Predicting Persistence of Functional Abdominal Pain From Childhood Into Young Adulthood
Open accessAbstract
Background & aims Pediatric functional abdominal pain has been linked to functional gastrointestinal disorders (FGIDs) in adulthood, but little is known about patient characteristics in childhood that increase the risk for FGID in young adulthood. We investigated the contribution of gastrointestinal symptoms, extraintestinal somatic symptoms, and depressive symptoms in pediatric patients with functional abdominal pain and whether these predicted FGIDs later in life.Methods In a longitudinal study, consecutive new pediatric patients, diagnosed with functional abdominal pain in a subspecialty clinic, completed a comprehensive baseline evaluation of the severity of their physical and emotional symptoms. They were contacted 5 to 15 years later and evaluated, based on Rome III symptom criteria, for abdominal pain-related FGIDs, including irritable bowel syndrome, functional dyspepsia, functional abdominal pain syndrome, and abdominal migraine. Controlling for age, sex, baseline severity of abdominal pain, and time to follow-up evaluation, multivariable logistic regression was used to evaluate the association of baseline gastrointestinal, extraintestinal somatic, and depressive symptoms in childhood with FGID in adolescence and young adulthood.Results Of 392 patients interviewed an average of 9.2 years after their initial evaluation, 41% (n = 162) met symptom criteria for FGID; most met the criteria for irritable bowel syndrome. Extraintestinal somatic and depressive symptoms at the initial pediatric evaluation were significant predictors of FGID later in life, after controlling for initial levels of GI symptoms. Age, sex, and abdominal pain severity at initial presentation were not significant predictors of FGID later in life.Conclusions In pediatric patients with functional abdominal pain, assessment of extraintestinal and depressive symptoms may be useful in identifying those at risk for FGID in adolescence and young adulthood.
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FSS symptoms frequently sustain into adulthood, carrying a significant risk of long-term impairment, reduced probability of obtaining higher education and high use of health care costs.
“Frequently, symptoms sustain into adulthood, carrying a significant risk of long-term impairment, reduced probability of obtaining a higher education and a high use of health care costs [9–13].”
From Feasibility of group-based acceptance and commitment therapy for adolescents (AHEAD) with multiple functional somatic syndromes: A pilot study (2020) · cites this paper as [10]
The Discussion (page unavailable) reports that 41% of patients with pediatric functional abdominal pain met criteria for a functional gastrointestinal disorder at follow-up in adolescence or young adulthood, supporting symptom persistence in this specific group. The paper does not establish persistence across FSS generally, or report the claimed long-term impairment, reduced likelihood of higher education, or high health-care costs. (LLM, conf=0.88)
Experimental — accuracy not yet measuredA substantial proportion of adolescents with FSS show continuity of functional symptoms into adulthood.
“A substantial proportion show continuity of functional symptoms into adulthood9–11”
From Comparing group-based acceptance and commitment therapy (ACT) with enhanced usual care for adolescents with functional somatic syndromes: A study protocol for a randomised trial (2016) · cites this paper as [10]
The Discussion reports that a large proportion of patients with pediatric functional abdominal pain still had frequent abdominal pain at follow-up in adolescence and young adulthood; the Abstract Results specify that 41% met criteria for a functional gastrointestinal disorder. This supports continuity for pediatric functional abdominal pain, but does not establish the same pattern for adolescents with functional somatic symptoms generally. (LLM, conf=0.85)
Experimental — accuracy not yet measured
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- Authors
- Horst, S., Shelby, G., Anderson, J., Acra, S., Polk, D. B., Saville, B. R., Garber, J., & Walker, L. S.
- Affiliations
- Vanderbilt University Medical Center (US)
- Vanderbilt University (US)
- Monroe Carell Jr. Children's Hospital (US)
- University of Southern California (US)
- Corresponding author
- Walker, Lynn S.
- ORCID
- Venue
- Clinical Gastroenterology and Hepatology
- Publisher
- Elsevier BV
- Published
- 2014-12
- Volume
- 12
- Issue
- 12
- Pages
- 2026-2032
- ISSN
- 1542-3565 (ISSN-L)
- PMC
- PMC4195814
- OpenAlex
- W2135236679
- Cited by
- 133
- References
- 47
- Citations by year
- 2026: 5 · 2025: 11 · 2024: 12 · 2023: 11 · 2022: 14 · 2021: 12 · 2020: 18 · 2019: 10 · 2018: 10 · 2017: 10 · 2016: 9 · 2015: 9 · 2014: 2
- FWCI
- 10.02
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Clinical Gastroenterology and Hepatology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (UL1TR000445)
- National Institute of Mental Health (T32MH018921)
- National Institute of Diabetes and Digestive and Kidney Diseases (DK058404, P30DK058404)
- National Center for Research Resources (UL1RR024975)
- National Center for Advancing Translational Sciences
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (P30HD015052, P30 HD-15052, R01 HD 23264, R01HD023264)
- Topics
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pediatric Pain Management Techniques
- Keywords
- functional abdominal pain, functional gastrointestinal disorders, pediatric patients, irritable bowel syndrome, functional dyspepsia, abdominal migraine, depressive symptoms, risk prediction, early adulthood, adolescence
- MeSH terms
- Adolescent, Child, Depression, Female, Gastrointestinal Diseases, Humans, Longitudinal Studies, Male, Prognosis, Abdominal Pain, Comorbidity, Young Adult
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