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Lee S, Tomlinson R, Lumley MN, Bax KC, Ashok D, McMurtry CM. Positive Schemas, Coping, and Quality of Life in Pediatric Recurrent Abdominal Pain. J Clin Psychol Med Settings 2024; 31:37-47. [PMID: 36952113 DOI: 10.1007/s10880-023-09952-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/24/2023] [Indexed: 03/24/2023]
Abstract
Pediatric recurrent abdominal pain is commonly associated with negative impacts on quality of life (QOL). Positive schemas (core beliefs about the self with subthemes of self-efficacy, optimism, trust, success, and worthiness) are a resilience factor that has not yet been examined within a pediatric recurrent pain context. This cross-sectional study examined (a) associations between positive schemas, pain coping, and youth QOL, and (b) exploratory analyses to investigate whether specific positive schema subthemes predicted QOL outcomes in youth with recurrent abdominal pain. Participants were 98 youth with recurrent abdominal pain (i.e., pain related to a disorder of gut-brain interaction [DGBI] or organic cause) who completed measures on positive schemas, QOL, and pain coping. Age and diagnostic status were controlled for in analyses. Positive schemas were significantly positively correlated with emotional, social, school, and overall QOL, as well as with approach and problem-focused avoidant coping, and significantly negatively correlated with emotion-focused coping. Worthiness was the strongest and only significant predictor of youth social functioning. Positive schemas may be an important cognitive resilience factor to consider within interventions for pediatric recurrent pain.
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Affiliation(s)
- Soeun Lee
- Pediatric Pain, Health, and Communication Lab, Department of Psychology, University of Guelph, Guelph, ON, N1G 2W1, Canada.
| | - Rachel Tomlinson
- Pediatric Pain, Health, and Communication Lab, Department of Psychology, University of Guelph, Guelph, ON, N1G 2W1, Canada
| | - Margaret N Lumley
- Pediatric Pain, Health, and Communication Lab, Department of Psychology, University of Guelph, Guelph, ON, N1G 2W1, Canada
| | - Kevin C Bax
- Department of Paediatrics, Western University, London, ON, Canada
| | - Dhandapani Ashok
- Department of Paediatrics, Western University, London, ON, Canada
| | - C Meghan McMurtry
- Pediatric Pain, Health, and Communication Lab, Department of Psychology, University of Guelph, Guelph, ON, N1G 2W1, Canada
- Department of Paediatrics, Western University, London, ON, Canada
- Pediatric Chronic Pain Program, McMaster Children's Hospital, Hamilton, ON, Canada
- Department of Anesthesia, McMaster University, Hamilton, ON, Canada
- Children's Health Research Institute, London, ON, Canada
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Abomoelak B, Saps M, Sudakaran S, Deb C, Mehta D. Gut Microbiome Remains Static in Functional Abdominal Pain Disorders Patients Compared to Controls: Potential for Diagnostic Tools. BIOTECH 2022; 11:biotech11040050. [PMID: 36412751 PMCID: PMC9680443 DOI: 10.3390/biotech11040050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 10/25/2022] [Accepted: 10/26/2022] [Indexed: 11/07/2022] Open
Abstract
Background: Functional Abdominal Pain disorders (FAPDs) are a group of heterogeneous gastrointestinal disorders with unclear pathophysiology. In children, FAPDs are more common in the winter months than summer months. The possible influence of school stressors has been proposed. Previously, our group showed differences in bacterial relative abundances and alpha diversity in the gut microbiome and its relationship with stressors in a cross-sectional evaluation of children suffering from FAPDs compared to a healthy control group. We present longitudinal data to assess whether the gut microbiome changes over school terms in the control and FAPDs groups. Methods: The longitudinal study included children with FAPDs (n = 28) and healthy controls (n = 54). Gastrointestinal symptoms, as well as stool microbiome, were assessed in both groups. Stool samples were serially collected from all participants during both the school term and summer vacation. The stool samples were subjected to total genomic extraction, 16S rRNA amplicon sequencing, and bioinformatics analysis. The gut microbiome was compared at school and during vacation. Other metrics, alpha diversity, and beta diversity, were also compared between the two school terms in every group. Results: In the healthy group, there were differences in microbiome composition between school terms and summer vacation. Conversely, we found no differences in the FAPDs group between the two terms. The healthy control group revealed differences (p-value < 0.05) in 55 bacterial species between the school term and vacation. Several of the differentially abundant identified bacteria were involved in short-chain fatty acids production (SCFAs), inflammation reduction, and gut homeostasis. Alpha diversity metrics, such as the Shannon index, were different in the control group and remained unchanged in the FAPDs group. Conclusion: Although preliminary, our findings suggest that the gut microbiome is static in FAPDs. This compares with a more dynamic healthy gut microbiome. Further studies are warranted to corroborate this and understand the interplay between stress, symptoms, and a less diverse and static microbiome. Future studies will also account for different variables such as diet and other patient demographic criteria that were missing in the current study.
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Affiliation(s)
- Bassam Abomoelak
- Arnold Palmer Pediatric Gastroenterology Clinic, Orlando Health, Orlando, FL 32806, USA
| | - Miguel Saps
- Pediatric Gastroenterology, Hepatology and Nutrition Division, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | | | - Chirajyoti Deb
- Arnold Palmer Pediatric Gastroenterology Clinic, Orlando Health, Orlando, FL 32806, USA
| | - Devendra Mehta
- Arnold Palmer Pediatric Gastroenterology Clinic, Orlando Health, Orlando, FL 32806, USA
- Correspondence:
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Llanos-Chea A, Fasano A. Gluten and Functional Abdominal Pain Disorders in Children. Nutrients 2018; 10:nu10101491. [PMID: 30322070 PMCID: PMC6212938 DOI: 10.3390/nu10101491] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 10/06/2018] [Accepted: 10/10/2018] [Indexed: 12/11/2022] Open
Abstract
In children, functional gastrointestinal disorders (FGIDs) are common at all ages. Consumption of certain foods, particularly gluten, is frequently associated with the development and persistence of FGIDs and functional abdominal pain disorders (FAPDs) in adults and children. However, this association is not well defined. Even without a diagnosis of celiac disease (CD), some people avoid gluten or wheat in their diet since it has been shown to trigger mostly gastrointestinal symptoms in certain individuals, especially in children. The incidence of conditions such as non-celiac gluten sensitivity (NCGS) is increasing, particularly in children. On the other hand, CD is a chronic, autoimmune small intestinal enteropathy with symptoms that can sometimes be mimicked by FAPD. It is still unclear if pediatric patients with irritable bowel syndrome (IBS) are more likely to have CD. Abdominal, pain-associated FGID in children with CD does not seem to improve on a gluten-free diet. The threshold for gluten tolerance in patients with NCGS is unknown and varies among subjects. Thus, it is challenging to clearly distinguish between gluten exclusion and improvement of symptoms related solely to functional disorders.
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Affiliation(s)
- Alejandro Llanos-Chea
- Mucosal Immunology and Biology Research Center, Division of Pediatric Gastroenterology and Nutrition, Massachusetts General Hospital, 114 16th Street (M/S 114-3503), Charlestown, Boston, MA 33131, USA.
- Department of Pediatrics, Harvard Medical School, Boston, MA 33131, USA.
- Division of Pediatric Gastroenterology, Hepatology & Nutrition, University of Miami Miller School of Medicine, Miami, FL 33136, USA.
| | - Alessio Fasano
- Mucosal Immunology and Biology Research Center, Division of Pediatric Gastroenterology and Nutrition, Massachusetts General Hospital, 114 16th Street (M/S 114-3503), Charlestown, Boston, MA 33131, USA.
- Department of Pediatrics, Harvard Medical School, Boston, MA 33131, USA.
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