title: Childhood nonspecific abdominal pain in family practice: incidence, associated factors, and management.
abstract: OBJECTIVE
  Nonspecific abdominal pain (NSAP) is a common complaint in childhood. In specialist care, childhood NSAP is considered to be a complex and time-consuming problem, and parents are hard to reassure. Little is known about NSAP in family practice, but the impression is that family physicians consider it to be a benign syndrome needing little more than reassurance. This discrepancy calls for a better understanding of NSAP in family practice.
  
  
  METHODS
  Data were obtained from the Second Dutch National Survey of General Practice (2001). Using registration data of 91 family practices, we identified children aged 4 to 17 years with NSAP. We calculated the incidence, and we studied factors associated with childhood NSAP, referrals, and prescriptions.
  
  
  RESULTS
  The incidence of NSAP was 25.0 (95% confidence interval [CI], 23.7-26.3) per 1,000 person years. Most children (92.7%) with newly diagnosed NSAP (N = 1,480) consulted their doctor for this condition once or twice. Factors independently associated with NSAP were female sex (odds ratio [OR] = 1.4; 95% CI, 1.3-1.5), nongastrointestinal-nonspecific somatic symptoms (OR = 1.3; 95% CI, 1.1-1.5), and health care use (OR = 1.04; 95% CI, 1.03-1.05). When NSAP was diagnosed at the first visit, 3% of the patients were referred to specialist care, and 1% received additional testing. Family physicians prescribed medication in 21.3% of the visits for NSAP.
  
  
  CONCLUSIONS
  Childhood NSAP is a common problem in family practice. Most patients visit their doctor once or twice for this problem. Family physicians use little additional testing and make few referrals in their management of childhood NSAP. Despite the lack of evidence for effectiveness, family physicians commonly prescribe medication for NSAP.
authors: Department of General Practice, Erasmus MC-University Medical Center, Rotterdam, The Netherlands.
authors: Marieke J
authors: MJ
authors: Gieteling
authors: Yvonne
authors: Y
authors: Lisman-van Leeuwen
authors: Johannes C
authors: JC
authors: van der Wouden
authors: Francois G
authors: FG
authors: Schellevis
authors: Marjolein Y
authors: MY
authors: Berger
mesh_terms: D015746:Abdominal Pain / Q000453:epidemiology* / Q000209:etiology; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D005194:Family Practice / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D010818:Practice Patterns, Physicians'; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012737:Sex Factors