Recurrent abdominal pain in school children: effect of obesity and diet

Aims: To study the epidemiology and some of the risk factors of childhood recurrent abdominal pain (RAP) in school age children. Methods: We used a questionnaire concerning socioeconomic parameters, intensity, frequency, duration, nature of RAP and anthropometric measures. We used several criteria to identify RAP and the Wong-Baker FACES scale for pain intensity and calculated the gender/age-specific body mass index (BMI) Z-score using NCHS standards. Obesity was defined as a BMI >= 95th percentile for age and gender. Results: A total of 925 children mean age of 9.5 years completed and returned the questionnaires. The prevalence of RAP was 24%; 22% among boys versus 26% among girls (p = 0.28) and reached its peak among children aged 7-9 (29%) years. Children with BMI >= 95% percentile reported more RAP compared to those not obese (33.3% vs. 22.5%) (OR = 1.8, p = 0.01). There was an inverse correlation between fruit consumption and RAP prevalence with 20% among children reporting more than three serving of fruit per week compared to 40% of those who did not consume any fruits (p < 0.002). Logistic regression analysis confirmed BMI >= 95th percentile and low consumption of fruits are significant risk factors for RAP. Conclusions: There is a significant association between RAP and obesity and both conditions are prevalent among children in this population. Understanding more about the co-morbidity between RAP and obesity could have important implications on RAP management and treatment.