Why should you care?

Chronic abdominal pain is a common problem that affects up to 20 percent of all school-aged children and teens. That's nearly a quarter of any local classroom at any given time. Despite how many youth struggle with abdominal pain, there is no clear agreement among medical professionals about how best to manage it. In the Abdominal Pain Program (APP) at Children's Mercy, we use a multidisciplinary approach that involves initial evaluation and follow-up by a team of professionals, including a pediatric gastroenterologist and pediatric psychologist and, occasionally, biofeedback therapists, dietitians, and other health professionals. Using this model, we take into account the many factors (biological, psychological, and social) that we believe can contribute to abdominal pain in children.

The only way to know for sure that this approach is the best way of taking care of our patients is to measure patient improvement in a regular, standardized way and closely monitor what we find. By doing this, we are able to identify opportunities to make our care even better. We also think that this information can help parents make the most informed decisions about their children's health care.

Who is impacted?

Everyone who experiences, lives with, and/or cares for a child with chronic abdominal pain is affected by it. We know that some kids suffer emotional and social difficulties as a result of their physical symptoms that complicate their treatment course and greatly affect their quality of life, as well as the quality of life of those who care for them. Without proper treatment, we know that abdominal pain and the related consequences don't get better on their own. In a recent review of our clinic patients, we found that the typical child has experienced abdominal pain for about two years at the time of their initial evaluation.

What does this all mean?

We ask children and their parents, when they first arrive in our clinic, to rate the child's current level of pain and how much the pain interferes with the child's ability to go to school, spend time with family and friends, do chores, etc. When the child returns for his or her first follow-up visit, families tell us whether they think their child is doing worse, the same, or better than at the time of their first appointment. Since February 2011, the average child's pain rating, at the time of initial evaluation, was classified as "mild" to "moderate." The average child's disability rating indicated that pain was "occasionally" to "regularly" interfering in everyday activities.

By the time children returned for their first follow up visit (typically 2 to 8 weeks from the time of initial evaluation), about 30 percent reported that their symptoms were nearly or completely gone and they were back to all of their normal daily activities. An additional 26 percent reported that their pain was better but was still interfering with their daily activities to some extent.

The first follow up visit is just the initial step in our comprehensive follow up program. Children who do not show improvement by the first follow up visit continue to be followed by our multidisciplinary team. Medication and other treatments are added or removed, as needed, and patients' progress is closely monitored. We are committed to helping all children find ways to live unimpaired by abdominal pain.

What do our patients and families say?

In a recent survey, nearly 90% of the families seen for their initial evaluation visit in the APP reported that they were "very satisfied" with the visit.

Furthermore, over 90% of these same families said that they intended to begin all of the treatments (e.g., medications, biofeedback, and/or individual therapy) recommended at their child's initial visit.

And, finally, when asked what specifically about the APP evaluation was helpful to them, roughly half highlighted their appreciation for the integrated medical and psychological perspectives. Specific comments included: "Knowing that they are looking at the whole picture, not just one-fourth of it" and "The mind-body connection - having both doctors meet with us together was very helpful." In sum, families said that having the medical and psychological teams working together resulted in a treatment plan in which all the components made sense and were tailored to their child's unique needs.

Read the full article.

Where can I go for more information?

For more information please visit the Children's Mercy Hospital Abdominal Pain Program website. You can also call (816) 983-6975 to speak with one of our clinic nurses.