Chronic functional abdominal pain

About: Chronic functional abdominal pain is a research topic. Over the lifetime, 44 publications have been published within this topic receiving 4218 citations.

Functional bowel disorders - A multicenter comparison of health status and development of illness severity index

Abstract: In a multicenter study of patients with painful functional bowel disorders (FBD), we compared the demographic, health status, and diagnostic features of patients with FBD and developed a functional bowel disorder severity index (FBDSI) for research and clinical care. Two hundred seventy patients with FBD in the United States, England, and Canada were surveyed on symptoms and health status, and their physicians made a diagnosis and rated illness severity as mild, moderate, or severe. Comparisons of 22 demographic and clinical variables were made by study site in addition to physicians' severity ratings. To develop the FBDSI, multiple regression analysis used the demographic and clinical variables to predict the physician's rating of severity. We found that most health status measures of patients with FBD across study sites are comparable and the derived and validated FBDSI scoring system uses three easy to obtain variables: FBDSI = [current pain by visual analog scale (0-100)] + [diagnosis of chronic functional abdominal pain (0 if absent and 106 if present)] + [number of physicians visits over previous six months x 11]. The FBDSI can be used to select patients for research protocols and/or follow their clinical outcome or response to treatments over time.

Irritable Bowel Syndrome: A Clinical Review

Abstract: Importance Irritable bowel syndrome (IBS) affects 7% to 21% of the general population. It is a chronic condition that can substantially reduce quality of life and work productivity. Objectives To summarize the existing evidence on epidemiology, pathophysiology, and diagnosis of IBS and to provide practical treatment recommendations for generalists and specialists according to the best available evidence. Evidence Review A search of Ovid (MEDLINE) and Cochrane Database of Systematic Reviews was performed for literature from 2000 to December 2014 for the terms pathophysiology , etiology , pathogenesis , diagnosis , irritable bowel syndrome , and IBS . The range was expanded from 1946 to December 2014 for IBS , irritable bowel syndrome , diet , treatment , and therapy . Findings The database search yielded 1303 articles, of which 139 were selected for inclusion. IBS is not a single disease but rather a symptom cluster resulting from diverse pathologies. Factors important to the development of IBS include alterations in the gut microbiome, intestinal permeability, gut immune function, motility, visceral sensation, brain-gut interactions, and psychosocial status. The diagnosis of IBS relies on symptom-based criteria, exclusion of concerning features (symptom onset after age 50 years, unexplained weight loss, family history of selected organic gastrointestinal diseases, evidence of gastrointestinal blood loss, and unexplained iron-deficiency anemia), and the performance of selected tests (complete blood cell count, C-reactive protein or fecal calprotectin, serologic testing for celiac disease, and age-appropriate colorectal cancer screening) to exclude organic diseases that can mimic IBS. Determining the predominant symptom (IBS with diarrhea, IBS with constipation, or mixed IBS) plays an important role in selection of diagnostic tests and treatments. Various dietary, lifestyle, medical, and behavioral interventions have proven effective in randomized clinical trials. Conclusions and Relevance The diagnosis of IBS relies on the identification of characteristic symptoms and the exclusion of other organic diseases. Management of patients with IBS is optimized by an individualized, holistic approach that embraces dietary, lifestyle, medical, and behavioral interventions.

Parent attention versus distraction: Impact on symptom complaints by children with and without chronic functional abdominal pain

Abstract: The objective of this study was to assess the impact of parent attention and distraction on symptom complaints by children with and without chronic functional abdominal pain. The water load symptom provocation task was used to induce visceral discomfort in pediatric patients with abdominal pain (N=104) and well children (N=119), ages 8-16 years. Parents were randomly assigned and trained to interact with their children according to one of three conditions: Attention, Distraction, or No Instruction. Children's symptom complaints and parents' responses were audiotaped and coded. Children completed a self-report measure of gastrointestinal (GI) symptoms before and after interacting with their parents. Parents' and children's perceptions of their interaction were assessed. Compared to the No Instruction condition, symptom complaints by pain patients and well children nearly doubled in the Attention condition and were reduced by half in the Distraction condition. The effect of attention on symptom complaints was greater for female pain patients than for male patients or well children. Findings for self-report GI symptoms were similar to those for audiotaped symptom complaints. Both pain patients and well children in the Distraction condition rated parents as making them feel better compared to ratings for the Attention condition. Parents of pain patients rated distraction as having greater potential negative impact on their children than attention. Parents' responses to children's symptom complaints can significantly increase or decrease those complaints. Girls with functional abdominal pain are particularly vulnerable to the symptom-reinforcing effects of parental attention.

Quality of Life for Children With Functional Abdominal Pain: A Comparison Study of Patients' and Parents' Perceptions

Abstract: OBJECTIVE. Children with chronic abdominal pain of nonorganic origin, termed functional abdominal pain (FAP), experience school absences and social withdrawal and report impaired physical ability. The aim of this study was to assess patients9 and parents9 perceptions of health-related quality of life (QoL) for children with FAP. METHODS. Between October 2002 and November 2003, 209 children (including 125 girls; age: 11.2 ± 3.5 years) and 209 parents were recruited from a pediatric referral center. At the time of their initial evaluations, participants completed a validated, health-related QoL instrument (Pediatric Quality of Life Inventory), which was scored on a scale of 0 (poor) through 100 (best). Children with FAP (n = 65) and their families were compared with control groups of healthy children (n = 46) and children with histologically proven inflammatory bowel disease (IBD) (n = 42) or gastroesophageal reflux disease (GERD) (n = 56). RESULTS. Children with FAP had self-reported QoL scores (score: 78) that were similar to those for children with GERD (score: 80) or IBD (score: 84). Children with FAP had lower QoL scores than did healthy children (score: 88). Parents of children with FAP reported lower QoL scores, compared with their children9s scores (scores: 70 vs 78). CONCLUSIONS. Children with FAP reported lower QoL, compared with their healthy peers, and had the same QoL scores as did children with IBD or GERD. Parents9 perceptions of QoL for children with FAP were lower than their children9s self-reported scores. These findings highlight the clinical significance of FAP and may provide insight into one facet of the disease9s biopsychosocial etiology.