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Prognosis of chronic or recurrent abdominal pain in children

Marieke J Gieteling1, Sita M A Bierma-Zeinstra, Jan Passchier

  • 1Department of General Practice, Erasmus Medical Centre, Rotterdam, The Netherlands. m.gieteling@erasmusmc.nl

Journal of Pediatric Gastroenterology and Nutrition
|August 30, 2008
PubMed

Insights

Chronic abdominal pain (CAP) persists in nearly 30% of children. Extensive medical testing offers no additional prognostic value for childhood abdominal pain when alarming symptoms are absent.

Area of Science:

  • Pediatric Gastroenterology
  • Clinical Epidemiology

Background:

  • Childhood chronic abdominal pain (CAP) is prevalent, often without identifiable organic causes.
  • Modern diagnostics reveal abnormalities in CAP patients, but their causal link and prognostic value remain debated.

Purpose of the Study:

  • To determine the persistence rate of CAP in children.
  • To assess the prognostic value of medical tests (labs, imaging, endoscopy) beyond clinical evaluation.

Main Methods:

  • Systematic literature review of prospective cohort studies (1960-2005) from MEDLINE, EMBASE, PsycINFO.
  • Inclusion of 18 studies with 1331 children followed for a median of 5 years.
  • Pooled analysis of reported outcomes and diagnostic test utility.

Main Results:

  • Chronic abdominal pain persisted in 29.1% of children after follow-up.
  • No significant difference in prognosis was observed between clinically diagnosed CAP and that diagnosed with additional testing.
  • The prognostic impact of extensive diagnostic testing was not evident.

Conclusions:

  • Approximately 29.1% of children experience persistent chronic abdominal pain.
  • Additional diagnostic testing does not improve the prognosis for CAP in the absence of alarming symptoms.
Abstract

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