Seasonal Association of Pediatric Functional Abdominal Pain Disorders and Anxiety

ABSTRACTObjectives:Abdominal pain related pediatric functional gastrointestinal disorders (AP-FGID) are defined by abdominal discomfort or pain that may provide obstacles to everyday activities, such as school attendance. It has been reported that AP-FGID symptoms may be reduced in summer, but it is unclear what drives this seasonal variation. This pilot study aimed to explore whether the seasonal variation in AP-FGID symptoms could be explained by various psychological and behavioral factors.Methods:Parents of children with AP-FGID symptoms completed online questionnaires on symptoms, anxiety, parental responses to pain, sleep, diet and physical activity once during spring months and again in the summer months.Results:In a sample of 34 participants who completed both questionnaires, 22 reported improvements during the summer months. These participants reported a significantly higher seasonal decrease in anxiety than participants whose children's symptoms did not improve from spring to summer (mean decrease 2.21 vs 0.08, P = 0.017). Both groups reported equal improvements in sleep and decreased stress from spring to summer. Neither group experienced statistically significant seasonal change in physical activity or fruit, vegetables, dairy, or caffeine consumption.Conclusions:This study suggests that amelioration of gastrointestinal symptoms in pediatric patients with AP-FGID during summer months is associated with amelioration of anxiety in the same time period. It is not yet clear whether decreased anxiety is the cause or effect of decreased AP-FGID symptoms. Objectives: Abdominal pain related pediatric functional gastrointestinal disorders (AP-FGID) are defined by abdominal discomfort or pain that may provide obstacles to everyday activities, such as school attendance. It has been reported that AP-FGID symptoms may be reduced in summer, but it is unclear what drives this seasonal variation. This pilot study aimed to explore whether the seasonal variation in AP-FGID symptoms could be explained by various psychological and behavioral factors. Methods: Parents of children with AP-FGID symptoms completed online questionnaires on symptoms, anxiety, parental responses to pain, sleep, diet and physical activity once during spring months and again in the summer months. Results: In a sample of 34 participants who completed both questionnaires, 22 reported improvements during the summer months. These participants reported a significantly higher seasonal decrease in anxiety than participants whose children's symptoms did not improve from spring to summer (mean decrease 2.21 vs 0.08, P = 0.017). Both groups reported equal improvements in sleep and decreased stress from spring to summer. Neither group experienced statistically significant seasonal change in physical activity or fruit, vegetables, dairy, or caffeine consumption. Conclusions: This study suggests that amelioration of gastrointestinal symptoms in pediatric patients with AP-FGID during summer months is associated with amelioration of anxiety in the same time period. It is not yet clear whether decreased anxiety is the cause or effect of decreased AP-FGID symptoms. Address correspondence and reprint requests to Miranda A.L. van Tilburg, Campbell University College of Pharmacy & Health Sciences, Buies Creek, NC 27506, PO Box 1090 (e-mail: vantilburg@campbell.edu). Received 11 August, 2017 Accepted 18 December, 2017 Supports: Partially funded by grant number T35-DK007386 from the National Institutes of Health. Website address and trial identification number: n/a. Funding for this work supported by: grant number T35-DK007386 from the National Institutes of Health. The authors report no conflicts of interest. Authors and Their Roles: Katharine L. Pollard- data collection, data analysis, and manuscript preparation. Christina Campbell- data collection and manuscript preparation. Megan Squires- data collection and manuscript preparation. Olafur Palsson- data collection and manuscript revision. Miranda van Tilburg- study creation, IRB approval, data analysis, and manuscript revision. © 2017 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,

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