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Chambers CT, Dol J, Tutelman PR, Langley CL, Parker JA, Cormier BT, Macfarlane GJ, Jones GT, Chapman D, Proudfoot N, Grant A, Marianayagam J. The prevalence of chronic pain in children and adolescents: a systematic review update and meta-analysis. Pain 2024:00006396-990000000-00603. [PMID: 38743558 DOI: 10.1097/j.pain.0000000000003267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 03/18/2024] [Indexed: 05/16/2024]
Abstract
ABSTRACT Chronic pain, defined as persistent or recurring pain or pain lasting longer than 3 months, is a common childhood problem. The objective of this study was to conduct an updated systematic review and meta-analysis on the prevalence of chronic pain (ie, overall, headache, abdominal pain, back pain, musculoskeletal pain, multisite/general pain, and other) in children and adolescents. EMBASE, PubMed, CINAHL, and PsycINFO were searched for publications between January 1, 2009, and June 30, 2023. Studies reporting population-based estimates of chronic nondisease related pain prevalence in children or adolescents (age ≤ 19 years) were included. Two independent reviewers screened articles based on a priori protocol. One hundred nineteen studies with a total of 1,043,878 children (52.0% female, mean age 13.4 years [SD 2.4]) were included. Seventy different countries were represented, with the highest number of data points of prevalence estimates coming from Finland and Germany (n = 19 each, 4.3%). The overall prevalence of chronic pain in children and adolescents was 20.8%, with the highest prevalence for headache and musculoskeletal pain (25.7%). Overall, and for all types of pain except for back pain and musculoskeletal pain, there were significant differences in the prevalence between boys and girls, with girls having a higher prevalence of pain. There was high heterogeneity (I 2 99.9%). Overall risk of bias was low to moderate. In summary, approximately 1 in 5 children and adolescents experience chronic pain and prevalence varies by pain type; for most types, there is higher pain prevalence among girls than among boys. Findings echo and expand upon the systematic review conducted in 2011.
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Affiliation(s)
- Christine T Chambers
- Centre for Pediatric Pain Research, IWK Health, Halifax, Canada
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, Canada
- Department of Pediatrics, Dalhousie University, Halifax, Canada
| | - Justine Dol
- Centre for Pediatric Pain Research, IWK Health, Halifax, Canada
| | - Perri R Tutelman
- Centre for Pediatric Pain Research, IWK Health, Halifax, Canada
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, Canada
| | | | | | | | - Gary J Macfarlane
- Aberdeen Centre for Arthritis and Musculoskeletal Health (Epidemiology Group), University of Aberdeen, Aberdeen, United Kingdom
| | - Gareth T Jones
- Aberdeen Centre for Arthritis and Musculoskeletal Health (Epidemiology Group), University of Aberdeen, Aberdeen, United Kingdom
| | | | | | - Amy Grant
- Maritime SPOR Support Unit, Halifax, Canada
| | - Justina Marianayagam
- Patient Partner and Resident Physician, Department of Pediatrics, University of British Columbia, Vancouver, Canada
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Siajunboriboon S, Tanpowpong P, Empremsilapa S, Lertudomphonwanit C, Nuntnarumit P, Treepongkaruna S. Prevalence of functional abdominal pain disorders and functional constipation in adolescents. J Paediatr Child Health 2022; 58:1209-1214. [PMID: 35348253 DOI: 10.1111/jpc.15950] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 03/01/2022] [Accepted: 03/06/2022] [Indexed: 11/28/2022]
Abstract
AIM Functional abdominal pain disorders (FAPDs) and functional constipation (FC) are the common functional gastrointestinal disorders in adolescents. We aimed to determine the prevalence of FAPDs and FC in adolescents using the Rome IV Questionnaire of Pediatric Gastrointestinal Symptoms and the factors associated with these two functional gastrointestinal disorders. METHODS A survey for the prevalence of FAPDs and FC in adolescents was carried out at two high schools. A translated and validated Thai version of Rome IV Questionnaire of Pediatric Gastrointestinal Symptoms was used. Potential associated factors were also collected. Psychosocial problems were evaluated by using the Strengths and Difficulties Questionnaire. RESULTS A total of 1700 adolescents (55.5% females) with a mean age (SD) of 16.1 (0.9) years were enrolled. The prevalence of FAPDs and FC was 5.3% and 8.1%, respectively. The subtypes of FAPDs were functional dyspepsia (4.7%; postprandial distress syndrome 3.9% and epigastric pain syndrome 0.8%), irritable bowel syndrome (0.6%), abdominal migraine (0.4%) and functional abdominal pain not otherwise specified (0.3%). Multiple logistic regression analysis revealed that FAPDs were associated with female gender (odds ratio (OR) 3.3, 95% confidence interval (CI): 1.7-6.4), underlying allergic diseases (OR 3.2, 95% CI: 1.6-6.6) and concomitant emotional problem (OR 2.7, 95% CI: 1.2-5.9). No significant associated factors with FC were found. CONCLUSION FAPDs and FC are common in adolescents. Postprandial distress syndrome is the most common subtype of FAPD. Associated factors for FAPDs may suggest hormonal, immune-related and psychological involvement in the disease pathogenesis.
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Affiliation(s)
- Sakonkarn Siajunboriboon
- Division of Gastroenterology, Department of Paediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Pornthep Tanpowpong
- Division of Gastroenterology, Department of Paediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Suthatip Empremsilapa
- Division of Ambulatory Paediatrics and Adolescent Medicine, Department of Paediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Chatmanee Lertudomphonwanit
- Division of Gastroenterology, Department of Paediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Pracha Nuntnarumit
- Division of Neonatology, Department of Paediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Suporn Treepongkaruna
- Division of Gastroenterology, Department of Paediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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Liyanarachchi H, Rajindrajith S, Kuruppu C, Chathurangana P, Ranawaka R, Devanarayana NM, Benninga MA. Association between childhood constipation and exposure to stressful life events: a systematic review. Neurogastroenterol Motil 2022; 34:e14231. [PMID: 34415089 DOI: 10.1111/nmo.14231] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 06/23/2021] [Accepted: 07/13/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND Several cross-sectional studies have reported an association between childhood constipation and exposure to stressful events. We planned to systematically review the literature on constipation and its associated stressful events. METHODS PubMed, Embase, and PsycINFO databases were searched (until February 2021) using standard search terms related to "constipation" and "stress" from 0 to 18 years that describe the association between psychological stressors and constipation. Studies were screened using pre-designed eligibility criteria. Studies that fulfilled the criteria were reviewed in a full-text format. The quality assessment of selected articles was conducted using standard methods. KEY RESULTS Of 2296 titles and abstracts screened, 38 were included in the full-text review. Out of that, 15 articles were included in this systematic review. There were 2954 children with constipation, and the age range was from 6 months to 16 years. Exposure to home-related stressors (divorce or separation of parents, severe illness in family, and parental job loss) school-related stressors (including being bullied at school, change in school, separation from the best friend at school, and failure in an examination), exposure to child maltreatments and exposure to war/civil unrest were associated with childhood constipation. CONCLUSIONS AND INFERENCES Exposure to day-to-day home- and school-related stressors, to child maltreatment, and to civil unrest is associated with constipation in children and adolescents. These factors need to be explored during clinical evaluation of children with constipation.
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Affiliation(s)
- Hasitha Liyanarachchi
- Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.,Lady Ridgeway Hospital for Children, Colombo, Sri Lanka
| | - Shaman Rajindrajith
- Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.,Lady Ridgeway Hospital for Children, Colombo, Sri Lanka
| | | | - Prasad Chathurangana
- Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.,Lady Ridgeway Hospital for Children, Colombo, Sri Lanka
| | - Randula Ranawaka
- Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.,Lady Ridgeway Hospital for Children, Colombo, Sri Lanka
| | - Niranga M Devanarayana
- Department of Physiology, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka
| | - Marc A Benninga
- Department of Pediatric Gastroenterology and Nutrition, Emma Children Hospital, Amsterdam University Medical Center, Amsterdam, The Netherlands
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Diagnostic Accuracy of the Rome IV Criteria for the Diagnosis of Functional Gastrointestinal Disorders in Children. J Pediatr Gastroenterol Nutr 2021; 72:538-541. [PMID: 33394887 DOI: 10.1097/mpg.0000000000003030] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
ABSTRACT The diagnosis of functional gastrointestinal disorders (FGIDs) centers on symptoms-based criteria (Rome criteria). The last edition of the criteria was published in 2016. Still, few data on its validity support its use in children. We conducted a study aimed at determining the diagnostic accuracy of the Rome IV criteria through the application of questionnaires (Questionnaire of Pediatric Gastrointestinal Symptoms-Rome IV QPGS-IV) to diagnose FGIDs in children. We hypothesized that the Rome IV criteria has adequate diagnostic accuracy supporting its use for diagnosing FGIDs in children. METHODS School children ages 10 to 18 years from Cali (Colombia) completed the Spanish version of the QPGS-IV. Children with FGIDs were matched with a group of children without FGIDs. Both groups had a medical consultation with a blinded experienced pediatric gastroenterologist (criterion standard) who provided his diagnosis. The questionnaire-based diagnoses were compared with the consultation's diagnoses. RESULTS Of 487 schoolchildren surveyed with the QPGS-IV, 97 (20.8%) had FGIDs. Eighty-nine with FGIDs were matched with 92 children without FGIDs (mean age 13.1 years [±1.3]). We found a higher prevalence of FGIDs during the medical visit than using the self-report QPGS-IV (66.3% vs 49.2%, P = 0.001), mainly in abdominal pain disorders (19.3% vs 10.5%, P = 0.013). The Rome IV diagnostic criteria using the QPGS-IV had a sensitivity of 75% (95% confidence interval, 59-79) and 90% specificity (95% confidence interval, 83-98). Positive predictive value is 85.8%, and negative predictive value is 79.9%. CONCLUSION Our study suggests that the QPGS-IV has adequate diagnostic accuracy.
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Zeevenhooven J, van der Heijden HS, Devanarayana NM, Rajindrajith S, Benninga MA. Epidemiology of Functional Abdominal Pain Disorders and Functional Defecation Disorders in Adolescents in Curacao. J Pediatr Gastroenterol Nutr 2020; 71:e103-e104. [PMID: 32639457 DOI: 10.1097/mpg.0000000000002839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- Judith Zeevenhooven
- Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Pediatric Gastroenterology, Hepatology and Nutrition, Amsterdam, The Netherlands
| | - Heleen Susanne van der Heijden
- Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Pediatric Gastroenterology, Hepatology and Nutrition, Amsterdam, The Netherlands
| | | | - Shaman Rajindrajith
- Department of Pediatrics, Faculty of Medicine, University of Colombo, Sri Lanka
| | - Marc A Benninga
- Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Pediatric Gastroenterology, Hepatology and Nutrition, Amsterdam, The Netherlands
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