Prevalence of Upper Gastrointestinal Symptoms Among School Age Children: A Community-Based Study

Abstract

Objective: To measure the prevalence of upper gastrointestinal (GI) symptoms among children in the Houston, Texas community and describe the clinical constellation and natural history of upper (GI) symptoms in children. Methods: A cross-sectional study was conducted on school children in Houston, Texas. After informed consent, parents of children attending two middle schools and one elementary school completed a standardized questionnaire concerning socioeconomic parameters, and upper abdominal pain discomfort. A subset of children completed a questionnaire regarding the presence, the frequency, and the intensity of upper (GI) symptoms that included heartburn, nausea/vomiting, belching, loss of appetite, and or bloating. The frequency and the intensity of the symptoms were categorized into 5 ratings; never, less than once/month, 1-3 times/month, once/week and more than once a week. Results: 700 children/parents completed the questionnaire about the presence/absence of abdominal pain. The overall prevalence of abdominal pain (AP) was 24%. 348 children completed a questionnaire about upper (GI) symptoms; 48% with AP and 52% without AP. The mean age of the children was 9.5 years, 38% African-Americans, 42% Hispanics, and 20% Caucasians. The overall prevalence of one or more of upper (GI) symptoms occurring at least 1-3 times/month was 38% and occurring once/week or more was 24%. There were no ethnic differences in the prevalence of upper (GI) symptoms occurring weekly between Black, Hispanic or White children; 25%, 22%, and 28%, respectively, p = 0.7, nor between boys and girls, p = 0.6. Abdominal pain was not associated with upper (GI) symptoms; (OR = 1.3, 95% CI = 0.8-2.1, p = 0.17). In a final logistic regression model, age, ethnicity, and the presence of AP were not associated with the upper (GI) symptoms. Conclusion: There is a high prevalence of upper (GI) symptoms among school age children in Houston, Texas, that is severe enough to occur more than once/week. This is a higher prevalence than other reports (Hyams-2000). Abdominal pain is not associated with upper GI symptoms in children. Further community studies are needed to identify who seek medical advice and who use over the counter medication to relive their upper (GI) symptoms.