Parents' fears and worries about recurrent abdominal pain (original) (raw)

Abdominal pain is common in children and adults alike. As many as 9 to 25% of schoolaged children suffer from recurring episodes of moderate to severe abdominal pain (RAP)(1). In addition to the distress that is associated with the anticipation of pain or actual pain, increased school absence is a significant worry in these children. Spontaneous recovery is common, but many children continue to suffer even into adulthood(2-4). Despite the risk for lifetime suffering and the effects on academic and social functioning, RAP has received relatively little attention in the medical literature in comparison to the adult functional bowel disorders. Children, especially at younger ages, are still developing their coping skills and are, therefore, often illequipped to deal with functional abdominal pain. Parents-as the major caregivers-are confronted with the difficult tasks of relieving their child's suffering and teaching better coping skills. Considering the irregularity and uncontrollability of functional abdominal pain, coping with its occurrence is a daunting task that even adults may struggle with. Because of the desire of any parent to ease their child's pain, it is understandable that many parents feel very frustrated and incapable of dealing with their child's stomachaches. Nevertheless, some parents seem to be doing better than others. Some families feel less need for treatment and diagnosis by a physician than others do, and not every child that suffers from recurrent abdominal pain misses many days out of school. One could argue that patients with more severe pain have an increased likelihood of seeing a doctor or missing school, but this is not necessarily the case. In adults suffering from Irritable Bowel Syndrome (IBS), consulting a doctor is associated with more psychological distress independent of symptom severity(5), and in high school students with RAP, more distress caused by pain was associated with seeing a physician(6). In younger children, the decision to visit a doctor or stay out of school is usually made by the parent rather than the child. Thus, parental thoughts and worries about their child's illness are of greater significance in these decisions than the child's cognitions. In fact, we have found that parents who have IBS themselves are far more likely to take their child to a doctor for gastrointestinal symptoms than parents who do not suffer from IBS(7). Research has shown that only a small proportion of people experiencing symptoms consult a doctor for them(8). Reasons for going to a doctor are "symptoms getting worse' or the fear that symptoms are caused by internal physical causes. High users of medical care perceive themselves as ill and vulnerable to illness, and believe their physician can be helpful. Low users, on the other hand, feel