Recurrent Abdominal Pain Syndrome in Children is a Significant Burden on Health Care System of Sri Lanka

Abstract

Background and objectives – Recurrent abdominal pain (RAP) is a common problem in Sri Lanka affecting more than 10% of children and adolescents. There have been relatively few studies on health care utilization in RAP and they have shown health care consultation of 8-48% in affected children. Methods- RAP patients identified during a school survey were recruited. RAP was defined according to Apley’s criteria; ‘at least three episodes of abdominal pain, severe enough to affect activities, over a period of not less than three months’. Information regarding health care consultations were obtained using parental questionnaire and confirmed during a clinical interview. A child taken to see a doctor due to abdominal pain at least once during the year 2001 was considered as a health care consulter. Results- Seventy seven with RAP were recruited in the study. Fifty five (70.1%) were health care consulters. Of them 6 (9.1%) were given in-patient care and 49 (90.9%) were managed by hospital out patient clinics or general practitioners. Average number of consultation was 2.0 visits per year (SD 2.5). Twenty three (29.1%) had not taken treatment even though they suffer from recurrent attacks of pain. Health care consultation was significantly high when the child with RAP was the eldest (p=0.0470), a good academic achiever (p=0.0210) and had pain associated with vomiting (p=0.00741). Conclusions- The health care consultation among Sri Lankan children with RAP is higher than reported from other countries. RAP is a significant burden on health care system of the country.