Location: Children's Nutrition Research CenterTitle: Multisite pain is highly prevalent in children with functional abdominal pain disorders and is associated with increased morbidity
|CHUMPITAZI, BRUNO - Baylor College Of Medicine|
|PALERMO, TONYA - Seattle Children'S Research Institute|
|HOLLIER, JOHN - Baylor College Of Medicine|
|SELF, MARIELLA - Baylor College Of Medicine|
|CZYZEWSKI, DANITA - Baylor College Of Medicine|
|WEIDLER, ERICA - Children'S Nutrition Research Center (CNRC)|
|HEITKEMPER, MARGARET - University Of Washington|
|SHULMAN, ROBERT - Children'S Nutrition Research Center (CNRC)|
Submitted to: Journal of Pediatrics
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 4/27/2021
Publication Date: 4/30/2021
Citation: Chumpitazi, B.P., Palermo, T.M., Hollier, J.M., Self, M.M., Czyzewski, D., Weidler, E.M., Heitkemper, M., Shulman, R.J. 2021. Multisite pain is highly prevalent in children with functional abdominal pain disorders and is associated with increased morbidity. Journal of Pediatrics. https://doi.org/10.1016/j.jpeds.2021.04.059
Interpretive Summary: When physicians see patients with chronic belly pain they often note that these patients also complain of other pains like headaches. This study showed that children with chronic belly pain actually do often have other types of chronic pain. Importantly, having other pains besides belly pain is related to worse belly pain and more psychological stress than children with just belly pain alone. Additional research is needed that further evaluates the pathways and association of the gut to that of other pain felt by the individual.
Technical Abstract: To characterize the types of multisite pain experienced by children with functional abdominal pain disorders (FAPDs) and to examine differences in psychosocial distress, functional disability, and health-related quality of life in children with multisite pain vs abdominal pain alone. Cross-sectional study of children ages 7-17 years (n = 406) with pediatric Rome III FAPDs recruited from both primary and tertiary care between January 2009 and June 2018. Subjects completed 14-day pain and stool diaries, as well as validated questionnaires assessing abdominal and nonabdominal pain symptoms, anxiety, depression, functional disability, and health-related quality of life. In total, 295 (73%) children endorsed at least 1 co-occurring nonabdominal pain, thus, were categorized as having multisite pain with the following symptoms: 172 (42%) headaches, 143 (35%) chest pain, 134 (33%) muscle soreness, 110 (27%) back pain, 94 (23%) joint pain, and 87 (21%) extremity (arms and legs) pain. In addition, 200 children (49%) endorsed 2 or more nonabdominal pain symptoms. Participants with (vs without) multisite pain had significantly higher abdominal pain frequency (P < .001) and severity (P = .03), anxiety (P < .001), and depression (P < .001). Similarly, children with multisite pain (vs without) had significantly worse functional disability (P < .001) and health-related quality of life scores (P < .001). Increasing number of multisite pain sites (P < .001) was associated with increased functional disability when controlling for demographic and other clinical factors. In children with FAPDs, nonabdominal multisite pain is highly prevalent and is associated with increased psychosocial distress, abdominal pain frequency and severity, functional disability, and lower health-related quality of life.