EARLY GASTROINTESTINAL SYMPTOMS and SUBSEQUENT RECURRENT ABDOMINAL PAIN OF CHILDHOOD

Abstract

Introduction Little is known of the precursors and natural history of childhood recurrent abdominal pain (RAP) and its relationship to early gastrointestinal (GI) function. This study determines the prevalence of common GI problems in childhood and assesses the relationship of RAP at age eight to prior GI function and symptoms. Methods The Raine Study enrolled 2979 women by the eighteenth week of pregnancy in a prospective cohort that has been followed to age eight with extensive data collection every 1 to 2 years. The prevalence of GI symptoms and problems in this population was determined and the relationship of these to the reporting of RAP at age eight was analysed. Results Two thousand eight hundred and sixty infants were assessed at birth, and 2162 of 2620 potentially still available were followed to year 8. One hundred and forty-two children (6.6%) experienced RAP at age eight (9.3% of girls, 5.3% of boys, P = 0.009). Only 16% of these children experienced pain more frequently than several times per week. The occurrence of GI symptoms and function at various ages up to eight have been defined. Seventy five percent of children at all ages defaecated between twice a day and once every second day. The proportion with infrequent defaecation increased with age. Ten per cent of 5-year old had been treated for constipation and 12% had difficulties with faecal soiling. The risk of RAP for early GI symptoms is shown in the table. Symptom/feature Prevalence (%) Odds ratio 95% CI * P < 0.05, ** P < 0.001. Infantile colic 28.7 4.23 3.6–5.0* GOReflux 0–4 months 29 1.23 0.84–1.80 GOReflux 5–12 months 12.8 1.16 0.70–1.91 Frequent stools year 1 17.2 0.70 0.42–1.17 Frequent stools year 2 5.9 1.0 0.43–2.34 Infrequent stools year 2 1.6 4.19 1.57–11.16* Infrequent stools year 8 2.9 4.12 2.17–7.8** Soiling year 5 11.8 1.38 0.28–6.79 Conclusions 1 RAP at age 8 is associated with infrequent defaecation at ages 2 and 8. 2 RAP at age 8 is associated with infantile colic This may reflect underlying sensitivity to gastrointestinal distension and contraction. or reflect parental anxiety. 3 RAP is not associated with frequent stools, GOReflux or with disorders of defaecation.