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
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
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.
Pain was gone OR pain was nearly gone or minimal and was not
interfering with a child's activities
Pain was better, but not yet minimal OR pain was minimal but still
interfering with a child's activities
Pain was the same or worse
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
Pain Program website. You can also call (816) 983-6975 to speak
with one of our clinic nurses.