Increased Somatic Complaints and Health-Care Utilization in Children: Effects of Parent IBS Status and Parent Response to Gastrointestinal Symptoms

University of Washington Seattle, Seattle, Washington, United States
The American Journal of Gastroenterology (Impact Factor: 10.76). 01/2005; 99(12):2442-51. DOI: 10.1111/j.1572-0241.2004.40478.x
Source: PubMed


Irritable bowel syndrome (IBS) runs in families. The aims of this study were (i) to exclude biased perception by a mother with irritable bowel as the explanation for increased gastrointestinal (GI) symptoms in their children, (ii) to determine whether non-GI as well as GI symptoms run in families, and (iii) to determine whether parent IBS status and solicitous responses to illness exert independent effects on children's symptom reports, medical clinic visits, and school absences.
Two hundred and eight mothers with irritable bowel and their 296 children (cases: average age 11.9 yr; 48.6% male) and 241 nonirritable bowel mothers and their 335 children (controls: 11.8 yr; 49.0% male) were interviewed. Other factors assessed were stress, mother's and child's psychological symptoms, child's perceived competence, pain coping style, age, and sex. Children were interviewed apart from their parents.
Case children independently reported more frequent stomach aches (F(591) = 9.22; p= 0.0025) and non-GI symptoms (F(562) = 21.03; p < 0.001) than control children. Case children also had more school absences (F(625) = 26.53; p < 0.0001), physician visits for GI symptoms (F(602) = 8.09; p= 0.005), and non-GI clinic visits (F(602) = 27.92; p < 0.001) than control children. Children whose mothers made solicitous responses to illness complaints independently reported more severe stomach aches (F(590) = 11.42; p < 0.001), and they also had more school absences for stomach aches (F(625) = 5.33; p < 0.05), but solicitous behavior did not significantly impact non-GI symptom reporting, clinic visits, or school absences. Differences between cases and controls remained significant after adjusting for potential moderators.
(i) Frequent GI complaints in children whose mothers have irritable bowel are not explained by the mother's biased perceptions; (ii) children of mothers with irritable bowel have more non-GI as well as GI symptoms, disability days, and clinical visits; (iii) and parent IBS status and solicitous responses to illness have independent effects on the child's symptom complaints.

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    • "An important goal of the cognitive component was reduction of pain-related catastrophic cognitions among both children and parents. A social learning component encouraged parents to respond to their children's symptoms in ways that encouraged activity and reinforced wellness versus illness behavior, important given research demonstrating links between parental solicitous responses to child gastrointestinal symptoms and child symptom severity and disability [13, 61, 62]. The present findings support this approach. "
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    • "For example, Levy et al (2004) found that children of mothers with irritable bowel syndrome (IBS)—a pain-predominant FGID—had more frequent stomachaches, nonabdominal symptoms, school absences, and physician visits than children of mothers without IBS. Others have shown that children of mothers with chronic pain (or poor physical health) have more functional impairment and seek more health care services than peers whose mothers are pain-free (Helgeland, Van Roy, Sandvik, Markestad, & Kristensen, 2011; Kashikar-Zuck et al., 2008; Levy et al., 2004). A related line of research has compared children with and without chronic pain and found that those with chronic pain were significantly more likely to have mothers with poor health as compared with children without chronic pain (Campo et al., 2007; Czyzewski, Eakin, Lane, Jarrett, & Shulman, 2007; Kaufman et al., 1997; Liakopoulou-Kairis et al., 2002; Walker, Garber, & Greene, 1991). "
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    ABSTRACT: Objective: To evaluate effects of mothers' and fathers' chronic pain on health outcomes in adult sons and daughters with a childhood history of functional abdominal pain (FAP). Method: Adults (n = 319; Mean age = 22.09 years) with a childhood history of FAP reported parental history of chronic pain and their own current health (chronic pain, somatic symptoms, disability, use of medication and health care, illness-related job loss). Results: Positive histories of maternal and paternal chronic pain were each associated with poorer health in sons and daughters, regardless of child or parent gender. Having 2 parents with chronic pain was associated with significantly poorer health than having 1 or neither parent with chronic pain. Conclusions: Chronic pain in both mothers and fathers is associated with poor health and elevated health service use in young adults with a childhood history of FAP. Having both parents with chronic pain increases risk for adverse outcomes.
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    • "). Conversely, children whose parents have FGIDs, anxiety, depression, somatization, or other pain disorders are more likely to exhibit FGIDs compared with children whose parents do not have these disorders (Ball and Weydert 2003; Huang et al. 2000; Kaminsky et al. 2006; Levy et al. 2004; Logan and Scharff 2005). The familial influence appears to be a complex interaction between environmental influences (i.e., modelling , parental responses), psychological factors (i.e., sensitivity to internal and external cues of threat), and an inherited altered brain-gut connection (Levy et al. 2006). "
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