Published online July 1, 2005
PEDIATRICS Vol. 116 No. 1 July 2005, pp. 46-50 (doi:10.1542/10.1542/peds.2004-1854)
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The Epidemiology of Recurrent Abdominal Pain From 2 to 6 Years of Age: Results of a Large, Population-Based Study

Paul G. Ramchandani, MRCPsych*, Matthew Hotopf, PhD{ddagger}, Bhupinder Sandhu, MD§, Alan Stein, FRCPsych* and the ALSPAC Study Team||

* Section of Child and Adolescent Psychiatry, University of Oxford, Oxford, United Kingdom
{ddagger} Department of Psychological Medicine, Institute of Psychiatry, London, United Kingdom
§ Bristol Royal Hospital for Children, Bristol, United Kingdom
|| Avon Longitudinal Study of Parents and Children, Department of Community-Based Medicine, University of Bristol, United Kingdom

Objective. Recurrent abdominal pain (RAP) is one of the most common complaints of childhood and is associated with several adverse outcomes in adulthood. Few large, population-based, longitudinal studies have been conducted. The purpose of this study was to investigate the prevalence and epidemiologic features of RAP through early childhood.

Design. We report findings from a large, population-based, cohort study of childhood (the Avon Longitudinal Study of Parents And Children). The prevalence and continuity of RAP from 2 to 6 years of age were explored, with associated physical and psychological symptoms among the children and their parents.

Results. In a population cohort of 13971 children, RAP was reported for 11.8% of 6-year-old children. It was less common at ages 2 years (3.8%) and 3 years (6.9%). There was a striking degree of continuity of RAP between the ages of 2 and 6 years. RAP was associated with headaches and limb pains among children and with higher rates of anxiety among both children (adjusted odds ratio: 2.12; 95% confidence interval: 1.70–2.65) and their mothers (odds ratio: 1.75; 95% confidence interval: 1.30–2.36).

Conclusions. In a large, population-based, cohort study, RAP was found to be increasingly common up to the age of 6 years. Children with RAP at a young age have a high risk of RAP later in childhood. RAP is associated with other somatic pain symptoms among children and with symptoms of anxiety among children and their mothers. These findings highlight the high prevalence and continuity of RAP through early childhood and the importance of considering psychological symptoms for these children and their families.

Key Words: recurrent abdominal pain • children • epidemiology • anxiety • parental health

Abbreviations: RAP, recurrent abdominal pain • SDQ, Strengths and Difficulties Questionnaire • CI, confidence interval • OR, odds ratio • ALSPAC, Avon Longitudinal Study of Parents and Children

Accepted Oct 14, 2004.


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