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A prospective community-based study of gastroenterological symptoms in school-age children
Miguel Saps1, Marcelo Sztainberg, Carlo Di Lorenzo
1Division of Pediatric Gastroenterology, Children's Hospital of Pittsburgh, Pittsburgh, PA, USA. miguelsaps@hotmail.com
Insights
Gastrointestinal (GI) symptoms are common in school-aged children, with headaches being the most frequent complaint. Most GI symptoms were mild and did not lead to school absence, suggesting a generally benign nature.
Area of Science:
- Pediatric Gastroenterology
- Community Health Research
- Epidemiology
Background:
- Existing data on pediatric gastrointestinal (GI) problems often rely on biased samples.
- Previous studies used office-based samples or retrospective questionnaires, limiting accuracy.
Purpose of the Study:
- To determine the prevalence of common GI symptoms in school-aged children.
- This study represents the first prospective community-based assessment in the US.
Main Methods:
- A prospective cohort pilot study involved 4th and 5th graders from an urban school.
- Weekly confidential surveys assessed 8 age-appropriate symptoms, including abdominal pain, constipation, and nausea.
- Validated questions were used to determine symptom presence and severity.
Main Results:
- Headaches were the most prevalent symptom (55% weekly).
- Over 70% of children reported at least one symptom weekly, with 60% experiencing GI symptoms.
- Key GI symptom prevalence: abdominal pain (46%), nausea (28%), constipation (18%), diarrhea (17%), and vomiting (5%).
Conclusions:
- Prospective school-based studies are feasible for assessing pediatric health.
- High prevalence of GI symptoms in children, often without school interference, indicates a benign clinical picture.
- GI symptoms are frequent somatic complaints in school-aged children.
Introduction:
Current knowledge on the prevalence of common gastrointestinal (GI) problems is based on office-based samples or retrospective questionnaires, leading to possible bias and inaccurate estimates.
Aims:
To examine the prevalence of GI symptoms in school-age children.
Importance:
This is the first American prospective community study intended to assess the prevalence of common GI symptoms in children.
Patients And Methods:
All fourth- and fifth-grade students from a middle-size urban school were invited to participate in a prospective cohort pilot study by completing confidential weekly surveys. The survey included a set of 8 age-appropriate, validated questions assessing the presence and severity of abdominal pain, constipation, diarrhea, nausea, vomiting, chest pain, headaches and limb pain.
Results:
A total of 48 children (32 boys and 16 girls) participated in the study. Data were obtained for 16 weeks on 690 (90.5%) of 768 possible children per week. Children reported at least 1 symptom in 544 (70%) children per week. Headaches were the most common complaint (55% [range, 40%-72%] children per week). Sixty percent of children (range, 46%-89%) reported at least 1 GI symptom weekly. The overall prevalence of GI symptoms was the following: abdominal pain 46% (range, 28%-72%), nausea 28% (range, 17%-59%), constipation 18% (range, 7%-39%), diarrhea 17% (range, 11%-24%) and vomiting 5% (range, 0%-13%). None of the children missed school because of persistent GI symptoms during the study.
Discussion:
The investigation demonstrates the feasibility of prospective school studies in children. The high prevalence of GI symptoms not interfering with school attendance in children underscores the benign nature of such symptoms in most children.
Conclusion:
Gastrointestinal symptoms are common somatic complaints among school-age children.
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