Assessment of abdominal pain through global outcomes and recent fda recommendations in children: Are we ready for change?

Saeed Mohammad*, Carlo Di Lorenzo, Nader N. Youssef, Adrian Miranda, Samuel Nurko, Paul Hyman, Miguel Saps

*Corresponding author for this work

Research output: Contribution to journalArticle

16 Scopus citations

Abstract

Objectives: Irritable bowel syndrome is a multisymptom construct, with abdominal pain (AP) acting as the driving symptom of patient-reported severity. The Food and Drug Administration considers a >30% decrease in AP as satisfactory improvement, but this has not been validated in children. We investigated the correspondence of 2 measures for AP assessment, ≥30% improvement in AP and global assessment of improvement. METHODS: Secondary analysis of data from 72 children who completed a randomized clinical trial for abdominal pain-associated functional gastrointestinal disorders. Children completed daily assessment of AP intensity, functional disability inventory (FDI), question regarding paine's interference with activities, and 2 global assessment questions. We measured the extent to which ≥30% improvement of AP and global assessment questions correlated with each other and with disability. RESULTS: The global questions correlated with each other (r=0.74; P<0.0001) and with a ≥30% improvement in AP (P<0.01). Global outcomes were satisfaction with treatment was inversely related to the childe's report of interference with activities (P<0.01) and symptom relief was positively associated with ≥30% improvement in FDI scores (P<0.009). A 30% change in FDI scores was associated with global questions of symptom relief (P=0.009) but not with satisfaction with treatment (P=0.07). The association of AP improvement with interference with activities (P=0.14) or change in FDI scores (P=0.27) did not reach significance. CONCLUSIONS: Currently used global assessments are significantly associated with decreased pain intensity, decreased interference with daily activities, and a ≥30% change in FDI scores, whereas recommended 30% improvement in pain intensity is not as comprehensive.

Original languageEnglish (US)
Pages (from-to)46-50
Number of pages5
JournalJournal of pediatric gastroenterology and nutrition
Volume58
Issue number1
DOIs
StatePublished - Jan 1 2014

Keywords

  • irritable bowel syndrome
  • outcomes
  • pediatric gastroenterology
  • symptom score

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Gastroenterology

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