Recurrent Abdominal Pain in Childhood -Characteristics and Course
Condition: Abdominal Pain
MeSH terms: Abdominal Pain
Study type: Observational

Summary: 
      Recurrent abdominal pain (RAP) is a common complaint in childhood. Identification of the
      processes that maintain illness is important.

      The purpose of this study is to get more knowledge about characteristics of children with
      recurrent abdominal pain and their parents, and about the course of their pain. These results
      may be important to identify children who need treatment.
    

Detailed description: 
      BACKGROUND:

      Recurrent abdominal pain (RAP), mainly constituted by functional gastrointestinal disorders
      (FGID), affects a significant number of children, and is a result of a complex interaction
      between biopsychosocial factors. Despite the seemingly benign nature of RAP, in some children
      RAP is associated with school absenteeism, functional impairment and frequent doctor visits.
      Identification of the processes that maintain illness is important. These results may be
      important to identify children who need treatment.

      AIMS:

      The aims of this study are to characterize children with RAP (in four out-patient clinics)
      and their parents, describe outcome and determine predictors of persistent RAP in children.

      SAMPLE:

      150 pediatric patients (4-15 years), their parents and teachers. Consecutive new patients
      referred to four pediatric out-patients clinics for evaluation of abdominal pain (primary
      complaint). Patients with RAP (abdominal pain at least once a month, in three consecutive
      months during the last year, and whose pains are severe enough to affect daily activity) are
      eligible.

      DESIGN: A prospective cohort study.

      MEASUREMENT:

      All pediatric patients will undergo a complete physical examination emphasizing diagnosing
      organic illness and FGID according to the international ROME classification. Routine
      laboratory will be done. A protocol to identify somatic causes is part of the study. In
      addition, parents will complete validated questionnaires regarding their child's
      physical/psychological health, temperamental characteristics and social skills and also
      psychosocial conditions concerning them selves. Self-report regarding the same aspects will
      be obtained from children above 8-9 years.
    

Observational model: Cohort
Time perspective: Prospective
Study population: 
        Consecutive new pediatric patients (4-15 years) referred by their general practitioners to
        four pediatric out-patient clinics in Innlandet Hospital Health Authorities for evaluation
        of recurrent abdominal pain.
      
Biospecimen description: 
      All patients have blood tests for hemoglobin, total leucocyte and differential count,
      sedimention rate, C-reactive protein, total IgE and IgE screen for food allergies, and
      antiendomysial and antigliadin antibodies (IgG and IgA) and anti-tissue transglutaminase
      antibodies for celiac disease. Furthermore, urine analyses for protein, blood and and
      leucocytes, three stool specimen for occult blood and one stool specimen for quantification
      of calprotectin.
    
Keywords: child; psychosocial; predictors; cohort; recurrent