Pediatric Gastroenterology, Hepatology & Nutrition

The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition (대한소아소화기영양학회)
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Impaired Health-Related Quality of Life in Brazilian Children with Chronic Abdominal Pain: A Cross-Sectional Study

  • Jesus, Carine Dias Ferreira de (Pediatric Gastroenterologist, Postgraduate Student Researcher of Botucatu Medical School, Sao Paulo State University) ;
  • Carvalho, Mary de Assis (Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Botucatu Medical School, São Paulo State University) ;
  • Machado, Nilton Carlos (Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Botucatu Medical School, São Paulo State University)
  • Received : 2022.02.07
  • Accepted : 2022.09.18
  • Published : 2022.11.15
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Abstract

Purpose: We compared the health-related quality of life (HRQOL) of children and adolescents with functional abdominal pain disorders (FAPDs) and organic abdominal pain disorders (ORGDs). Methods: This was a single-center, cross-sectional, observational study. The PedsQL 4.0 generic cores scales parent proxy-report was administered to parents/caregivers of 130 and 56 pediatric patients with FAPDs and ORGDs respectively on their first visit. The self-reported pain intensity in the patients was assessed using a visual analog scale (VAS) and facial affective scale (FAS). Results: Irritable bowel syndrome was the most prevalent FAPDs, and the most prevalent ORGDs were reflux esophagitis (41.1%) and gastritis associated with Helicobacter pylori (21.4%). There was no difference in HRQOL among patients diagnosed with ORGDs and FAPDs (p>0.05). Patients with ORGDs and FAPDs had lower HRQOL Scale scores than healthy Brazilian and American children's references, with a high proportion of children at risk for impaired HRQOL (p<0.0001). There was no difference in the VAS and the FAS scores between the ORGDs and the FAPDs. FAPDs had a higher prevalence of girls' and couples' disagreement (p<0.02), although poor school performance (p<0.0007) and bullying (p<0.01) were higher in patients with ORGD. Conclusion: This study revealed that there was a difference in impaired HRQOL between patients with ORGDs and FAPDs. Thus, considering the high prevalence of chronic abdominal pain in children, a well-founded treatment plan is necessary for a multidisciplinary cognitive-behavioral Pain management program.

Keywords

Acknowledgement

The authors would like to thank all the parents and children's participants in the study.

References

  1. American Academy of Pediatrics Subcommittee on Chronic Abdominal Pain. Chronic abdominal pain in children. Pediatrics 2005;115:812-5. https://doi.org/10.1542/peds.2004-2497
  2. Korterink JJ, Diederen K, Benninga MA, Tabbers MM. Epidemiology of pediatric functional abdominal pain disorders: a meta-analysis. PLoS One 2015;10:e0126982. https://doi.org/10.1371/journal.pone.0126982
  3. Spee LA, Lisman-Van Leeuwen Y, Benninga MA, Bierma-Zeinstra SM, Berger MY. Prevalence, characteristics, and management of childhood functional abdominal pain in general practice. Scand J Prim Health Care 2013;31:197-202. https://doi.org/10.3109/02813432.2013.844405
  4. Hyams JS, Di Lorenzo C, Saps M, Shulman RJ, Staiano A, van Tilburg M. Functional disorders: children and adolescents. Gastroenterology 2016;150:1456-68.e2. https://doi.org/10.1053/j.gastro.2016.02.015
  5. Correa Silva RG, Machado NC, Carvalho MA, Rodrigues MA. Helicobacter pylori infection is high in paediatric nonulcer dyspepsia but not associated with specific gastrointestinal symptoms. Acta Paediatr 2016;105:e228-31. https://doi.org/10.1111/apa.13347
  6. Carvalho MA, Machado NC, Ortolan EV, Rodrigues MA. Upper gastrointestinal histopathological findings in children and adolescents with nonulcer dyspepsia with Helicobacter pylori infection. J Pediatr Gastroenterol Nutr 2012;55:523-9. https://doi.org/10.1097/MPG.0b013e3182618136
  7. Gulewitsch MD, Enck P, Schwille-Kiuntke J, Weimer K, Schlarb AA. Rome III criteria in parents' hands: pain-related functional gastrointestinal disorders in community children and associations with somatic complaints and mental health. Eur J Gastroenterol Hepatol 2013;25:1223-9.
  8. Varni JW, Bendo CB, Nurko S, Shulman RJ, Self MM, Franciosi JP, et al.; Pediatric Quality of Life Inventory (PedsQL) Gastrointestinal Symptoms Module Testing Study Consortium. Health-related quality of life in pediatric patients with functional and organic gastrointestinal diseases. J Pediatr 2015;166:85-90. https://doi.org/10.1016/j.jpeds.2014.08.022
  9. Lisman-van Leeuwen Y, Spee LA, Benninga MA, Bierma-Zeinstra SM, Berger MY. Prognosis of abdominal pain in children in primary care--a prospective cohort study. Ann Fam Med 2013;11:238-44. https://doi.org/10.1370/afm.1490
  10. Assa A, Ish-Tov A, Rinawi F, Shamir R. School attendance in children with functional abdominal pain and inflammatory bowel diseases. J Pediatr Gastroenterol Nutr 2015;61:553-7. https://doi.org/10.1097/MPG.0000000000000850
  11. Warschburger P, Hanig J, Friedt M, Posovszky C, Schier M, Calvano C. Health-related quality of life in children with abdominal pain due to functional or organic gastrointestinal disorders. J Pediatr Psychol 2014;39:45-54.
  12. Groenewald CB, Wright DR, Palermo TM. Health care expenditures associated with pediatric pain-related conditions in the United States. Pain 2015;156:951-7. https://doi.org/10.1097/j.pain.0000000000000137
  13. Dhroove G, Chogle A, Saps M. A million-dollar work-up for abdominal pain: is it worth it? J Pediatr Gastroenterol Nutr 2010;51:579-83. https://doi.org/10.1097/MPG.0b013e3181de0639
  14. Calvano C, Warschburger P. Chronic abdominal pain in children and adolescents: parental threat perception plays a major role in seeking medical consultations. Pain Res Manag 2016;2016:3183562.
  15. Youssef NN, Murphy TG, Langseder AL, Rosh JR. Quality of life for children with functional abdominal pain: a comparison study of patients' and parents' perceptions. Pediatrics 2006;117:54-9. https://doi.org/10.1542/peds.2005-0114
  16. Varni JW, Lane MM, Burwinkle TM, Fontaine EN, Youssef NN, Schwimmer JB, et al. Health-related quality of life in pediatric patients with irritable bowel syndrome: a comparative analysis. J Dev Behav Pediatr 2006;27:451-8. https://doi.org/10.1097/00004703-200612000-00001
  17. Apley J, Naish N. Recurrent abdominal pains: a field survey of 1,000 school children. Arch Dis Child 1958;33:165-70. https://doi.org/10.1136/adc.33.168.165
  18. Di Lorenzo C, Colletti RB, Lehmann HP, Boyle JT, Gerson WT, Hyams JS, et al. Chronic abdominal pain in children: a clinical report of the American Academy of Pediatrics and the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition. J Pediatr Gastroenterol Nutr 2005;40:245-8. https://doi.org/10.1097/01.MPG.0000155367.44628.21
  19. Physical status: the use and interpretation of anthropometry. Report of a WHO Expert Committee. World Health Organ Tech Rep Ser 1995;854:1-452.
  20. WHO. WHO AnthroPlus for personal computers manual: software for assessing growth of the world's children and adolescents [Internet]. Geneva: WHO; 2009 [cited 2022 Jan 10]. Available from: https://cdn.who.int/media/docs/default-source/child-growth/growth-reference-5-19-years/who-anthroplus-manual.pdf?sfvrsn=ddd24b2_1
  21. Gragg RA, Rapoff MA, Danovsky MB, Lindsley CB, Varni JW, Waldron SA, et al. Assessing chronic musculoskeletal pain associated with rheumatic disease: further validation of the pediatric pain questionnaire. J Pediatr Psychol 1996;21:237-50. https://doi.org/10.1093/jpepsy/21.2.237
  22. McGrath PA. Pain in children: nature, assessmemt, and treatment. New York: Guilford Press, 1989.
  23. Gold JI, Mahrer NE, Yee J, Palermo TM. Pain, fatigue, and health-related quality of life in children and adolescents with chronic pain. Clin J Pain 2009;25:407-12. https://doi.org/10.1097/AJP.0b013e318192bfb1
  24. Hirschfeld G, Zernikow B. Variability of "optimal" cut points for mild, moderate, and severe pain: neglected problems when comparing groups. Pain 2013;154:154-9. https://doi.org/10.1016/j.pain.2012.10.008
  25. Lundell LR, Dent J, Bennett JR, Blum AL, Armstrong D, Galmiche JP, et al. Endoscopic assessment of oesophagitis: clinical and functional correlates and further validation of the Los Angeles classification. Gut 1999;45:172-80. https://doi.org/10.1136/gut.45.2.172
  26. Knuff TE, Benjamin SB, Worsham GF, Hancock JE, Castell DO. Histologic evaluation of chronic gastroesophageal reflux. An evaluation of biopsy methods and diagnostic criteria. Dig Dis Sci 1984;29:194-201. https://doi.org/10.1007/BF01296251
  27. Varni JW, Burwinkle TM, Seid M, Skarr D. The PedsQL 4.0 as a pediatric population health measure: feasibility, reliability, and validity. Ambul Pediatr 2003;3:329-41. https://doi.org/10.1367/1539-4409(2003)003<0329:TPAAPP>2.0.CO;2
  28. Klatchoian DA, Len CA, Terreri MT, Silva M, Itamoto C, Ciconelli RM, et al. Quality of life of children and adolescents from Sao Paulo: reliability and validity of the Brazilian version of the Pediatric Quality of Life Inventory version 4.0 Generic Core Scales. J Pediatr (Rio J) 2008;84:308-15.
  29. Campo JV, Bridge J, Lucas A, Savorelli S, Walker L, Di Lorenzo C, et al. Physical and emotional health of mothers of youth with functional abdominal pain. Arch Pediatr Adolesc Med 2007;161:131-7. https://doi.org/10.1001/archpedi.161.2.131
  30. van der Veek SM, Derkx HH, de Haan E, Benninga MA, Boer F. Abdominal pain in Dutch schoolchildren: relations with physical and psychological comorbid complaints in children and their parents. J Pediatr Gastroenterol Nutr 2010;51:481-7. https://doi.org/10.1097/MPG.0b013e3181d51a59
  31. Palermo TM, Long AC, Lewandowski AS, Drotar D, Quittner AL, Walker LS. Evidence-based assessment of health-related quality of life and functional impairment in pediatric psychology. J Pediatr Psychol 2008;33:983-96; discussion 997-8. https://doi.org/10.1093/jpepsy/jsn038
  32. von Baeyer CL. Children's self-report of pain intensity: what we know, where we are headed. Pain Res Manag 2009;14:39-45. https://doi.org/10.1155/2009/259759
  33. McGrath PJ, Walco GA, Turk DC, Dworkin RH, Brown MT, Davidson K, et al. Core outcome domains and measures for pediatric acute and chronic/recurrent pain clinical trials: PedIMMPACT recommendations. J Pain 2008;9:771-83. https://doi.org/10.1016/j.jpain.2008.04.007
  34. Greenley RN, Kunz JH, Schurman JV, Swanson E. Abdominal pain and health related quality of life in pediatric inflammatory bowel disease. J Pediatr Psychol 2013;38:63-71. https://doi.org/10.1093/jpepsy/jss097
  35. Walker LS, Claar RL, Garber J. Social consequences of children's pain: when do they encourage symptom maintenance? J Pediatr Psychol 2002;27:689-98. https://doi.org/10.1093/jpepsy/27.8.689