title: Prevalence and Impact of Functional Abdominal Pain Disorders in Children With Inflammatory Bowel Diseases (IBD-FAPD).
abstract: We sought to describe the prevalence of the overlap of functional abdominal pain disorders (FAPDs) in children with inflammatory bowel diseases (IBDs), a condition we have designated as IBD-FAPD. We also aimed to describe the psychological profile of this group, and to assess predictors of disease and the impact of IBD-FAPD on quality of life.
  
  
  
  This cross-sectional prospective study included patients ages 8 to 18 years with a diagnosis of IBD. Disease activity was assessed by physician's global assessment, laboratory studies, and abbreviated Pediatric Crohn's Disease Activity Index or Pediatric Ulcerative Colitis Activity Index scoring. Age-appropriate validated questionnaires were used to diagnose FAPDs according to the Rome III criteria, depression, anxiety symptoms, and quality of life.
  
  
  
  There were 128 patients recruited. Eighty-one (63%) completed questionnaires (36 girls; 45 boys; mean age 14.4 ± 2.6 years) (62 Crohn disease, 19 ulcerative colitis). The prevalence of IBD-FAPD in clinical remission was 26% (17 Crohn disease, 4 ulcerative colitis; 95% confidence interval: 20.6%-79.4%), with significantly more girls having IBD-FAPD (P = 0.038). Anxiety symptoms were in 14.3% of patients with IBD-FAPD (P = 0.06) and depression in 23.8% (P = 0.006). The average Pediatric Quality of Life Inventory Gastrointestinal Symptoms score for the IBD-FAPD group was significantly lower than those without FAPDs (71 vs 86.5, P = 0.008).
  
  
  
  In our cohort, the prevalence of IBD-FAPD was 26%. This is the first study to assess all FAPDs using the Rome III criteria and to demonstrate increased anxiety, depression, and worse quality of life in children with IBD-FAPD. The identification of patients predisposed to IBD-FAPD may allow implementing strategies that could improve symptoms and quality of life.
authors.affiliation: *Division of Gastroenterology, Hepatology and Nutrition, Akron Children's Hospital, Akron †Division of Gastroenterology, Hepatology and Nutrition, Nationwide Children's Hospital, Columbus, OH.
authors.forename: Kevin L
authors.initials: KL
authors.lastname: Watson
authors.forename: Sandra C
authors.initials: SC
authors.lastname: Kim
authors.forename: Brendan M
authors.initials: BM
authors.lastname: Boyle
authors.forename: Miguel
authors.initials: M
authors.lastname: Saps
mesh_terms: D015746:Abdominal Pain / Q000150:complications* / Q000453:epidemiology / Q000523:psychology; D000293:Adolescent; D001007:Anxiety / Q000453:epidemiology / Q000209:etiology; D002648:Child; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology / Q000209:etiology; D004415:Dyspepsia / Q000150:complications* / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000150:complications* / Q000523:psychology; D043183:Irritable Bowel Syndrome / Q000150:complications* / Q000453:epidemiology / Q000523:psychology; D008297:Male; D008881:Migraine Disorders / Q000150:complications* / Q000453:epidemiology / Q000523:psychology; D015995:Prevalence; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology