Abdominal Pain–Predominant Functional Gastrointestinal Diseases in Children and Adolescents: Prevalence, Symptomatology, and Association With Emotional Stress

• Published in: Journal of pediatric gastroenterology and nutrition Vol. 53; no. 6; pp. 659 - 665
• Main Authors: Devanarayana, Niranga Manjuri, Mettananda, Sachith, Liyanarachchi, Chathurangi, Nanayakkara, Navoda, Mendis, Niranjala, Perera, Nimnadi, Rajindrajith, Shaman
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Copyright by ESPGHAN and NASPGHAN 01-12-2011; Lippincott Williams & Wilkins
• Subjects: Abdominal Pain - complications; Abdominal Pain - diagnosis; Abdominal Pain - epidemiology; Adolescent; Biological and medical sciences; Child; Cross-Sectional Studies; Developing Countries; Dyspepsia - complications; Dyspepsia - diagnosis; Dyspepsia - epidemiology; Feeding. Feeding behavior; Female; Fundamental and applied biological sciences. Psychology; Gastroenterology. Liver. Pancreas. Abdomen; Gastrointestinal Diseases - complications; Gastrointestinal Diseases - diagnosis; Gastrointestinal Diseases - epidemiology; Humans; Irritable Bowel Syndrome - complications; Irritable Bowel Syndrome - diagnosis; Irritable Bowel Syndrome - epidemiology; Male; Medical sciences; Migraine Disorders - complications; Migraine Disorders - diagnosis; Migraine Disorders - epidemiology; Other diseases. Semiology; Prevalence; Reproducibility of Results; Sri Lanka - epidemiology; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Stress, Psychological - complications; Stress, Psychological - epidemiology; Surveys and Questionnaires; Vertebrates: anatomy and physiology, studies on body, several organs or systems; Sri Lanka; Human; Prevalence; Dyspepsia; Metabolic diseases; Epidemiology; Stress; Abdomen; Symptomatology; abdominal pain; Pain; Dysfunction; Abdominal disease; Gastrointestinal diseases; Adolescent; Irritable bowel syndrome; Gastroenterology; functional gastrointestinal disorder; Digestive diseases; Intestinal disease; Child
• ISSN: 0277-2116; 1536-4801
• DOI: 10.1097/MPG.0b013e3182296033

BACKGROUND AND OBJECTIVE:Functional gastrointestinal disorders (FGD) are common among children, but little is known regarding their prevalence in developing countries. We assessed the prevalence of abdominal pain–predominant FGD, in addition to the predisposing factors and symptomatology, in Sri Lankan children.
PATIENTS AND METHODS:A cross-sectional survey was conducted among a randomly selected group of 10- to 16-year-olds in 8 randomly selected schools in 4 provinces in Sri Lanka. A validated, self-administered questionnaire was completed by children independently in an examination setting. FGD were diagnosed using Rome III criteria.
RESULTS:A total of 2180 questionnaires were distributed and 2163 (99.2%) were included in the analysis (1189 [55%] boys, mean age 13.4 years, standard deviation 1.8 years). Of them, 270 (12.5%) had at least 1 abdominal pain–predominant FGD. Irritable bowel syndrome (IBS) was seen in 107 (4.9%), functional dyspepsia in 54 (2.5%), functional abdominal pain in 96 (4.4%), and abdominal migraine (AM) in 21 (1.0%) (2 had AM and functional dyspepsia, 6 had AM and IBS). Extraintestinal symptoms were more common among affected children (P < 0.05). Abdominal pain–predominant FGD were higher in girls and those exposed to stressful events (P < 0.05). Prevalence negatively correlated with age (r = −0.05, P = 0.02).
CONCLUSIONS:Abdominal pain–predominant FGD affects 12.5% of children ages 10 to 16 years and constitutes a significant health problem in Sri Lanka. IBS is the most common FGD subtype present. Abdominal pain–predominant FGD are higher in girls and those exposed to emotional stress. Prevalence of FGD decreased with age. Extraintestinal symptoms are more frequent in affected children.