Risk Categorization Predicts Disability in Pain-associated Functional Gastrointestinal Disorders After 6 Months

J Pediatr Gastroenterol Nutr. 2017 May;64(5):685-690. doi: 10.1097/MPG.0000000000001342.

Abstract

Introduction: For a large portion of youth, pain-associated functional gastrointestinal disorders (FGIDs) are associated with significant impairment over time. Clinically feasible methods to categorize youth with FGIDs at greatest risk for persistent pain-related impairment have not yet been identified.

Methods: Measures of functional disability, pain intensity, and anxiety were collected on 99 patients with FGIDs (ages 8-18) during a visit to a pediatric gastroenterology office to assess for the presence of risk. Follow-up data were obtained on a subset of this sample (n = 64) after 6 months, either in person or via mail. The present study examined whether a greater number of risk factors at baseline predicted greater pain-related disability at follow-up.

Results: Patients were divided into 4 groups based on number of risk factors present at the initial assessment: 0 (18.2%), 1 (24.2%), 2 (26.3%), and 3 (31.3%). The presence of 2 or 3 risk factors significantly predicted greater disability at follow-up compared to those with 0 risk factors (R = 0.311) and those with just 1 risk factor (Cohen's d values of -1.07 and -1.44, respectively).

Discussion: A simple approach to risk categorization can identify youth with FGIDs who are most likely to report increased levels of pain-related impairment over time. These findings have important clinical implications that support the utility of a brief screening process during medical care to inform referral for targeted treatment approaches to FGIDs.

Publication types

  • Clinical Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Abdominal Pain / diagnosis*
  • Abdominal Pain / etiology
  • Adolescent
  • Algorithms
  • Anxiety / diagnosis
  • Anxiety / etiology
  • Child
  • Decision Support Techniques
  • Disability Evaluation*
  • Female
  • Follow-Up Studies
  • Gastrointestinal Diseases / complications*
  • Gastrointestinal Diseases / diagnosis
  • Humans
  • Male
  • Pain Measurement*
  • Prognosis
  • Psychiatric Status Rating Scales
  • Risk Assessment
  • Risk Factors
  • Severity of Illness Index*