title: Prognosis of abdominal pain in children in primary care--a prospective cohort study.
abstract: OBJECTIVE
  Abdominal pain is a common complaint in children. Because few data exist on its natural history, we wanted to investigate the prognosis of abdominal pain in children in general practice.
  
  
  METHODS
  In a prospective cohort study of children (aged 4 to 17 years) complaining of abdominal pain, follow-up was at 3, 6, 9, and 12 months using standardized questionnaires. The primary outcome measure was chronic abdominal pain: abdominal pain at least 1 time a month during at least 3 consecutive months that had an impact on daily activities. Prevalence, incidence, and duration of chronic abdominal pain were assessed.
  
  
  RESULTS
  Three hundred five children (116 boys, 189 girls), with a median age of 7.8 years (interquartile range [IQR] = 5.7-10.5 years) were included. Chronic abdominal pain was present in 142 (46.6%) children at an initial visit to the primary care physician for this complaint. During follow-up, 78.7% fulfilled the criteria for chronic abdominal pain at 1 or more follow-up points. Among 163 children at risk for developing chronic abdominal pain, the cumulative incidence of chronic abdominal pain was 60.1% (95% CI, 52.1%-67.7%) and was higher in girls than in boys (RR = 1.23; 95% CI, 0.94-1.61). Median duration of abdominal pain was 7.5 months (IQR = 4.5-12.0 months). Children aged 10 to 17 years had the longest duration of abdominal pain (median = 9.0 months; IQR = 7.5-12.4 months). Children with symptoms of irritable bowel syndrome seemed to have a less favorable prognosis compared with children with symptoms of functional dyspepsia or functional abdominal pain.
  
  
  CONCLUSIONS
  The presence and development of chronic abdominal pain is common and of long duration among children consulting in primary care for abdominal pain. These poor outcome data warrant follow-up.
authors.affiliation: Department of General Practice, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands. Y.Lisman-van.Leeuwen@umcg.nl
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Lisman-van Leeuwen
authors.forename: Leo A A
authors.initials: LA
authors.lastname: Spee
authors.forename: Marc A
authors.initials: MA
authors.lastname: Benninga
authors.forename: Sita M A
authors.initials: SM
authors.lastname: Bierma-Zeinstra
authors.forename: Marjolein Y
authors.initials: MY
authors.lastname: Berger
mesh_terms: D015746:Abdominal Pain / Q000453:epidemiology* / Q000628:therapy; D000293:Adolescent; D017677:Age Distribution; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D015331:Cohort Studies; D005260:Female; D058006:General Practice / Q000458:organization & administration*; D006304:Health Status; D006801:Humans; D008297:Male; D010147:Pain Measurement; D010818:Practice Patterns, Physicians'; D015995:Prevalence; D011320:Primary Health Care / Q000458:organization & administration*; D011379:Prognosis; D011446:Prospective Studies; D012008:Recurrence; D012307:Risk Factors
keywords: child; chronic abdominal pain; epidemiology; primary care; prognosis