Introduction: The incidence of recurrent abdominal pain has been reported to be 10% to 15% in children between 4 to 16 years of age. However, over the years, we were seeing an increase in the children with RAP in our hospital. This study was done to determine the incidence and epidemiology of RAP among Singaporean adolescents attending secondary school, and to determine if there are any associated factors with RAP.
Methods: This is a self-administered questionnaire study carried out in 5 randomly selected schools, with 400 children recruited from each. Students were randomly selected such that there was an equal distribution across the various age groups. RAP was defined as abdominal pain lasting for at least 3 months and affecting normal daily activities. Students were asked a variety of questions including dietary intake (milk/soy/vegetables/fruits), stool frequency, life-events (eg school stress) and family history of RAP. Data from the questionnaires were entered into a database by two of the authors who checked for consistency and error in student responses. Univariate and multivariate analysis was carried out using SPSS 12.0.
Results: 1625 children returned the questionnaire. However, only 1579 children responded positively or negatively to the question on RAP, and were therefore included in the analysis. The median age was 14.3 years (range 12.3–19.4 yrs), of whom 51.6% were male. Majority were Chinese (82.1%), followed by Malays (8.7%) and Indians (6.3%). The incidence of RAP was 23.2%, of whom 47.6% were male. Univariate analysis showed significant association of RAP with female sex (p =0.028), milk intake (p =0.041), stress (p =0.035) and constipation (p =0.035). On multivariate analysis, only cow’s milk intake and constipation were significant associations.
Conclusion: Our population study found that RAP is more common in adolescent school children than previously thought, with significant associations with cow’s milk intake and constipation.