1
|
Piriyakitphaiboon V, Sirinam S, Noipayak P, Sirivichayakul C, Pornrattanarungsri S, Limkittikul K. Risk Factors for Recurrent Abdominal Pain in Children with Nonorganic Acute Abdominal Pain. Pediatr Gastroenterol Hepatol Nutr 2022; 25:129-137. [PMID: 35360380 PMCID: PMC8958051 DOI: 10.5223/pghn.2022.25.2.129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 11/22/2021] [Accepted: 02/06/2022] [Indexed: 11/14/2022] Open
Abstract
PURPOSE The purpose of this study was to identify the risk factors for recurrent abdominal pain (RAP) in children who presented with nonorganic acute abdominal pain. METHODS A retrospective, single study was conducted on 2-15-year-old children diagnosed with nonorganic acute abdominal pain at the pediatric outpatient department of Vajira Hospital, Nawamindradhiraj University, between January 2015 and December 2019. The potential risk factors were analyzed using univariate and multivariate analyses. RESULTS Of the 367 patients with nonorganic acute abdominal pain, 94 (25.6%) experienced RAP within three months. In this group with RAP, 76 patients (80.8%) were diagnosed with functional gastrointestinal disorders, including functional dyspepsia, irritable bowel syndrome, functional abdominal pain-not otherwise specified, and functional constipation. History of gastrointestinal infection (p=0.011), mental health problems (p=0.022), abdominal pain lasting ≥7 days (p<0.001), and change in stool frequency (p=0.001) were the independent risk factors associated with RAP in children with nonorganic acute abdominal pain; their odds ratios and 95% confidence intervals were 3.364 (1.314-8.162), 3.052 (1.172-7.949), 3.706 (1.847-7.435), and 2.649 (1.477-4.750), respectively. CONCLUSION RAP is a common problem among children who first present with nonorganic acute abdominal pain. The identification of risk factors may provide proper management, especially follow-up plans for this group in the future.
Collapse
Affiliation(s)
- Varisa Piriyakitphaiboon
- Department of Pediatrics, Faculty of Medicine, Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand
| | - Salin Sirinam
- Department of Tropical Pediatrics, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Pongsak Noipayak
- Department of Pediatrics, Faculty of Medicine, Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand
| | - Chukiat Sirivichayakul
- Department of Tropical Pediatrics, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Suwanna Pornrattanarungsri
- Department of Pediatrics, Faculty of Medicine, Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand
| | - Kriengsak Limkittikul
- Department of Tropical Pediatrics, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| |
Collapse
|
2
|
Wager J, Ruhe AK, Stahlschmidt L, Leitsch K, Claus BB, Häuser W, Brähler E, Dinkel A, Kocalevent R, Zernikow B. Long-term outcomes of children with severe chronic pain: Comparison of former patients with a community sample. Eur J Pain 2021; 25:1329-1341. [PMID: 33619774 DOI: 10.1002/ejp.1754] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
BACKGROUND Findings on the short- and long-term effectiveness of intensive interdisciplinary pain treatment (IIPT) for children with severe chronic functional pain are promising. However, a definitive appraisal of long-term effectiveness cannot be made due to a lack of comparison groups. The aim of the present study was to compare the health status of former patients with the health status of an age- and sex-matched comparison group from the community. METHODS Data from two samples, a clinical sample of former patients (n = 162; aged 14 to 26) and an age- and sex-matched community sample (n = 162), were analysed. Former patients provided data 7 years after IIPT. Pain characteristics, physical and mental health status, autonomy, coping and health care utilisation were compared between the two samples. RESULTS Seven years after treatment, the majority (58%) of the clinical sample were completely pain-free. Compared to the community sample, the clinical sample demonstrated worse physical and mental health and continued to seek more frequent health care, irrespective of whether or not they experienced ongoing chronic pain. However, the clinical sample reported better coping strategies and a comparable level of autonomy. CONCLUSION Patients experiencing severe chronic pain in childhood who engage in IIPT are likely to have recovered from their pain in early adulthood. Long-term treatment effects may manifest in better coping strategies. However, reduced mental and physical health status may indicate a negative long-term effect of early chronic pain experiences or a general vulnerability in people developing a chronic pain condition in childhood. SIGNIFICANCE The majority of severely impaired paediatric chronic pain patients no longer suffer from chronic pain seven years after intensive interdisciplinary pain treatment. However, former patients have worse physical and mental health status than a community sample, and continue to seek out more frequent health care utilisation, irrespective of whether or not they continue to experience chronic pain. Therefore, potential negative long-term effects of childhood chronic pain experiences need specific attention early on.
Collapse
Affiliation(s)
- Julia Wager
- German Paediatric Pain Centre, Children's and Adolescents' Hospital, Datteln, Germany.,Department of Children's Pain Therapy and Paediatric Palliative Care, Faculty of Health, School of Medicine, Witten/Herdecke University, Witten, Germany.,PedScience Research Institute, Datteln, Germany
| | - Ann-Kristin Ruhe
- German Paediatric Pain Centre, Children's and Adolescents' Hospital, Datteln, Germany.,Department of Children's Pain Therapy and Paediatric Palliative Care, Faculty of Health, School of Medicine, Witten/Herdecke University, Witten, Germany
| | - Lorin Stahlschmidt
- German Paediatric Pain Centre, Children's and Adolescents' Hospital, Datteln, Germany
| | - Kathrin Leitsch
- Department of Children's Pain Therapy and Paediatric Palliative Care, Faculty of Health, School of Medicine, Witten/Herdecke University, Witten, Germany
| | | | - Winfried Häuser
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Elmar Brähler
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany.,Clinic and Polyclinic for Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Mainz, Germany
| | - Andreas Dinkel
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Rüya Kocalevent
- Institute and Polyclinic of Primary Medical Care, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Boris Zernikow
- German Paediatric Pain Centre, Children's and Adolescents' Hospital, Datteln, Germany.,Department of Children's Pain Therapy and Paediatric Palliative Care, Faculty of Health, School of Medicine, Witten/Herdecke University, Witten, Germany.,PedScience Research Institute, Datteln, Germany
| |
Collapse
|
3
|
Höfel L, Draheim N, Haas JP, Ebinger F. [Medical pain care for children and adolescents with chronic pain in Germany : An inventory]. Schmerz 2020; 35:94-102. [PMID: 33112976 DOI: 10.1007/s00482-020-00510-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 09/13/2020] [Accepted: 09/21/2020] [Indexed: 12/25/2022]
Abstract
Chronic pain in children and adolescents is increasing in prevalence, affects the quality of life, predisposes to pain in adulthood and causes numerous contacts to the healthcare system. In contrast, the number of therapeutic offers tailored to the special needs of this age group is insufficient and confusing. The working group on pain in children and adolescents of the German Pain Society therefore documented appropriate facilities in a questionnaire survey carried out using a snowball system. The response rate of 27/109 questionnaires was low. Thus, the results may not be entirely representative. Nevertheless, the heterogeneity of the offers and in total an undersupply became very clear. In order to improve the care situation, joint efforts by the various pediatric subdisciplines dealing with pain, an increase in the number of child pain treatment centers and a better networking are necessary.
Collapse
Affiliation(s)
- Lea Höfel
- Zentrum für Schmerztherapie junger Menschen, Kinderklinik Garmisch-Partenkirchen gGmbH, Garmisch-Partenkirchen, Deutschland
| | - Nicole Draheim
- Zentrum für Schmerztherapie junger Menschen, Kinderklinik Garmisch-Partenkirchen gGmbH, Garmisch-Partenkirchen, Deutschland
| | - Johannes-Peter Haas
- Deutsches Zentrum für Kinder- und Jugendrheumatologie, Kinderklinik Garmisch-Partenkirchen gGmbH, Garmisch-Partenkirchen, Deutschland
| | - Friedrich Ebinger
- Klinik für Kinder- und Jugendmedizin, St. Vincenz-Krankenhaus, Husener Str. 81, 33098, Paderborn, Deutschland.
| |
Collapse
|
4
|
Tumin D, Frech A, Lynch JL, Raman VT, Bhalla T, Tobias JD. Weight Gain Trajectory and Pain Interference in Young Adulthood: Evidence from a Longitudinal Birth Cohort Study. PAIN MEDICINE 2020; 21:439-447. [PMID: 31386156 DOI: 10.1093/pm/pnz184] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Obesity is associated with chronic pain, but the contribution of body mass index (BMI) trajectories over the life course to the onset of pain problems remains unclear. We retrospectively analyzed how BMI trajectories during the transition to adulthood were associated with a measure of pain interference obtained at age 29 in a longitudinal birth cohort study. METHODS Data from the National Longitudinal Survey of Youth, 1997 Cohort (follow-up from 1997 to 2015), were used to determine BMI trajectories from age 14 to 29 via group trajectory modeling. At age 29, respondents described whether pain interfered with their work inside and outside the home over the past four weeks (not at all, a little, or a lot). Multivariable ordinal logistic regression was used to evaluate pain interference according to BMI trajectory and study covariates. RESULTS Among 7,875 respondents, 11% reported "a little" and 4% reported "a lot" of pain interference at age 29. Four BMI trajectory groups were identified, varying in starting BMI and rate of weight gain. The "obese" group (8% of respondents) had a starting BMI of 30 kg/m2 and gained an average of 0.7 kg/m2/y. On multivariable analysis, this group was the most likely to have greater pain interference, compared with "high normal weight" (odds ratio [OR] = 1.47, 95% confidence interval [CI] = 1.14-1.88), "low normal weight" (OR = 1.45, 95% CI = 1.13-1.87), and "overweight" trajectories (OR = 1.33, 95% CI = 1.02-1.73). CONCLUSIONS Obesity and rapid weight gain during the transition to adulthood were associated with higher risk of pain interference among young adults.
Collapse
Affiliation(s)
- Dmitry Tumin
- Department of Pediatrics, Brody School of Medicine at East Carolina University, Greenville, North Carolina
| | - Adrianne Frech
- Department of Health Sciences, University of Missouri, Columbia, Missouri
| | - Jamie L Lynch
- Department of Sociology, St. Norbert College, De Pere, Wisconsin
| | - Vidya T Raman
- Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital and The Ohio State University, Columbus, Ohio
| | - Tarun Bhalla
- Department of Anesthesia & Pain Medicine, Akron Children's Hospital, Akron, Ohio, USA
| | - Joseph D Tobias
- Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital and The Ohio State University, Columbus, Ohio
| |
Collapse
|
5
|
Pate JW, Hancock MJ, Hush JM, Gray K, Pounder M, Pacey V. Prognostic factors for pain and functional disability in children and adolescents with persisting pain: A systematic review and meta-analysis. Eur J Pain 2020; 24:722-741. [PMID: 31997486 DOI: 10.1002/ejp.1539] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 01/23/2020] [Accepted: 01/27/2020] [Indexed: 01/30/2023]
Abstract
BACKGROUND AND OBJECTIVE The aim of this study was to investigate prognostic factors for pain and functional disability in children and/or adolescents with persisting pain. DATABASES AND DATA TREATMENT To be included, studies had to be published, peer-reviewed prospective cohort studies of children and/or adolescents with persisting pain at baseline, that reported at least one baseline prognostic factor and its relationship with pain or functional disability at least 1 month after baseline. Two reviewers independently assessed study eligibility, completed data extraction and undertook quality assessment. Meta-analyses were performed when a prognostic factor was reported in two or more studies. RESULTS Of 10,992 studies identified from electronic database searches, 18 were included, investigating 62 potential prognostic factors. In clinical settings, insufficient data were available for meta-analysis. Some positive associations with pain and/or disability were reported by single studies for older age, baseline pain intensity and baseline functional disability across multiple combinations of follow-up times and outcomes. In community settings, meta-analyses of two studies found that prognostic factors for the ongoing presence of pain at medium-term (1-year) follow-up were older age (OR 1.25; 95% CI = 1.05-1.47), weekly day tiredness (OR 1.69; 95% CI = 1.14-2.51), weekly abdominal pain (OR 1.44; 95% CI = 1.03-2.02) and waking during the night (OR 1.49; 95% CI = 1.05-2.13). No studies in community settings reported on prognostic factors for functional disability. CONCLUSIONS Prognostic factors having significant associations with future pain and disability were identified; however, as few were investigated in more than one comparable study, the results need to be interpreted with caution. SIGNIFICANCE Prognostic factors from across the biopsychosocial spectrum are important to consider in paediatric pain clinical practice. However, most prognostic factors that experts have previously agreed upon have not been assessed in prospective cohort studies to date. The findings may help with prioritising data to collect during clinical assessments of children presenting with pain, in the context of pain and functional disability outcomes.
Collapse
Affiliation(s)
- Joshua W Pate
- Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Mark J Hancock
- Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Julia M Hush
- Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Kelly Gray
- Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Meg Pounder
- Department of Pain Medicine, The Children's Hospital, Westmead, New South Wales, Australia
| | - Verity Pacey
- Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, Australia
| |
Collapse
|
6
|
Wager J, Brown D, Kupitz A, Rosenthal N, Zernikow B. Prevalence and associated psychosocial and health factors of chronic pain in adolescents: Differences by sex and age. Eur J Pain 2020; 24:761-772. [DOI: 10.1002/ejp.1526] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 11/19/2019] [Accepted: 12/24/2019] [Indexed: 12/14/2022]
Affiliation(s)
- Julia Wager
- German Paediatric Pain Centre, Children's and Adolescents' Hospital Datteln, Department of Children's Pain Therapy and Paediatric Palliative Care, Faculty of Health, School of Medicine Witten/Herdecke University Witten Germany
| | - Donnamay Brown
- German Paediatric Pain Centre, Children's and Adolescents' Hospital Datteln, Department of Children's Pain Therapy and Paediatric Palliative Care, Faculty of Health, School of Medicine Witten/Herdecke University Witten Germany
| | - Anna Kupitz
- German Paediatric Pain Centre, Children's and Adolescents' Hospital Datteln, Department of Children's Pain Therapy and Paediatric Palliative Care, Faculty of Health, School of Medicine Witten/Herdecke University Witten Germany
| | - Nicola Rosenthal
- German Paediatric Pain Centre, Children's and Adolescents' Hospital Datteln, Department of Children's Pain Therapy and Paediatric Palliative Care, Faculty of Health, School of Medicine Witten/Herdecke University Witten Germany
| | - Boris Zernikow
- German Paediatric Pain Centre, Children's and Adolescents' Hospital Datteln, Department of Children's Pain Therapy and Paediatric Palliative Care, Faculty of Health, School of Medicine Witten/Herdecke University Witten Germany
| |
Collapse
|
7
|
Pavlova M, Graham SA, Jordan A, Chorney J, Vinall J, Rasic N, Brookes J, Hoy M, Yunker WK, Noel M. Socialization of Pain Memories: Parent-Child Reminiscing About Past Painful and Sad Events. J Pediatr Psychol 2019; 44:679-691. [DOI: 10.1093/jpepsy/jsz009] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 01/20/2019] [Accepted: 01/30/2019] [Indexed: 12/22/2022] Open
Affiliation(s)
| | - Susan A Graham
- Department of Psychology, University of Calgary
- Owerko Centre
| | | | - Jill Chorney
- Department of Anesthesia, Pain Management and Perioperative Medicine, Dalhousie University
| | | | - Nivez Rasic
- Department of Anesthesia, University of Calgary
| | | | - Monica Hoy
- Department of Surgery, University of Calgary
| | | | - Melanie Noel
- Department of Psychology, University of Calgary
- Alberta Children’s Hospital Research Institute
| |
Collapse
|