Abdominal pain predominant functional gastrointestinal diseases in children and adolescents: prevalence, symptomatology and association with emotional stress

Abstract

INTRODUCTION AND OBJECTIVES: To assess the prevalence of abdominal pain predominant functional gastrointestinal diseases (FGD) in Sri Lankan children, their symptomatology, and predisposing factors. METHODS: A cross sectional survey was conducted among a randomly selected group of 10-16 year olds, in 8 randomly selected schools, in 4 provinces in Sri Lanka. A validated, self-administered questionnaire was distributed in an examination setting. Research assistants were present while filling the questionnaire and explanations were given. FGD Were Diagnosed using Rome III criteria. RESULTS: A total of 2180 questionnaires were distributed and 2163 (99.2%) were included in the analysis [1189 (55%) males, mean age 13.4 years, SD 1.8 years]. Seventeen incompletely filled questionnaires were excluded. Two hundred and seventy (12.5%) had at least one abdominal pain predominant FGD. Irritable bowel syndrome (IBS) was seen in 107 (4.9%), functional dyspepsia (FD) in 54 (2.5%), functional abdominal pain in 96 (4.4%) and abdominal migraine (AM) in 21 (1.0%) (2 had AM and FD, 6 had AM and IBS). Extraintestinal somatic symptoms (headache, limb pain, sleeping difficulty) were more common among affected children (p<0.05). Abdominal pain predominant FGD were significantly higher in girls and those exposed to stressful events (p<0.05). Prevalence negatively correlated with age. CONCLUSION: Abdominal pain predominant FGD were a significant health problem in Sri Lankan children affecting 12.5%. IBS was the commonest FGD diagnosed. Abdominal pain predominant FGD were higher in girls and those exposed to emotional stress. Prevalence of FGD decreased with age. Somatic symptoms were more frequent in affected children.