title: Predicting persistence of functional abdominal pain from childhood into young adulthood.
abstract: OBJECTIVE
  Pediatric functional abdominal pain has been linked to functional gastrointestinal disorders (FGIDs) in adulthood, but little is known about patient characteristics in childhood that increase the risk for FGID in young adulthood. We investigated the contribution of gastrointestinal symptoms, extraintestinal somatic symptoms, and depressive symptoms in pediatric patients with functional abdominal pain and whether these predicted FGIDs later in life.
  
  
  METHODS
  In a longitudinal study, consecutive new pediatric patients, diagnosed with functional abdominal pain in a subspecialty clinic, completed a comprehensive baseline evaluation of the severity of their physical and emotional symptoms. They were contacted 5 to 15 years later and evaluated, based on Rome III symptom criteria, for abdominal pain-related FGIDs, including irritable bowel syndrome, functional dyspepsia, functional abdominal pain syndrome, and abdominal migraine. Controlling for age, sex, baseline severity of abdominal pain, and time to follow-up evaluation, multivariable logistic regression was used to evaluate the association of baseline gastrointestinal, extraintestinal somatic, and depressive symptoms in childhood with FGID in adolescence and young adulthood.
  
  
  RESULTS
  Of 392 patients interviewed an average of 9.2 years after their initial evaluation, 41% (n = 162) met symptom criteria for FGID; most met the criteria for irritable bowel syndrome. Extraintestinal somatic and depressive symptoms at the initial pediatric evaluation were significant predictors of FGID later in life, after controlling for initial levels of GI symptoms. Age, sex, and abdominal pain severity at initial presentation were not significant predictors of FGID later in life.
  
  
  CONCLUSIONS
  In pediatric patients with functional abdominal pain, assessment of extraintestinal and depressive symptoms may be useful in identifying those at risk for FGID in adolescence and young adulthood.
authors.affiliation: Department of Gastroenterology, Hepatology, and Nutrition, Vanderbilt University Medical Center, Nashville, Tennessee.
authors.forename: Sara
authors.initials: S
authors.lastname: Horst
authors.affiliation: Department of Psychology and Human Development, Peabody College, Vanderbilt University, Nashville, Tennessee.
authors.forename: Grace
authors.initials: G
authors.lastname: Shelby
authors.affiliation: Department of Pediatric Gastroenterology, Hepatology, and Nutrition, Vanderbilt University Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, Tennessee.
authors.forename: Julia
authors.initials: J
authors.lastname: Anderson
authors.affiliation: Department of Pediatric Gastroenterology, Hepatology, and Nutrition, Vanderbilt University Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, Tennessee.
authors.forename: Sari
authors.initials: S
authors.lastname: Acra
authors.affiliation: Department of Pediatrics, University of Southern California and Children's Hospital Los Angeles, Los Angeles, California.
authors.forename: D Brent
authors.initials: DB
authors.lastname: Polk
authors.affiliation: Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee.
authors.forename: Benjamin R
authors.initials: BR
authors.lastname: Saville
authors.affiliation: Department of Psychology and Human Development, Peabody College, Vanderbilt University, Nashville, Tennessee.
authors.forename: Judy
authors.initials: J
authors.lastname: Garber
authors.affiliation: Division of Adolescent and Young Adult Health, Department of Pediatrics, Vanderbilt University Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, Tennessee. Electronic address: lynn.walker@vanderbilt.edu.
authors.forename: Lynn S
authors.initials: LS
authors.lastname: Walker
mesh_terms: D015746:Abdominal Pain / Q000175:diagnosis* / Q000453:epidemiology* / Q000503:physiopathology; D000293:Adolescent; D002648:Child; D015897:Comorbidity; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D005767:Gastrointestinal Diseases / Q000175:diagnosis / Q000453:epidemiology; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D011379:Prognosis; D055815:Young Adult
keywords: Depression; Functional Gastrointestinal Disorders; Irritable Bowel Syndrome; Prospective; Somatic Symptoms
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