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Characteristics of pain and stooling in children with recurrent abdominal pain
Robert J Shulman1, Michelle N Eakin, Monica Jarrett
1Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Children's Nutrition Research Center, Houston, USA.
Insights
Children with recurrent abdominal pain (RAP) experience more frequent and severe pain that interferes with daily life compared to healthy children. Many RAP cases align with irritable bowel syndrome criteria, highlighting the need for targeted pain management.
Area of Science:
- Pediatric Gastroenterology
- Child Health Research
- Symptomology Studies
Background:
- Recurrent abdominal pain (RAP) is a common pediatric issue.
- Understanding longitudinal symptom patterns in children with RAP is crucial for effective management.
- Differentiating RAP from functional abdominal pain and irritable bowel syndrome requires detailed symptom analysis.
Purpose of the Study:
- To longitudinally collect and compare symptom data in children with recurrent abdominal pain (RAP) and asymptomatic controls.
- To investigate the frequency, severity, and impact of abdominal pain on daily activities in children.
- To analyze stooling patterns and their relationship with pain in pediatric populations.
Main Methods:
- A 2-week daily diary study was conducted with children aged 7-10 years.
- Participants included children with RAP (n=77) and healthy controls (n=33).
- Diaries tracked pain frequency/severity, activity interference, and stooling patterns.
Main Results:
- Children with RAP reported significantly more pain episodes and higher severity than controls.
- Pain interference with activities was greater in the RAP group, showing a positive correlation with pain.
- While both groups reported stool changes, watery stools were positively associated with pain in all children.
Conclusions:
- This study provides the first longitudinal symptom comparison of children with RAP and controls.
- Significant overlap exists in historical symptom data between RAP and control groups.
- A majority of RAP cases met criteria for irritable bowel syndrome, emphasizing the need for targeted interventions to reduce disability.
Objective:
To collect symptom data longitudinally from children with recurrent abdominal pain (RAP) and control (asymptomatic) children.
Patients And Methods:
Children with RAP (n = 77) and controls (n = 33) 7 to 10 years of age completed daily diaries for 2 weeks tracking pain frequency and severity, how often the pain interfered with activities, and stooling pattern.
Results:
RAP children reported a greater number of pain episodes and greater pain severity than control children. Pain commonly was reported to be in the periumbilical area and occurred evenly across the day in both groups. However, the pain interfered with activity more often in the RAP group. There was a positive relationship between pain and interference with activities. Both groups reported stool changes, but there were no differences between groups in stool character (eg, hard, mushy). For both groups, the presence of watery stool was related positively to pain. Of children with RAP, 65% could be categorized as having irritable bowel syndrome, whereas 35% were classifiable as having functional abdominal pain according to the pediatric Rome II criteria.
Conclusions:
To the best of our knowledge, this is the first longitudinal report of symptoms in children with RAP compared with controls. These data demonstrate that there is considerable overlap between children with RAP and control children on a number of items commonly obtained in the history (eg, pain location, timing, stooling pattern). Most children with RAP could be characterized as having irritable bowel syndrome. The relationship between pain reports and interference with activities substantiates the need to deal specifically with the abdominal pain to decrease disability. The relationship between pain and watery stools requires further study.
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