Stolk, R. (2012) Patient-specific factors that play a role in the natural course of functional abdominal pain and irritable bowel syndrome in children. thesis, Medicine.
Full text available on request.Abstract
AIM: To identify patient-specific factors that predict the course of functional abdominal pain and irritable bowel syndrome in children. BACKGROUND: Approximately 20% of school-aged children suffer from abdominal pain on weekly or daily base. In 90% of cases an organic cause cannot be found. The majority of patients is diagnosed, according to the Rome III criteria, with functional abdominal pain (FAP) or irritable bowel syndrome (IBS). The FAP and IBS symptoms have a high impact on daily life of patients and their family. Little is known about the course of symptoms and the prognosis of children with chronic abdominal complaints. Therapeutic options are limited. A substantial part of the children continue to experience symptoms in adulthood. Moreover, 50% will develop psychological problems in later life. It is still unclear which factors play a role in the natural course of FAP and IBS. Insight in the patient-specific factors that affect the course of FAP and IBS would provide opportunities to develop an effective treatment and can lead to a better outcome for patients and their family. METHODS: A prospective, observational study was conducted to determine patient characteristics, clinical data and outcome of patients with FAP and IBS aged 8 to 18 years. Data obtained by using questionnaires taken during a visit at the outpatient clinic or during telephonic consult were analysed. Evaluations took place at a three month interval. The primary outcome of this study is severity of symptoms compared to baseline (time of diagnosis). RESULTS: Three months after diagnosis, the symptoms were worse in 1 patient compared to baseline (3,4%). Symptoms were unchanged in 12 patients (41,4%) and in 11 patients symptoms were improved (37,9%). In 5 patients (17,2%) symptoms were completely resolved. Patients with improved and not improved symptoms do not differ in demographic characteristics and clinical features. Duration of symptoms of more than a year is significant associated with a reduction of symptoms after 3 months (correlation coefficient 0,372; p=0,049). There is no significant correlation between gender, school absenteeism or the presence of a life-event at the onset of symptoms and outcome after 3 months. CONCLUSION: This study shows that duration of the symptoms of more than 1 year at the time of diagnosis is positively correlated to the reduction of symptoms after 3 months of treatment. Other patient characteristics such as gender, degree of school absenteeism or presence of a life-event at the onset of complaints, did not seem to correlate with a decrease of complaints. Given the limited sample size of 29 patients and the restricted follow-up data no firm conclusions could be drawn. Hitherto, there is little evidence available which focuses on patient-specific factors that may play a role in the course of symptoms and may therefore predict prognosis of FAP and IBS. Sufficient long-term, prospective data are also lacking, so future research on these disorders is evidently needed.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Faculty supervisor: and Alleman Dr. M.A., Isala klinieken Zwolle |
| Supervisor name: | Benninga, Prof. Dr. M.A.AMC and Location: Academic Medical Centre (AMC), Amsterdam and Department:Paediatric Gastroenterology, Emma Children’s Hosp |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:57 |
| Last Modified: | 25 Jun 2020 10:57 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/1729 |
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