A prospective school-based study of abdominal pain and other common somatic complaints in children.

OBJECTIVE: To determine the prevalence and impact of pediatric abdominal pain (AP). STUDY DESIGN: Prospective cohort study (12/2005-06/2006), with gastrointestinal and other symptoms assessed weekly. Anxiety, depression, functional disability, quality of life, somatization, coping, school absenteeism and medical care were assessed in 237 students in the third through eighth grades (11.8 years; 134 girls) from 2 public schools weekly. Complete data were obtained on 4606 of 5175 (89%) possible questionnaires. RESULTS: Seventy-two percent of children reported >1 somatic symptom weekly, and 45% of children reported >1 gastrointestinal symptom weekly. The weekly prevalence of AP was 38%, and 90% of children reported AP at least once. AP persisted >4 consecutive weeks in 52% of children and was associated with higher anxiety (P < .001) and depression (P < .001) scores and worse quality of life (P < .001). Twenty-three percent of children missed school for AP (average, 2.3 days), and 10% of parents of those children missed work (average, 1.9 days). Presence of AP (P < .001) was independently associated with school absences. Four children (2%) sought medical attention. CONCLUSIONS: AP is common in school-age children and is associated with worse quality of life, psychological co-morbidities, school absenteeism, and parental work absences.

Cost and consultation patterns of abdominal pain in Uruguayan children.

BACKGROUND: Children with abdominal pain (AP) have worse quality of life and poorer social functioning and school attendance than their healthy peers. This is the first investigation of consultation patterns and costs of AP in South American children. PATIENTS AND METHODS: All data were collected from Unidad Coronaria Movil in Montevideo, Uruguay. Diagnoses of all house calls during a 4-year period (January 2002 through December 2005) were analyzed. Variances in consultation patterns based on sex and age were investigated. Supply and personnel costs were analyzed and prorated to obtain an accurate estimate of the cost per house call and outpatient visit. RESULTS: A total of 125,945 in-home visits and 1588 outpatient consultations were analyzed. Consultation rates for AP peaked among patients 7 to 9 years of age. Female subjects 9 to 14 years of age consulted significantly more frequently for AP than male subjects in the same age group. The average AP consultation accounted for approximately 3.8% of the per capita health care spending in Uruguay in 2005. CONCLUSIONS: AP is a global health problem that is present across ethnicities, nationalities, and geographic locations and is associated with significant health care expenditure.