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Abdominal Pain–Predominant Functional Gastrointestinal Diseases in Children and Adolescents: Prevalence, Symptomatology, and Association With Emotional Stress

Devanarayana, Niranga Manjuri*; Mettananda, Sachith; Liyanarachchi, Chathurangi; Nanayakkara, Navoda; Mendis, Niranjala; Perera, Nimnadi; Rajindrajith, Shaman

Journal of Pediatric Gastroenterology and Nutrition: December 2011 - Volume 53 - Issue 6 - p 659–665
doi: 10.1097/MPG.0b013e3182296033
Original Articles: Gastroenterology

Background and Objective: Functional gastrointestinal disorders (FGD) are common among children, but little is known regarding their prevalence in developing countries. We assessed the prevalence of abdominal pain–predominant FGD, in addition to the predisposing factors and symptomatology, in Sri Lankan children.

Patients and Methods: A cross-sectional survey was conducted among a randomly selected group of 10- to 16-year-olds in 8 randomly selected schools in 4 provinces in Sri Lanka. A validated, self-administered questionnaire was completed by children independently in an examination setting. FGD were diagnosed using Rome III criteria.

Results: A total of 2180 questionnaires were distributed and 2163 (99.2%) were included in the analysis (1189 [55%] boys, mean age 13.4 years, standard deviation 1.8 years). Of them, 270 (12.5%) had at least 1 abdominal pain–predominant FGD. Irritable bowel syndrome (IBS) was seen in 107 (4.9%), functional dyspepsia in 54 (2.5%), functional abdominal pain in 96 (4.4%), and abdominal migraine (AM) in 21 (1.0%) (2 had AM and functional dyspepsia, 6 had AM and IBS). Extraintestinal symptoms were more common among affected children (P < 0.05). Abdominal pain–predominant FGD were higher in girls and those exposed to stressful events (P < 0.05). Prevalence negatively correlated with age (r = −0.05, P = 0.02).

Conclusions: Abdominal pain–predominant FGD affects 12.5% of children ages 10 to 16 years and constitutes a significant health problem in Sri Lanka. IBS is the most common FGD subtype present. Abdominal pain–predominant FGD are higher in girls and those exposed to emotional stress. Prevalence of FGD decreased with age. Extraintestinal symptoms are more frequent in affected children.

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*Department of Physiology

Department of Paediatrics, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka.

Address correspondence and reprint requests to Dr Niranga M Devanarayana, Department of Physiology, Faculty of Medicine, Talagolla Road, Ragama, Sri Lanka (e-mail:

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Received 11 January, 2011

Accepted 20 May, 2011

The study received financial support from the University of Kelaniya, Sri Lanka.

The authors report no conflicts of interest.

Copyright 2011 by ESPGHAN and NASPGHAN