title: Studies of the symptom abdominal pain--a systematic review and meta-analysis.
abstract: BACKGROUND
  Diagnostic reasoning in primary care patients with abdominal pain is a complex challenge for GPs. To ensure evidence-based decision making for this symptom, GPs need setting-specific knowledge about the prevalence, potential risks for diseases and chance of recovery or risk of undesirable courses of disease.
  
  
  OBJECTIVE
  We conducted a systematic review of symptom-evaluating studies on prevalence, aetiology or prognosis of abdominal pain.
  
  
  METHODS
  We included all studies evaluating the symptom 'abdominal pain' as a reason for consultation in primary care. We included all types of study designs except for qualitative studies. Studies focussed solely on children or settings other than primary care were also excluded.
  
  
  RESULTS
  We identified 14 studies. Mean consultation prevalence is 2.8% for abdominal pain. In about one-third of patients the underlying cause of abdominal pain cannot be specified. The most common aetiologies are gastroenteritis (7.2-18.7%), irritable bowel disease (2.6-13.2%), urological cause (5.3%) and gastritis (5.2%). About 1 in 10 abdominal pain patients suffers from an acute disease like appendicitis (1.9%), diverticulitis (3.0%), biliary/pancreatic (4.0%) or neoplastic (1.0%) diseases needing immediate therapy.
  
  
  CONCLUSIONS
  There is a high prevalence of patients consulting GPs for abdominal pain. The review identified a comparably high rate of acute underlying diseases in need of further investigation or therapy. At the same time, the underlying cause of the complaints often remains unexplained. Further symptom-evaluating studies are necessary, ideally using standardized methodology in order to gain sufficient evidence for developing much-needed guidelines and decision support tools.
authors.affiliation: Department of General Practice/Family Medicine, University of Marburg, Marburg, Germany. annika.viniol@staff.uni-marburg.de.
authors.forename: Annika
authors.initials: A
authors.lastname: Viniol
authors.affiliation: Department of General Practice/Family Medicine, University of Marburg, Marburg, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Keunecke
authors.affiliation: Department of General Practice/Family Medicine, University of Marburg, Marburg, Germany.
authors.forename: Tobias
authors.initials: T
authors.lastname: Biroga
authors.affiliation: Department of General Practice/Family Medicine, University of Marburg, Marburg, Germany.
authors.forename: Rebekka
authors.initials: R
authors.lastname: Stadje
authors.affiliation: Department of General Practice/Family Medicine, University of Marburg, Marburg, Germany.
authors.forename: Katharina
authors.initials: K
authors.lastname: Dornieden
authors.affiliation: Department of General Practice/Family Medicine, University of Marburg, Marburg, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Bösner
authors.affiliation: Department of General Practice/Family Medicine, University of Marburg, Marburg, Germany.
authors.forename: Norbert
authors.initials: N
authors.lastname: Donner-Banzhoff
authors.affiliation: Department of General Practice/Family Medicine, University of Marburg, Marburg, Germany.
authors.forename: Jörg
authors.initials: J
authors.lastname: Haasenritter
authors.affiliation: Department of General Practice/Family Medicine, University of Marburg, Marburg, Germany.
authors.forename: Annette
authors.initials: A
authors.lastname: Becker
mesh_terms: D015746:Abdominal Pain / Q000453:epidemiology* / Q000209:etiology*; D001660:Biliary Tract Diseases / Q000150:complications; D005759:Gastroenteritis / Q000150:complications*; D058006:General Practice / Q000706:statistics & numerical data*; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000150:complications; D009369:Neoplasms / Q000150:complications*; D010182:Pancreatic Diseases / Q000150:complications; D015995:Prevalence; D011379:Prognosis; D012017:Referral and Consultation / Q000706:statistics & numerical data; D014570:Urologic Diseases / Q000150:complications
keywords: Abdominal pain; aetiology; prevalence; primary care; symptom evaluating study; systematic review.