RAP is regarded by pediatricians to be a short-term phenomenon with no long-standing clinical consequences. However, there is comparatively little literature on the long-term outcome in children with RAP. Studies from clinical samples suggest that between 25% and 50% continue to experience symptoms into adulthood and have higher rates of psychiatric disorders (40).
Conversely, medically unexplained symptoms in adult life, including unexplained hospitalizations, are associated with experiencing abdominal pain in childhood (48,49). Overall, this evidence adds weight to the theory that RAP is a childhood form of functional disorder. For some, the natural history of abdominal pain may be life long.
The chapter has reviewed the epidemiology of abdominal pain and the most well-recognized functional GI disorders. These symptoms are each common in the community, with one out of four people reporting RAP. Although many of these people have not had diagnostic testing to exclude organic diseases, the current literature suggests that most of these people have functional GI disorders. The remainder of this book will cover why people have these symptoms and what can be done to help them. Improved understanding of these conditions is necessary to alleviate suffering and reduce the economic burden of these syndromes.
1. Sandler RS et al. Abdominal pain, bloating, and diarrhea in the United States: prevalence and impact. Dig Dis Sci 2000; 45(6):1166.
2. Talley N, Zinsmeister AR, Melton LJ III. Irritable bowel syndrome in a community: symptom subgroups, risk factors and health care utilization. Am J Epidemiol 1995; 142:76.
3. Talley N et al. Dyspepsia and dyspepsia subgroups: a population-based study. Gastroenterology 1992; 102(4 Pt 1):1259.
4. Talley NJ et al. Onset and disappearance of gastrointestinal symptoms and functional gastrointestinal disorders. Am J Epidemiol 1992; 136(2):165.
5. Rang E, Fairbairn A, Acheson E. An enquiry into the incidence and prognosis of undiagnosed abdominal pain treated in hospital. Br J Prev Soc Med 1970; 24(1):47.
6. Sheridan W et al. Non-specific abdominal pain: the resource implications. Ann R Coll Surg Engl 1992; 74(2):181.
7. Talley N et al. Prevalence of gastrointestinal symptoms in the elderly: a population-based study. Gastroenterology 1992; 102(3):895.
8. Kay L, Jorgensen T, Schultz-Larsen K. Abdominal pain in a 70-year-old Danish population. An epi-demiological study of the prevalence and importance of abdominal pain. J Clin Epidemiol 1992; 45(12):1377.
9. Thompson WG et al. Functional bowel disorders and functional abdominal pain. Gut 1999; 45 (Suppl 2):II43.
10. Talley NJ, Spiller R. Irritable bowel syndrome: a little understood organic disease? Lancet 2002; 360(9332):555.
11. Locke GR. The epidemiology of functional gastrointestinal disorders in North America. Gastroen-terol Clin North Am 1996; 25(1):1.
12. Saito YA, Schoenfeld P, Locke GR III. The epidemiology of irritable bowel syndrome in North America: a systematic review. Am J Gastroenterol 2002; 97:1910.
13. Talley N et al. Epidemiology of colonic symptoms and the irritable bowel syndrome. Gastroenterol-ogy 1991; 101:927.
14. Agreus L et al. The epidemiology of abdominal symptoms: prevalence and demographic characteristics in a Swedish adult population. A report from the Abdominal Symptom Study. Scand J Gastroenterol 1994; 29(2):102.
15. Talley NJ et al. Medical costs in community subjects with irritable bowel syndrome. Gastroenterol-ogy 1995; 109(6):1736.
16. Agreus L et al. Irritable bowel syndrome and dyspepsia in the general population: overlap and lack of stability over time. Gastroenterology 1995; 109:671.
17. Rodriquez LG et al. Detection of colorectal tumor and inflammatory bowel disease during follow-up of patients with initial diagnosis of irritable bowel syndrome. Scand J Gastroenterol 2000; 35:306.
18. Locke GRI et al. The incidence of clinically diagnosed irritable bowel syndrome in the community. Gastroenterology 1999; 116:A76.
19. Greenlee RT et al. Cancer statistics. CA Cancer J Clin 2000; 50(1):7.
20. Loftus EV, Sandborn WJ. Epidemiology of inflammatory bowel disease. Gastroenterol Clin North Am 2002; 31(1):1.
21. Sandler RS et al. The burden of selected digestive diseases in the United States. Gastroenterology 2002; 122(5):1500.
22. El-Serag H, Olden K, Bjorkman D. Health-related quality of life among persons with irritable bowel syndrome: a systematic review. Aliment Pharmacol Ther 2002; 16:1171.
23. Jones R et al. Dyspepsia in England and Scotland. Gut 1990; 31(4):401.
24. Bernersen B, Johnsen R, Straume B. Towards a true prevalence of peptic ulcer: the Sorreisa gastrointestinal disorder study. Gut 1990; 31:989.
25. Drossman DA et al. U.S. householder survey of functional gastrointestinal disorders. Prevalence, sociodemography, and health impact. Dig Dis Sci 1993; 38(9):1569.
26. Kay L, Jorgensen T. Epidemiology of upper dyspepsia in a random population. Scand J Gastroenterol 1994; 29:1.
27. Locke GR III et al. Prevalence and clinical spectrum of gastroesophageal reflux: a population-based study in Olmsted County, Minnesota. Gastroenterology 1997; 112:1448.
28. Klauser A et al. What is behind dyspepsia?. Dig Dis Sci 1993; 38(1):147.
29. Bytzer P, Hansen J, Schaffalitzky de Muckadell O. Empirical H2-blocker therapy or prompt endos-copy in management of dyspepsia. Lancet 1994; 343:811.
30. Castillo J et al. Overlap of IBS and dyspepsia: how much is explained by upper abdominal pain associated with bowel habit?. Gastroenterology 2002; 126(4 Suppl 2):A371.
31. Jones R, Lydeard S. Dyspepsia in the community. Br J Clin Pract 1992; 46:95.
32. Drossman D et al. Rome II: a multinational consensus document on functional gastrointestinal disorders. Gut 1999; 45(Suppl n):H1.
33. Goodacre S et al. The health care burden of acute chest pain. Heart 2005; 91(2):229.
34. Alban Davies J. Anginal pain of esophageal origin: Clinical presentation, prevalence, and prognosis. Am J Med 1992; 92(Suppl 5A):5S.
35. Ockene I et al. Unexplained chest pain in patients with normal coronary arteriograms: a follow-up study of functional status. N Engl J Med 1980; 303:1249.
36. Eslick GD, Jones MP, Talley NJ. Non-cardiac chest pain: prevalence, risk factors, impact and consulting—a population-based study. Aliment Pharmacol Ther 2003; 17(9):1115.
37. Cormier L et al. Chest pain with negative cardiac diagnostic studies. Relationship to psychiatric illness. J Nerv Ment Dis 1988; 176:351.
38. Whitehead WE et al. Functional disorders of the anus and rectum. Gut 1999; 45(Suppl 2):II55.
39. Thompson WG. Proctalgia fugax. Dig Dis Sci 1981; 26(12):1121.
40. Hotopf M et al. Why do children have chronic abdominal pain, and what happens to them when they grow up? Population-based cohort study. BMJ 1998; 316(7139):1196.
41. Huang R, Palmer L, Forbes D. Prevalence and pattern of childhood abdominal pain in an Australian general practice. J Paediatr Child Health 2000; 36(4):349.
42. Apley J. The Child with Abdominal Pains. Oxford: Blackwell Scientific Publications, 1975.
43. Apley J, Naish N. Recurrent abdominal pains: a field study of 1000 school children. Arch Dis Child 1958; 33:165.
44. Scharff L. Recurrent abdominal pain in children: a review of psychological factors and treatment. Clin Psychol Rev 1997; 17(2):145.
45. Boey C, Yap S, Goh K. The prevalence of recurrent abdominal pain in 11 to 16-year-old Malaysian schoolchildren. J Paediatr Child Health 2000; 36(2):114.
46. Williams N et al. Incidence of non-specific abdominal pain in children during school term: population survey based on discharge diagnoses. BMJ 1999; 318(7196):1455.
47. Heafield R et al. Outcome of emergency surgical admissions for non-specific abdominal pain. Gut 1990; 31:A1167, 1990.
48. Hotopf M et al. Childhood risk factors for adults with medically unexplained symptoms: results from a national birth cohort study. Am J Psychiatry 1999; 156(11):1796.
49. Hotopf M et al. Childhood predictors of adult medically unexplained hospitalisations. Results from a national birth cohort study. Br J Psychiatry 2000; 176:273.
Section II THE NEUROBIOLOGY AND PSYCHOBIOLOGY OF CHRONIC VISCERAL PAIN
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