PT - JOURNAL ARTICLE AU - van Tilburg, Miranda A. L. AU - Runyan, Desmond K. AU - Zolotor, Adam J. AU - Graham, J. Christopher AU - Dubowitz, Howard AU - Litrownik, Alan J. AU - Flaherty, Emalee AU - Chitkara, Denesh K. AU - Whitehead, William E. TI - Unexplained Gastrointestinal Symptoms After Abuse in a Prospective Study of Children at Risk for Abuse and Neglect AID - 10.1370/afm.1053 DP - 2010 Mar 01 TA - The Annals of Family Medicine PG - 134--140 VI - 8 IP - 2 4099 - http://www.annfammed.org/content/8/2/134.short 4100 - http://www.annfammed.org/content/8/2/134.full SO - Ann Fam Med2010 Mar 01; 8 AB - PURPOSE Unexplained gastrointestinal symptoms are more common in adults who recall abuse as a child; however, data available on children are limited. The aim of this study was to investigate the association of childhood maltreatment and early development of gastrointestinal symptoms and whether this relation was mediated by psychological distress. METHODS Data were obtained from the Longitudinal Studies of Child Abuse and Neglect, a consortium of 5 prospective studies of child maltreatment. The 845 children who were observed from the age of 4 through 12 years were the subjects of this study. Every 2 years information on gastrointestinal symptoms was obtained from parents, and maltreatment allegations were obtained from Child Protective Services (CPS). At the age of 12 years children reported gastrointestinal symptoms, life-time maltreatment, and psychological distress. Data were analyzed by logistic regression. RESULTS Lifetime CPS allegations of sexual abuse were associated with abdominal pain at age 12 years (odds ratio [OR] = 1.75; 95% confidence interval [CI] = 1.1–2.47). Sexual abuse preceded or coincided with abdominal pain in 91% of cases. Youth recall of ever having been psychologically, physically, or sexually abused was significantly associated with both abdominal pain and nausea/vomiting (range, OR = 1.5 [95% CI, 1.1–2.0] to 2.1 [95% CI, 1.5–2.9]). When adjusting for psychological distress, most effects became insignificant except for the relation between physical abuse and nausea/vomiting (OR = 1.5; 95% CI, 1.1–2.2). CONCLUSION Youth who have been maltreated are at increased risk for unexplained gastrointestinal symptoms, and this relation is partially mediated by psychological distress. These findings are relevant to the clinical care for children who complain of unexplained gastrointestinal symptoms.