Why do children have chronic abdominal pain, and what happens to them when they grow up? Population based cohort study

Abstract

Abstract Objective: To test the hypotheses that children with abdominal pain have anxious parents and come from families with high rates of physical illness and that they grow up to suffer from high rates of medically unexplained symptoms and psychiatric disorders. Design: Population based birth cohort study. Setting: General population. Subjects: Participants in the Medical Research Council (MRC) national survey of health and development, a population based birth cohort study established in 1946. Main outcome measures: Abdominal pain present throughout childhood in the absence of defined organic disease, and measures of physical symptoms and psychiatric disorder at age 36 years. Results: There were high rates of complaints about physical health among the parents of children with persistent abdominal pain, and the mothers had higher neuroticism scores. Children with persistent abdominal pain were more likely to suffer from psychiatric disorders in adulthood (odds ratio 2.72 (95% confidence interval 1.65 to 4.49)) but were not especially prone to physical symptoms once psychiatric disorder was controlled for (odds ratio 1.39 (0.83 to 2.36)). Conclusions: Persistent abdominal pain is associated with poor health and emotional disorder in the parents. Children with abdominal pain do not necessarily continue to experience physical symptoms into adulthood but are at increased risk of adult psychiatric disorders. Key messages Persistent abdominal pain in childhood is more common in families with high rates of reported physical illness and psychological symptoms The outcome for persistent abdominal pain is good in terms of mortality Children with persistent abdominal pain are not at greatly increased risk of developing physical symptoms in adulthood Abdominal pain in childhood is associated with considerably increased risk of psychiatric disorders in adulthood