title: Abdominal pain-predominant functional gastrointestinal diseases in children and adolescents:  prevalence, symptomatology, and association with emotional stress.
abstract: OBJECTIVE
  Functional gastrointestinal disorders (FGD) are common among children, but little is known regarding their prevalence in developing countries. We assessed the prevalence of abdominal pain-predominant FGD, in addition to the predisposing factors and symptomatology, in Sri Lankan children.
  
  
  METHODS
  A cross-sectional survey was conducted among a randomly selected group of 10- to 16-year-olds in 8 randomly selected schools in 4 provinces in Sri Lanka. A validated, self-administered questionnaire was completed by children independently in an examination setting. FGD were diagnosed using Rome III criteria.
  
  
  RESULTS
  A total of 2180 questionnaires were distributed and 2163 (99.2%) were included in the analysis (1189 [55%] boys, mean age 13.4 years, standard deviation 1.8 years). Of them, 270 (12.5%) had at least 1 abdominal pain-predominant FGD. Irritable bowel syndrome (IBS) was seen in 107 (4.9%), functional dyspepsia in 54 (2.5%), functional abdominal pain in 96 (4.4%), and abdominal migraine (AM) in 21 (1.0%) (2 had AM and functional dyspepsia, 6 had AM and IBS). Extraintestinal symptoms were more common among affected children (P < 0.05). Abdominal pain-predominant FGD were higher in girls and those exposed to stressful events (P < 0.05). Prevalence negatively correlated with age (r = -0.05, P = 0.02).
  
  
  CONCLUSIONS
  Abdominal pain-predominant FGD affects 12.5% of children ages 10 to 16 years and constitutes a significant health problem in Sri Lanka. IBS is the most common FGD subtype present. Abdominal pain-predominant FGD are higher in girls and those exposed to emotional stress. Prevalence of FGD decreased with age. Extraintestinal symptoms are more frequent in affected children.
authors.affiliation: Department of Physiology, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka. niranga1230@lycos.com
authors.forename: Niranga Manjuri
authors.initials: NM
authors.lastname: Devanarayana
authors.forename: Sachith
authors.initials: S
authors.lastname: Mettananda
authors.forename: Chathurangi
authors.initials: C
authors.lastname: Liyanarachchi
authors.forename: Navoda
authors.initials: N
authors.lastname: Nanayakkara
authors.forename: Niranjala
authors.initials: N
authors.lastname: Mendis
authors.forename: Nimnadi
authors.initials: N
authors.lastname: Perera
authors.forename: Shaman
authors.initials: S
authors.lastname: Rajindrajith
mesh_terms: D015746:Abdominal Pain / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D000293:Adolescent; D002648:Child; D003430:Cross-Sectional Studies; D003906:Developing Countries; D004415:Dyspepsia / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D005767:Gastrointestinal Diseases / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology; D008297:Male; D008881:Migraine Disorders / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology; D015995:Prevalence; D015203:Reproducibility of Results; D013188:Sri Lanka / Q000453:epidemiology; D013315:Stress, Psychological / Q000150:complications / Q000453:epidemiology*; D011795:Surveys and Questionnaires