Original article
A Prospective School-based Study of Abdominal Pain and Other Common Somatic Complaints in Children

https://doi.org/10.1016/j.jpeds.2008.09.047Get rights and content

Objective

To determine the prevalence and impact of pediatric abdominal pain (AP).

Study design

Prospective cohort study (12/2005-06/2006), with gastrointestinal and other symptoms assessed weekly. Anxiety, depression, functional disability, quality of life, somatization, coping, school absenteeism and medical care were assessed in 237 students in the third through eighth grades (11.8 years; 134 girls) from 2 public schools weekly. Complete data were obtained on 4606 of 5175 (89%) possible questionnaires.

Results

Seventy-two percent of children reported >1 somatic symptom weekly, and 45% of children reported >1 gastrointestinal symptom weekly. The weekly prevalence of AP was 38%, and 90% of children reported AP at least once. AP persisted >4 consecutive weeks in 52% of children and was associated with higher anxiety (P < .001) and depression (P < .001) scores and worse quality of life (P < .001). Twenty-three percent of children missed school for AP (average, 2.3 days), and 10% of parents of those children missed work (average, 1.9 days). Presence of AP (P < .001) was independently associated with school absences. Four children (2%) sought medical attention.

Conclusions

AP is common in school-age children and is associated with worse quality of life, psychological co-morbidities, school absenteeism, and parental work absences.

Section snippets

Methods

All third through eighth grade students attending 2 Chicago public schools with mixed ethnicity and socioeconomic populations were invited to participate in a prospective cohort study. The aims of the study were not revealed to the children or parents to minimize bias. General information about the study was provided by the principal investigator to the children, and informational letters and consents were sent to the parents. The study was approved by the institutional review board of

Results

A total of 237 of 495 children (48%) were enrolled in the study. The remaining children either declined to participate or failed to return signed consent forms. All participants completed the study. Differing school schedules necessitated staggered start times. The study began in December 2005 at 1 school and February 2006 at the other. However, once the study was begun, both schools adhered to the same protocol and schedule for its duration.

An average of 209 children (range, 184-233) responded

Discussion

This large, prospective, epidemiological study assessed common somatic symptoms in school-age American children. The prospective design, 100% subject retention, and large, complete dataset are several strengths of our investigation. Our study provides systematic data, including co-morbidity and cost impact.

Few studies have examined AP in community-based samples of children, with published studies suffering from design limitations, questionable external validity, or both.30 We collected data in

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    Funding for this study was provided by the American College of Gastroenterology's 2004 Clinical Research Award. The authors declare no potential conflicts of interest, real or perceived.

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