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Spectrum of Functional Abdominal Pain Disorders in Children and Their Clinical, Social Characteristics: A
Jayendra Seetharaman1, Ujjal Poddar1, Anshu Srivastava1
1Department of Pediatric Gastroenterology Sanjay Gandhi Post Graduate Institute of Medical Sciences Lucknow India.
Insights
Pediatric functional abdominal pain disorders (FAPDs) are common, with functional abdominal pain-not otherwise specified (FAP-NOS) being the most frequent subtype in India. Stressors and family history of functional disorders are linked to symptom severity in children.
Area of Science:
- Pediatric Gastroenterology
- Functional Gastrointestinal Disorders
- Child Health Outcomes
Background:
- Pediatric functional abdominal pain disorders (FAPDs) encompass subtypes like functional dyspepsia (FD), irritable bowel syndrome (IBS), functional abdominal pain-not otherwise specified (FAP-NOS), and abdominal migraine (AM).
- These conditions are influenced by various demographic and social factors, impacting diagnosis and management.
- Understanding the spectrum and associated factors is crucial for effective pediatric care.
Purpose of the Study:
- To evaluate the spectrum of FAPD subtypes in children.
- To identify demographic and social factors associated with different FAPD subtypes.
- To determine predictors of severe symptoms in pediatric FAPDs.
Main Methods:
- A cohort of 479 children under 18 diagnosed with FAPD subtypes (ROME-IV criteria) between April 2018 and March 2020 were analyzed.
- Clinical, demographic, and social parameters were compared across FAPD subtypes.
- Factors associated with symptom severity were investigated using statistical analysis.
Main Results:
- Functional abdominal pain-not otherwise specified (FAP-NOS) was the most common subtype (63%), followed by IBS (17.4%) and FD (15%).
- Significant differences were observed in age at presentation, pain site, symptom duration, and associated symptoms among subtypes (p < 0.001).
- Family history of functional disorders (OR: 2.21), presence of stressors (OR: 2.03), and rural origin (OR: 1.75) predicted severe symptoms.
Conclusions:
- FAP-NOS is the predominant FAPD subtype in Indian children, often presenting at a younger age.
- Stressors and a family history of functional disorders are associated with increased symptom severity.
- Further prospective studies are recommended to validate these findings and inform clinical practice.
Background/Aims:
Pediatric functional abdominal pain disorders (FAPDs) subtypes; functional dyspepsia (FD), irritable bowel syndrome (IBS), functional abdominal pain-not otherwise specified (FAP-NOS), and abdominal migraine (AM) are influenced by demographic and social factors. The study aimed to evaluate the spectrum and demographic and social factors associated with FAPD subtypes.
Methods:
Consecutive children (< 18 years) diagnosed with FAPD subtypes according to ROME-IV criteria between April 2018 and March 2020 were included. The clinical, demographic, and social parameters were analyzed between various subtypes of FAPD, and factors responsible for severe symptoms were studied.
Results:
A total of 479 children (mean age 12.34 ± 3.82 years, 60% boys) were included. FAP-NOS (63%) was the most commonly diagnosed subtype followed by IBS (17.4%) and FD (15%). The age at presentation, site of pain, duration of symptoms, and associated symptoms were significantly different among the three main subtypes (p < 0.001). Stressors could be identified in 39.3% and academic pressure (22.3%) was the most common. Family members with functional disorders (OR: 2.21, 95% CI: 1.31-3.42, p = 0.02), presence of stressors (OR: 2.03, 95% CI: 1.14-3.65, p = 0.016), and rural origin (OR: 1.75, 95% CI: 1.08-2.83, p = 0.023) predicted severe symptoms.
Conclusions:
FAP-NOS is the most common FAPD subtype in children in India. Children with FAP-NOS are much younger than other subtypes of FAPD. The presence of stressors and functional disorders in family members could be associated with severe symptoms. However, it mandates more prospective studies to validate the findings.
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