Functional abdominal pain disorders: Prevalence, clinical and socio demographic profile

Abstract

Background: Paediatric 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)−having different clinical presentations. It is a pressing clinical issue worldwide, accounting for a substantial proportion of emergency visits. Objectives: To see the prevalence, clinical profile, and sociodemographic factors of FAPDs in school-aged children. Materials and methods: The Bangladesh Shishu Hospital & Institute, Department of Pediatric Gastroenterology, Hepatology, and Nutrition conducted a cross-sectional study on 74 children with FAPDs from December 2023 to November 2024 according to Rome IV criteria. Results: The mean age was 8.7 ± 2.1 years, mostly less than 11 years of age (86.5%). The female-male ratio was 1.1:1. Most of them are from rural areas (47, 63.5%) and the lower-middle income group (43, 58.1%). The prevalence of functional abdominal pain in school-aged children was 11.7%. Among them, the prevalence of subtypes of FAPDs, with FAP-NOS at 39 (52.7%), IBS at 24 (32.4%), FD at 9 (37.5%), and multiple entities at 2 (2.7%). Onset of abdominal pain was reported as gradual in 56.7% of cases, with 43.24% experiencing sudden onset. The duration of pain per episode varied, with 52.7% experiencing symptoms for between 3 and 5 days, with a mean of 3.16±1.67 days. The pain was predominantly located in the epigastric (29.73%) and umbilical (28.38%) regions. Regarding pain, the character varied, with cramping (48.6%), dull (16.2%), sharp (16.2%), and stabbing (12.1%) sensations being the most described. Regarding pain severity, 68.9% rated their pain as severe, while 27.03% considered it moderate. From associated symptoms and medical history, there was a change in bowel movement in 51 (68.9%) cases, recent dietary changes in 43 (58.1%), vomiting in 38 (51.3%), constipation in 23 (31.0%), and diarrhea in 13 (17.5%) cases. Social factors or stressors were identified in 25 (33.7%) cases. Among them, most were due to academic pressure in 12 (48%), followed by parental anxiety in 5 (20%). Conclusion: Most FAPD in children is FAP-NOS, which causes abdominal pain in school-aged children, especially in the epigastric and umbilical areas, and is characterized by severe cramping. Most impacted youngsters were under 11 and from rural, lower-middle-income households. Changes in bowel motions, recent food changes, vomiting, and constipation were prevalent symptoms. Nearly half of stressors related to academic pressures.

DS (Child) H J 2024; 40(2): 29-33