The Epidemiology of Recurrent Abdominal Pain From 2 to 6 Years of Age: Results of a Large, Population-Based Study

Ramchandani, Paul; Hotopf, Matthew; Sandhu, Bhupinder; Stein, Alan

doi:10.1542/peds.2004-1854

Cited by 109 publications

(98 citation statements)

References 25 publications

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“…Although not studied yet, explanations for this age peak might be school attendance and its associated anxieties. The observed age peak of 12 to 16 years for girls in our study might be explained by menarche or dysmenorrhea.In the medical literature a variety of expressions are used for childhood nonorganic abdominal pain: recurrent abdominal pain; 1,3,20,22 chronic abdominal pain; 23,24 functional abdominal pain; 25 and nonspecifi c abdominal pain.26,27 Most of these terms include a minimal duration of abdominal pain, usually 3 months. This time criterion was arbitrarily set by Apley et al, who were the fi rst to describe the pain syndrome in 1958.…”

mentioning

confidence: 99%

Childhood Nonspecific Abdominal Pain in Family Practice: Incidence, Associated Factors, and Management

Gieteling¹,

Leeuwen²,

Wouden³

et al. 2011

The Annals of Family Medicine

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PURPOSE Nonspecifi c abdominal pain (NSAP) is a common complaint in childhood. In specialist care, childhood NSAP is considered to be a complex and time-consuming problem, and parents are hard to reassure. Little is known about NSAP in family practice, but the impression is that family physicians consider it to be a benign syndrome needing little more than reassurance. This discrepancy calls for a better understanding of NSAP in family practice.METHODS Data were obtained from the Second Dutch National Survey of General Practice (2001). Using registration data of 91 family practices, we identifi ed children aged 4 to 17 years with NSAP. We calculated the incidence, and we studied factors associated with childhood NSAP, referrals, and prescriptions. RESULTSThe incidence of NSAP was 25.0 (95% confi dence interval [CI], 23.7-26.3) per 1,000 person years. Most children (92.7%) with newly diagnosed NSAP (N = 1,480) consulted their doctor for this condition once or twice. Factors independently associated with NSAP were female sex (odds ratio [OR] = 1.4; 95% CI, 1.3-1.5), nongastrointestinal-nonspecifi c somatic symptoms (OR = 1.3; 95% CI, 1.1-1.5), and health care use (OR = 1.04; 95% CI, 1.03-1.05). When NSAP was diagnosed at the fi rst visit, 3% of the patients were referred to specialist care, and 1% received additional testing. Family physicians prescribed medication in 21.3% of the visits for NSAP.CONCLUSIONS Childhood NSAP is a common problem in family practice. Most patients visit their doctor once or twice for this problem. Family physicians use little additional testing and make few referrals in their management of childhood NSAP. Despite the lack of evidence for effectiveness, family physicians commonly prescribe medication for NSAP. Ann Fam Med 2011;9:337-343. doi:10.1370/afm.1268. INTRODUCTIONA bdominal pain is a common complaint in children worldwide. 1 Although its effect on a child's well-being is considerable, and it leads to substantial school absenteeism, 2 childhood abdominal pain is usually not associated with organic disease. 3,4 In this study, we use the expression nonspecifi c abdominal pain (NSAP) for abdominal pain for which the physician does not suspect an organic pathologic cause. Most studies on NSAP are carried out in specialist care and include children with chronic or recurrent abdominal pain.Little is known about childhood NSAP in family practice. In population and school-based studies, the prevalence of NSAP ranges from 4% to 10%. 1 The occurrence of NSAP in family practice has hardly been studied, nor has family physicians' management. The impression is that family physicians consider NSAP in children to be a benign disorder needing little more than reassurance of parent and child. This view, how- 5,7,9 and the high prevalence of prolonged symptoms 11 found in children referred to secondary and tertiary care. In specialist care, childhood NSAP is considered to be a complex and time-consuming problem, and parents of children with NSAP are found to be hard to reassure. 11,12 For...

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confidence: 99%

Childhood Nonspecific Abdominal Pain in Family Practice: Incidence, Associated Factors, and Management

Gieteling¹,

Leeuwen²,

Wouden³

et al. 2011

The Annals of Family Medicine

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“…In a large population-based study, the prevalence of abdominal pains in preschool-age children was found to be high (39.7%) [1]. However in this sample the presence of recurrent abdominal pains (RAP), according to Apley's criteria, was much lower (3.8%-11.8%).…”

mentioning

confidence: 68%

“…Moreover, children with RAP are more likely to experience headache than those without RAP, 27.7% vs. 14.3% at 42 months and 55.4% vs. 37.8% at 81 months, with a statistically significant difference [1].…”

mentioning

confidence: 93%

Headache and recurrent abdominal pains in preschool children

Battistella

Toldo

2006

J Headache Pain

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“…Tilbagevendende funktionelle somatiske symptomer oce i form af mavesmerter, hovedpine, traethed eller smerter i arme eller ben (voksevaerk) udgør betydelige kliniske problemer, idet denne type klager forekommer hos ca. 10-15% af alle børn og hyppigt medfører kontakt til sundhedsvaesenet (Offord 1987, Goodman 1991, Ramchandani 2005. Kontakten sker som regel til egen laege eller paediater grundet symptomernes fysiske karakter.…”

Section: En Udviklingsorienteret Biopsykosocial Tilgang I Klinikkenunclassified

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Rask¹

2005

TFSS

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The Epidemiology of Recurrent Abdominal Pain From 2 to 6 Years of Age: Results of a Large, Population-Based Study

Cited by 109 publications

References 25 publications

Childhood Nonspecific Abdominal Pain in Family Practice: Incidence, Associated Factors, and Management

Childhood Nonspecific Abdominal Pain in Family Practice: Incidence, Associated Factors, and Management

Headache and recurrent abdominal pains in preschool children

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