Functional Abdominal Pain in Relation to Behavioral Pattern Triggers in Children

D. Kesavelu, K. Pai, K. Veligandla
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Abstract

Background: Functional abdominal pain (FAP) in children is a common problem encountered by clinicians. The etiology of FAP is multifactorial and this study explains the correlates of FAP to certain behavioral patterns in children. This is the first Indian study which looks into this area. Methods: Eighteen participants between 4 and 18 years old who had consulted pediatric gastroenterologist with abdominal pain in one single multi-specialty hospital were included. A written consent was obtained from parents. The Child Behavior Checklist (CBCL) was given to the parents to understand the various behavioral problems in the children; and intelligence quotient (IQ) assessments were done in all children. A 5-point Likert scale was used to assess anxiety in children which was rated by the child. Results: The CBCL identified the stressors reported by children such as academic pressure, difficulty to comprehend, need for affection from parents, interpersonal problems at home (frequent arguments between parents, comparison with a brighter sibling) and poor self-esteem. It is observed that 11/18 (61%) children had average or above average IQ and 7/18 (39%) children had low average or dull IQ. The anxiety levels of children in majority, 16 out of 18 children (88.8%) who presented with FAP, were found to be high or very high on a Likert scale. Conclusions: Children with FAP have variable IQ levels and high anxiety levels. The need for clinicians to counsel parents and children in order to address the stressors at home and school is warranted as this may help in management of FAP in children. Further multi-centric research is necessary to understand these findings in Indian children. Int J Clin Pediatr. 2020;9(2):31-34 doi: https://doi.org/10.14740/ijcp371
儿童行为模式诱发的功能性腹痛
背景:儿童功能性腹痛(FAP)是临床医生经常遇到的问题。FAP的病因是多因素的,本研究解释了FAP与儿童某些行为模式的相关性。这是印度首次对这一领域进行研究。方法:18名年龄在4至18岁之间,在一家多专科医院因腹痛就诊过儿科胃肠科医生的患者被纳入研究对象。得到了父母的书面同意。向家长发放儿童行为检查表(CBCL),了解儿童的各种行为问题;对所有儿童进行智商(IQ)评估。采用李克特5分量表评估儿童的焦虑程度,由儿童自行评定。结果:CBCL确定了儿童报告的压力源,如学业压力、理解困难、需要父母的关爱、家庭人际关系问题(父母之间经常争吵、与聪明的兄弟姐妹比较)和自卑。观察到11/18(61%)的儿童智商平均或高于平均水平,7/18(39%)的儿童智商低或低。大多数患有FAP的儿童(88.8%)的焦虑水平在李克特量表上被发现是高或非常高的。结论:FAP患儿具有不同的智商水平和高焦虑水平。临床医生需要向家长和儿童提供咨询,以解决家庭和学校的压力源,因为这可能有助于管理儿童FAP。进一步的多中心研究是必要的,以了解这些发现在印度儿童。国际儿科临床杂志,2020;9(2):31-34 doi: https://doi.org/10.14740/ijcp371
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