Predictors for the course of chronic non-organic upper abdominal pain

A group of outpatients with chronic non-organic upper abdominal pain was followed up 5-7 years after the index investigation, to evaluate the predictive value of several variables on the basis of a questionnaire and a laboratory pain study. Fifty-four per cent had symptoms of irritable bowel syndrome. A low pain tolerance measured with an ischemic pain technique significantly predicted a poor course of the disease (P = 0.03). So did a high score indicating psychic vulnerability (P = 0.02) and two social factors: poor school and vocational education (P less than 0.01). Without significant predictive value were level of abdominal pain rated on a visual analogue scale, length of dyspepsia history, bowel habits, relation of pain to meals and to life events, heartburn, headache, back pain, dysmenorrhea, paresthesias in fingers or feet, present occupation, sex, marital status, days absent from work because of the disease, and consumption of tranquilizers, cigarettes, and alcohol. The findings indicate that psychologic factors and a low pain tolerance may be elements in this poorly understood syndrome. This is supported by earlier findings of a decreased pain tolerance and an elevated psychologic score in this group compared with controls.