Risk factors of recurrent abdominal pain in adolescents

Muzal Kadim; Anjar Setiani; Aryono Hendarto

doi:10.14238/pi61.3.2021.141-8

Muzal Kadim Gastrohepatology Division, Child Health Department, University of Indonesia, RSCM Hospital
Anjar Setiani
Aryono Hendarto

DOI: https://doi.org/10.14238/pi61.3.2021.141-8

Keywords: adolescent, reccurent abdominal pain, risk factor, Rome III

Abstract

Background Recurrent abdominal pain is 2-4% of all cases encountered by pediatricians. Risk factors vary among countries. There is no data on prevalence and risk factors of recurrent abdominal pain in adolescents in Indonesia.

Objective To evaluate prevalence and risk factors of recurrent abdominal pain in junior high school students.

Methods A cross-sectional study was performed among junior high school students in South Jakarta who experienced recurrent abdominal pain according to Roma III criteria. Students allowed by their parents to participate to this study were asked to complete a Roma III questionnaire. Data about sociodemographic and history of recurrent abdominal pain among the parents were also collected using a questionnaire.

ResultsThree hundred ninety-six adolescents participated in this study, 17.2% among them experiencing recurrentabdominal pain. Irritable bowel syndrome (IBS) was the most common type (42.6%), followed by functional dyspepsia (30.9%), functional abdominal pain syndrome (11.8%), functional abdominal pain (10.3%), and abdominal migraine (4.4%). The risk factor most responsible was anxious personality (OR 3.86; 95%CI 2.05 to 7.29, P<0.001). Other risk factors that contribute were female, age > 13 years, and middle to lower family income.

Conclusions Prevalence of recurrent abdominal pain in adolescents is 17.2%. Irritable bowel syndrome is the most common type. The risk factors are anxious personality, female, age > 13 years, and middle to lower family income.

References

1. Pace F, Zuin G, Giacomo SD, Molteni P, Casini V, Fontana M, et al. Family history of irritable bowel syndrome is the major determinant of persistent abdominal complaints in young adlts with a history of pediatric recurrent abdominal pain. World J Gastroenterol. 2006;12:3874-7. DOI: 10.3748/wjg.v12.i24.3874.
2. Stordal K, Nygaard EA, Bentsen B. Organic abnormalities in recurrent abdominal pain in children. Acta Paediatr. 2001;90:638-42. PMID: 11440096.
3. Devarayana NM, Rajindrajith S, De Silva HJ. Recurrent abdominal pain in children. Indian Paediatr. 2009;46:389-96. PMID: 19478352.
4. Boey CC, Yap S, Goh KL. The prevalence of recurrent abdominal pain in 11- to 16 years- old Malaysian school children. J Paediatr Child Health. 2000;36:114-6. DOI: 10.1046/j.1440-1754.2000.00465.x.
5. Boey CC, Goh KL. Predictors of recurrent abdominal pain among 9 to 15 –year-old urban school children in Malaysia. Acta Paediatr. 2001;90:353-5. PMID: 11332181.
6. Rasul CH, Khan MAD. Recurrent abdominal pain in school children in Bangladesh. J Ceylon Coll Physicians. 2000;33:110-4.
7. Devarayana NM, de Silva DGH, de Silva HJ. Recurrent abdominal pain syndrome in cohort of Sri Lanka children and adolescents. J Trop Pediatr. 2008;54:178-83. DOI: 10.1093/tropej/fmm114.
8. Devarayana NM, de Silva DGH, de Silva HJ. Aetiology of recurrent abdominal pain in a cohort of Sri Lankan children. J Paediatr Child Health. 2008;44:195–200. DOI: 10.1111/j.1440-1754.2008.01295.x.
9. Huang RC, Plamer LJ, Forbes DA. Prevalence and pattern of childhood abdominal pain in an Australian general practice. J Paediatr Child Health. 2000;36:349-53. DOI: 10.1046/j.1440-1754.2000.00513.x.
10. Hyam SJ, Hyman EP. Recurrent abdominal pain and the biopsychosocial model of medical perctice. J Paediatr.1998;133:473-8. DOI: 10.1016/s0022-3476(98)70053-8.
11. Ramchandani PG, Stein A, Hotopf M, Wiles NJ; ALSPAC study team. Early parental and child predictors of recurrent abdominal pain at school age: results of a large population-based study. J Am Acad Child Adolesc Psychiatry 2006;45:729-36. DOI: 10.1097/01.chi.0000215329.35928.e0.
12. Ioannis X, Antigoni M, Natalia N, Konstantina V, Ioanna K, Kleomenis S, et al. The role of psychosocial factors in children with recurrent abdominal pain. Pediat Therapeut. 2013;3:1-5. DOI; 10.4172/2161-0665.1000170.
12.13. Apley J, Naish N. Recurrent abdominal pains: A field survey of 1.000 school children. Arch Dis Child. 1958;33:165-70. DOI: 10.1136/adc.33.168.165.
13.14. Rasquin A, Di Lorenzo C, Forbes D, Guiraldes E, Hyams J, Staiano A, et al. Childhood functional gastrointestinal disorders: child/adolescent. Gastroenterology 2006;130:1527-37. DOI: 10.1053/j.gastro.2005.08.063.
15. Lundh, L.G., Wangby-Lundh, M., & Bjarehed, J Self reported emotional and behavioral problems in Swedish 14 to 15-year-old adolescents: A study with the self-report version of the Strengths and Difficulties Questionnaire. 2008 Scand J Psycol 49:523–532. DOI: 10.1111/j.1467-9450.2008.00668.x.
16. El-Matary W, Spray C, Sandhu B. Irritable bowel syndrome: the commonest cause of recurrent abdominal pain in children. Eur J Pediatr. 2004;163:584-8. DOI: 10.1007/s00431-004-1503-0.
17. Walker LS, Lipani TA, Greene JW, Caines K, Stutts J, Polk DB, et al. Recurrent abdominal pain: symptom subtypes based on the Rome II Criteria for pediatric functional gastrointestinal disorders. J Pediatr Gastroenterol Nutr. 2004;38:187-91. DOI: 10.1097/00005176-200402000-00016.
18. Schurman JV, Friesen CA, Danda CE, Andre L, Welchert E, Lavenbarg T, et al. Diagnosing functional abdominal pain with the Rome II criteria: parent. child. and clinician agreement. J Pediatr Gastroenterol Nutr. 2005;41:291-5. DOI: 10.1097/01.mpg.0000178438.64675.c4
19. Ramchandani PG, Hotopf M, Sandhu B, Stein A. The epidemiology of recurrent abdominal pain from 2 to 6 years of age:results of a large. Population-based study. Pediatric. 2005;116:46-50. DOI: 10.1542/peds.2004-1854.
20. Olafsdottir E, Ellertsen B, Berstad A, Fluge G. Personality profiles and heart rate variability (vagal tone) in children with recurrent abdominal pain. Acta Paediatr.2001;90: 632-7. PMID: 11440095.
14.21. Walker LS, Smith CA, Garber J, Claar RL. Appraisal and coping with daily stressors by pediatric patients with chronic abdominal pain. J Pediatr Psychol.2007;32:206–16. DOI: 10.1093/jpepsy/jsj124.
15.22. Kaminsky L, Robertson M, Dewey D. Psychological correlates of depression in children with recurrent abdominal pain. J Pediatr Psychol.2006;31:956–66. DOI: 10.1093/jpepsy/jsj103.
23. Bode G, Brenner H, Adler G, Rothenbacher D. Recurrent abdominal pain in children. Evidence from a population-based study that social and familial factors play a major role but not Helicobacter pylori infection. J Psychosom Res. 2003;54:417-21. DOI: 10.1016/s0022-3999(02)00459-2
24. Campo JV, Bridge J, Lucas A, Savorelli S, Walker L, Lorenzo CD, et al. Physical and emotional health of mothers of youth with functional abdominal pain.Arch Pediatr Adolesc Med. 2007;161:131–7. DOI: 10.1001/archpedi.161.2.131.
25. Cuomo R, Andreozzi P, Zito FP, Passananti V, De Carlo G, Sarnelli G. Irritable bowel syndrome and food interaction. World J Gastroenterol. 2014;20:8837–8845. DOI: 10.3748/wjg.v20.i27.8837.