Suresh Kumar, V (2012) Clinical and Psychosocial Profile of Chronic Abdominal Pain in Children Aged 5 to 12 Years in a Tertiary Centre. Masters thesis, Madras Medical College, Chennai.
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Abstract
INTRODUCTION: Chronic abdominal pain is the commonest gastrointestinal complaint the physician or pediatrician is confronted with, in his outpatient clinic. The term chronic abdominal pain was derived from British pediatrician John Apley’s pioneering study of 1000 school children in 1950 1. He defined abdominal pain as chronic or recurrent if at least one episode of pain occurs per month for three consecutive months and is severe enough to interfere with routine functioning. The pain is classified as non-organic (functional) when there is no explainable cause. Early studies suggested 5 to 10% have organic causes 1, 2, but with the advent of advanced investigations, the incidence of organic abdominal pain is on the rise. Hyams in his work has reported 76 children having organic abdominal pain out of 227 children (33%) 3 studied. Differentiating organic pain from non organic ones is often problematic resulting in management difficulties. Organic symptoms may have emotional components and vice versa. One of the main reasons for the reluctance to accept abdominal pain as psychosomatic disorder stems from the fear of overlooking serious organic illnesses by the mistaken belief that a definite emotional cause has to be found. AIM OF THE STUDY: 1. To study the psychosocial factors in chronic abdominal pain in children aged 5-12 years in a tertiary referral centre. 2. To study the prevalence of anxiety and depression in chronic abdominal pain in children aged 5-12 years in a tertiary referral centre. DISCUSSION: Chronic abdominal pain is a significant public health problem. Our centre receives at least 15-20 children per week, which constitutes 12.5% of the Gastroenterology Outpatients 53. These children live in a different psychosocial environment both at school and home, which may play a critical role in the genesis or persistence or aggravation of pain in these children. This study has revealed 81% (57 children) of children with chronic abdominal pain were non organic and 19% were of organic cause. This is similar to the study done by S.Dutta et. al 7.who have reported 74% of children with chronic abdominal pain were nonorganic. Use of extensive investigation like antibodies for celiac disease, hydrogen breath test and special test for H.pylori may be helpful to diagnose more organic cases. Our study has revealed that 44 %( 25 cases) of children with chronic abdominal pain- non organic were diagnosed as functional abdominal pain as per Rome classification .Devanarayana et.al. reported functional abdominal pain in 71% of case9and Boey et.al reported that Irritable Bowel Syndrome constituted 52% of chronic abdominal pain- non organic5,but in our study only 14% with non organic group were diagnosed as Irritable Bowel Syndrome. In our study chronic abdominal pain was found to be more common in the 9 to 12 years (table-). Similar findings were reported by Jacob oster MD et al 40 and John Apley et al 1. Our study has revealed equal gender distribution of chronic abdominal pain as against female predominance reported by Jacob oster MD et al40 and John Apley et al1. Bharat Balani et.al.54 reported male predominance in his work. CONCLUSION: 1. Chronic abdominal pain is significantly associated with adverse psychosocial factors in relation with family and child. 2. There is an association between anxiety and depressive disorders and chronic abdominal pain in these children. 3. Structured psychosocial assessment would be helpful in evaluation of these children as biopsycho social factors play a major role in planning an appropriate and adequate intervention. 4. More studies are needed to understand cultural and religious influences and effectiveness of different type’s intervention including pharmacotherapy, psychotherapy and behavior modification.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Clinical ; Psychosocial Profile ;Chronic Abdominal Pain ; Children Aged 5 to 12 Years ; Tertiary Centre |
| Subjects: | MEDICAL > Paediatrics |
| Depositing User: | Ravindran C |
| Date Deposited: | 16 Apr 2018 08:53 |
| Last Modified: | 16 Apr 2018 08:53 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/7010 |
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