Location: Children's Nutrition Research CenterTitle: Maintenance of pain in children with functional abdominal pain
|CZYZEWSKI, DANITA - Baylor College Of Medicine|
|SELF, MARIELLA - Baylor College Of Medicine|
|WILLIAMS, AMY - Indiana University School Of Medicine|
|WEIDLER, ERICA - Children'S Nutrition Research Center (CNRC)|
|BLATZ, ALLISON - George Washington University Medical Center|
|SHULMAN, ROBERT - Children'S Nutrition Research Center (CNRC)|
Submitted to: Journal of Pediatric Gastroenterology and Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 8/14/2015
Publication Date: 3/1/2016
Citation: Czyzewski, D.I., Self, M.M., Williams, A.E., Weidler, E.M., Blatz, A.M., Shulman, R.J. 2016. Maintenance of pain in children with functional abdominal pain. Journal of Pediatric Gastroenterology and Nutrition. 62(3):393-398.
Interpretive Summary: A lot of children with abdominal pain develop chronic pain. We investigated what factors may be associated with abdominal pain becoming a long term problem. We found that children who had pain associated with changes in stooling pattern were most likely to develop long term belly pain. These children are known often to find that certain foods make their pain worse. These results will help us identify children most at risk for developing long term belly pain and intervene early with dietary management.
Technical Abstract: A significant proportion of children with functional abdominal pain develop chronic pain. Identifying clinical characteristics predicting pain persistence is important in targeting interventions. We examined whether child anxiety and/or pain-stooling relations were related to maintenance of abdominal pain frequency and compared the predictive value of 3 methods for assessing pain-stooling relations (ie, diary, parent report, child report). Seventy-six children (7-10 years old at baseline) who presented for medical treatment of functional abdominal pain were followed up 18 to 24 months later. Baseline anxiety and abdominal pain-stooling relations based on pain and stooling diaries and child- and parent questionnaires were examined in relationship to the persistence of abdominal pain frequency. Children's baseline anxiety was not related to persistence of pain frequency. Children who, however, displayed irritable bowel syndrome (IBS) symptoms at baseline maintained pain frequency at follow-up, whereas in children in whom there was no relationship between pain and stooling, pain frequency decreased. Pain and stool diaries and parent report of pain-stooling relations were predictive of pain persistence but child-report questionnaires were not. The presence of IBS symptoms in school-age children with functional abdominal pain appears to predict persistence of abdominal pain over time, whereas anxiety does not. Prospective pain and stooling diaries and parent report of IBS symptoms were predictors of pain maintenance, but child report of symptoms was not.