Functional abdominal pain in childhood and adolescence increases risk for chronic pain in adulthood

Abstract

A few studies of long-term outcomes for pediatric functional abdominal pain (FAP) have assessed acute non-abdominal pain at follow-up, but none has assessed chronic pain. We followed a cohort of pediatric patients with FAP (n = 155) and a well control group (n = 45) prospectively for up to 15 years. Participants ranged in age from 18 to 32 years at a follow-up telephone interview. FAP patients were classified as Resolved (n = 101) versus Unresolved (n = 54) at follow-up, based on whether they reported symptoms consistent with the adult Rome III criteria for a functional gastrointestinal disorder. Headache symptoms and reports of chronic non-abdominal pain also were assessed at follow-up. In the Unresolved group, 48.1% reported one or more sites of chronic non-abdominal pain at follow-up, compared to 24.7% in the Resolved group and 13.3% in the control group, p < 0.01. More than half (57.4%) of the Unresolved group endorsed symptoms consistent with International Headache Society criteria for headache, compared to 44.6% of the Resolved group and 31% of controls, p < 0.05. One-third of the Unresolved group reported both headache and one or more sites of chronic non-abdominal pain at follow-up, compared to 17.8% of the Resolved group and 4.4% of controls. Youth with FAP that persists into adulthood may be at increased risk for chronic pain and headache. Examination of central mechanisms that are common across chronic pain disorders may enhance understanding of this subgroup of FAP.

Is Resolution of Chronic Pain Associated With Changes in Blood Pressure-related Hypoalgesia?

“…Participants were recruited from a sample participating in a large prospective study of adolescents and young adults with childhood functional abdominal pain [25][26][27]. Participants from the original study had presented to the Vanderbilt Pediatric Gastroenterology Clinic for evaluation of chronic abdominal pain when they were 8-16 years old.…”

“…To address this gap in the literature and build upon our prior work [25][26][27], in this study, we examined the effect of resolution of chronic pain on BP-related hypoalgesic mechanisms as they relate to responses to both static and dynamic evoked pain stimuli. Specifically, we compared young adults with a known childhood history of functional abdominal pain in whom the condition had resolved versus not resolved at the time of testing, regarding the associations between resting BP and thermal pain threshold, tolerance, and temporal summation.…”

Lėtinis vaikų skausmas biopsichosocialiniu požiūriu: samprata, įvertinimo ir gydymo strategija

“…Taigi nepakankamai sprendžiant lėtinio skausmo problemas vaikystėje ar paauglystėje, didėja rizika šiems ligoniams ir ateityje turėti funkcinę negalią bei psichologinių problemų [30]. Be to, ilgalaikiai tyrimai pateikia įtikina-mų įrodymų, kad negydomas skausmas, patirtas vaikystė-je, dažnai tęsiasi ir pasireiškia naujomis skausmo formomis suaugus [31].…”

How to Deal with Pediatric Functional Gastrointestinal Disorders

“…Another study which prospectively followed youth with FAP for up to 15 years found that they may be at increased risk for chronic pain and headache [50]. The most long lasting benefit among the different treatments for childhood FGID seems to be the gut-directed hypnotherapy.…”