report of interference with activities was related to the use of CAM treatments (P = 0.04), but the child's self report was not. Neither the child's self report or parent's report of pain severity or frequency, or the parent or child's report of psychological characteristics were related to the use of CAM treatments. Conclusions are 1) CAM use is prevalent in children with FAP and IBS; 2) Herbal remedies are used more frequently by children in tertiary care; 3) The mother's report of pain interfering with activities is related to CAM use in both tertiary and primary care patients.