Article Figures & Data
Tables
- Table 1
Overview of Questions on the Somatic Complaints Syndrome Scale of the Child Behavior Checklist
Questions for Children Aged 4–5 Years Questions for Children Aged 6–16 Years Do you/does your child experience: Do you/does your child experience: Pain in general (without medical explanation; not abdominal pain or headaches)? Pain in general (without medical explanation; not abdominal pain or headaches)? Headaches? Headaches? Nausea, feels sick? Nausea, feels sick? Constipation? Constipation? Vomiting, throwing up? Vomiting, throwing up? Can’t stand having things out of place? Problems with eyes (not if corrected by glasses)? Diarrhea or loose bowels (when not sick)? Rashes or other skin problems? Doesn’t eat well? Nightmares? Painful bowel movements? Feels dizzy or lightheaded? Too concerned with neatness or cleanliness? Overtired without good reason? Predictor CAP (n = 105) No CAP (n = 178) Original OR (95% CI)a Pooled OR (95% CI)b P Valuec Candidate positive predictors Age, mean (SD), y 8.8 (3.2) 8.0 (2.7) 1.10 (1.02–1.20) 1.09 (1.00–1.18) .05 Sex, female, No. (%) 73 (69.5) 104 (58.4) 1.62 (0.97–2.71) 1.47 (0.89–2.44) .14 Dyspepsia, No. (%) 53 (50.5) 74 (44.0) 1.30 (0.79–2.11) 1.27 (0.78–2.06) .33 Waking up at night because of pain, No. (%) 53 (50.5) 56 (31.5) 2.22 (1.35–3.65) 2.08 (1.29–3.36) .003 Overweight, No. (%)d 15 (14.3) 13 (7.3) 2.12 (0.96–4.64) 1.81 (0.82–4.00) .14 High level of other somatic symptoms, No. (%) 28 (26.7) 20 (11.2) 2.87 (1.52–5.42) 2.58 (1.38–4.82) .003 CAP at baseline, No. (%) 58 (55.2) 73 (41.0) 1.78 (1.09–2.89) 1.63 (1.01–2.62) .04 Parent with functional GI complaints, No. (%) 37 (35.6) 49 (28.0) 1.42 (0.85–2.39) 1.60 (0.88–2.90) .13 Candidate negative predictors Vomiting, No. (%) 16 (15.2) 30 (16.9) 0.89 (0.46–1.72) 0.91 (0.47–1.75) .77 Fever, No. (%) 20 (19.0) 28 (15.7) 1.26 (0.67–2.37) 1.23 (0.65–2.31) .52 Dysuria, No. (%) 8 (7.6) 9 (5.1) 1.55 (0.58–4.15) 1.36 (0.31–3.62) .53 Blood on stools, No. (%) 3 (2.9) 4 (2.3) 1.27 (0.28–5.80) 1.15 (0.25–5.29) .86 Epigastric pain, No. (%) 5 (4.9) 20 (12.6) 0.36 (0.13–0.99) 0.45 (0.18–1.10) .08
Additional Files
The Article in Brief
Predictors of Chronic Abdominal Pain Affecting the Well-Being of Children in Primary Care
Leo A. A. Spee , and colleagues
Background Abdominal pain is a frequent complaint among children but its prognosis is difficult to predict. The ability to identify children at risk for long-term abdominal pain would help clinicians make more appropriate management decisions at an earlier stage. This study seeks to identify characteristics that can predict chronic abdominal pain severe enough to influence the child's wellbeing at 1-year follow-up.
What This Study Found More than one in three children coming to a family practice with abdominal pain have persistent pain affecting quality of life after one year. Increased age, waking up at night with pain, high levels of other physical complaints, and chronic abdominal pain at the initial visit independently predict chronic pain at one year. The probability of having chronic abdominal pain after one year ranges from 19 percent in children with none of the predictors to 66 percent among those having three or four. However, the predictors collectively explain only 14 percent of variance in the development of chronic abdominal pain.
Implications
- On the basis of medical evaluation alone, the family physician is unable to accurately predict the prognosis of a child with abdominal pain. Other yet to be identified psychosocial, environmental or family stressors may play a role.
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