Increased Somatic Complaints and Health-Care Utilization in Children: Effects of Parent IBS Status and Parent Response to Gastrointestinal Symptoms

Abstract

(i) Frequent GI complaints in children whose mothers have irritable bowel are not explained by the mother's biased perceptions; (ii) children of mothers with irritable bowel have more non-GI as well as GI symptoms, disability days, and clinical visits; (iii) and parent IBS status and solicitous responses to illness have independent effects on the child's symptom complaints.

Validation of a Measure of Protective Parent Responses to Children's Pain

“…Mothers who participated in the original study by Levy and colleagues 4 completed a research protocol that included the parent report version of the ARCS as a paper questionnaire, and their children completed a child report version of this questionnaire. These protocols were completed in their homes or at their HMO clinic, according to the family's preference.…”

“…4 The sample for the larger study (n = 449) included families with children between the ages of 8 and 15 years and in which no family member had a diagnosis of ulcerative colitis or Crohn disease. Approximately half of the mothers who were enrolled in the primary study had received a diagnosis of irritable bowel syndrome at a health care visit to the HMO, Group Health Cooperative of Puget Sound.…”

“…The stem for each item is, "When your child has abdominal pain, how often do you …?" Responses are rated on a 5-point scale ranging from "never" (0) to "always" (4). Items refer to protective parental behavior such as giving the child special attention and limiting the child's normal activities and responsibilities.…”

“…For example, solicitous behavior by spouses is associated with increased pain complaints and disability in adults with chronic pain. [1][2][3] Similarly, the pediatric literature shows that increased attention from parents is associated with higher levels of pain complaints and disability in children with chronic pain [4][5][6][7] and delayed recovery by children undergoing painful oral surgery. 8 This research is grounded in social learning theory 9 and the findings have been interpreted as evidence that significant others may reinforce patients' pain behavior.…”

Development of irritable bowel syndrome may be associated with a parental history of bowel problems

“…In fact, it has been reported that children of mothers with IBS have more somatic as well as GI symptoms, disability days and clinical visits. 6 The recent genetic studies on the serotonin transporter (SERT) gene-linked polymorphic region (5-HTTLPR) revealed that IBS is not equivalent to SERT dysfunction but SERT dysfunction may contribute to behavioural and functional gut disorders. 7 In the further research on epidemiological studies for IBS, such genetic and environmental (e.g.…”