ORIGINAL ARTICLE

Psychiatric, somatic, and gastrointestinal disorders, and Helicobacter pylori infection in children with recurrent abdominal pain

Y Nakayama¹, A Horiuchi¹, T Kumagai², S Kubota², Y Taki¹, S Oishi¹, H M Malaty³

¹ Departments of Pediatrics and Gastroenterology, Showa Inan General Hospital, Komagane, Japan
² Department of Laboratory Medicine, Shinshu University Hospital, Matsumoto, Japan
³ Department of Medicine, Veterans Affairs Medical Center, Baylor Collage of Medicine, Houston, Texas, USA

Correspondence to:
Dr H M Malaty
Veterans Affair Medical Center (111D), 2002 Holcombe Blvd., Houston, Texas 77030, USA; Hmalaty{at}bcm.tmc.edu

Aims: To examine the utility of the Rome II criteria in children with recurrent abdominal pain (RAP) and compare them to those who met Apley’s criteria and those who met neither criteria.

Methods: Prospective study in general paediatric clinics in Komagane, Japan. Children with abdominal pain were classified into those who met Rome II criteria, those who met Apley’s criteria, and those who met neither.

Results: A total of 182 children with RAP participated; 45 children met Rome II criteria, 55 met Apley’s criteria, and 82 met neither. Children who met Rome II criteria had a significantly higher prevalence of psychiatric and somatic disorders compared to the group met neither (36% v 6%, 22% v 10%, respectively). The overall prevalence of H pylori was 7%; prevalence increased with age from 3% at age 10 to 10% for children >10 years. Children who met Rome II criteria had a significantly higher prevalence of H pylori infection than the reference group (18% v 4%). In a logistic regression model, all the study variables were included in the model specifying first the Rome II criteria group as the independent variable; psychiatric disorders, H pylori infection, and older age group were independent risk factors.

Conclusions: More than half the children suffering from recurrent abdominal pain met neither Apley’s nor Rome II criteria. Children who meet Rome II criteria should be evaluated for psychiatric disorders and should be tested for H pylori infection. Despite the overall trend for a fall in the prevalence of H pylori infection among children in Japan, there are subpopulations of sick children where the prevalence of the infection is relatively high.

Keywords: recurrent abdominal pain; Rome II criteria; H pylori infection

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