Characteristics of Pain and Stooling in Children With Recurrent Abdominal Pain

Abstract

Objective-To collect symptom data longitudinally from children with recurrent abdominal pain (RAP) and Control (asymptomatic) children.Methods-Children with RAP (n = 77) and Controls (n = 33) ages 7-10 yrs. completed daily diaries for two weeks tracking pain frequency and severity, how often the pain interfered with activities, and stooling pattern.Results-RAP children reported a greater number of pain episodes and greater pain severity than Control children. Pain commonly was reported to be in the periumbilical area and occurred evenly across the day in both groups. However, the pain interfered with activity more often in the RAP group. There was a positive relation between pain and interference with activities. Both groups reported stool changes but there were no differences between groups in stool character (e.g., hard, mushy, etc.). For both groups the presence of watery stool was related positively to pain. Of children with RAP, 65% could be categorized as having irritable bowel syndrome (IBS) whereas 35% were classifiable as having functional abdominal pain (FAP) according to the pediatric Rome II criteria.Conclusions-To our knowledge this is the first longitudinal report of symptoms in children with RAP compared with Controls. These data demonstrate that there is considerable overlap between children with RAP and Control children on a number of items commonly obtained in the history (e.g., pain location, timing, and stooling pattern). A majority of children with RAP could be characterized as having IBS. The relationship between pain reports and interference with activities substantiates the need to deal specifically with the abdominal pain to decrease disability. The relationship between pain and watery stools requires further study.

Endoscopic and symptoms analysis in Mexican patients with irritable Bowel syndrome, dyspepsia, and gastroesophageal reflux disease

“…Furthermore, liquid stools were more frequently reported in patients with abdominal pain or discomfort associated with a change in the consistency of stool. These data agree with a study in children with recurrent abdominal pain for which the presence of watery stool was positively related to pain (Shulman et al 2007). Regarding IBS, our patients mainly fell into the group of those with alternating bowel habits.…”

Increased Gastrointestinal Permeability and Gut Inflammation in Children with Functional Abdominal Pain and Irritable Bowel Syndrome

“…As shown in Table IV, and as is recognized clinically, Control children may report episodes of abdominal pain (18). However, there were significantly more pain episodes in the FAP/IBS group compared with Controls.…”

“…FAP/IBS Symptoms-Ratings of pain intensity and the degree to which pain interfered with activity were made 3 times a day (awakening, after lunch, and evening) over a two week period as we have described previously (18). The child rated their pain using a visual analogue scale (VAS) (20)(21)(22).…”

“…Similarly, there were no differences between groups on the type of stools such as mushy, hard balls, watery, or the number of days without a bowel movement. Using the criteria of having a pain episode with a change in stool character that day or the day after, 70 children had IBS and 12 had FAP (18).…”

Gut microbiota influences low fermentable substrate diet efficacy in children with irritable bowel syndrome

“…In order to measure these outcomes, children kept a one-week pain and stool diary as described previously during both the baseline and LFSD periods. 32,33 Abdominal pain ratings were made 3 times per day (awakening, after lunch, and evening) during each one-week period. Pain ratings were recorded directly into the database via a dedicated touchtone telephone line.…”