Abdominal pain-predominant functional gastrointestinal diseases in children and adolescents: prevalence, symptomatology, and association with emotional stress

J Pediatr Gastroenterol Nutr. 2011 Dec;53(6):659-65. doi: 10.1097/MPG.0b013e3182296033.

Abstract

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Abdominal Pain / complications
  • Abdominal Pain / diagnosis
  • Abdominal Pain / epidemiology*
  • Adolescent
  • Child
  • Cross-Sectional Studies
  • Developing Countries
  • Dyspepsia / complications
  • Dyspepsia / diagnosis
  • Dyspepsia / epidemiology
  • Female
  • Gastrointestinal Diseases / complications
  • Gastrointestinal Diseases / diagnosis
  • Gastrointestinal Diseases / epidemiology*
  • Humans
  • Irritable Bowel Syndrome / complications
  • Irritable Bowel Syndrome / diagnosis
  • Irritable Bowel Syndrome / epidemiology
  • Male
  • Migraine Disorders / complications
  • Migraine Disorders / diagnosis
  • Migraine Disorders / epidemiology
  • Prevalence
  • Reproducibility of Results
  • Sri Lanka / epidemiology
  • Stress, Psychological / complications
  • Stress, Psychological / epidemiology*
  • Surveys and Questionnaires