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J Pediatr Gastroenterol Nutr. 2017 May;64(5):685-690. doi: 10.1097/MPG.0000000000001342.

Risk Categorization Predicts Disability in Pain-associated Functional Gastrointestinal Disorders After 6 Months.

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*Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center †Department of Pediatrics, University of Cincinnati College of Medicine ‡Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Cincinnati Children's Hospital Medical Center, Cincinnati, OH §Department of Pediatrics, University of Alabama at Birmingham, Birmingham ||Boonshoft School of Medicine, Wright State University ¶Dayton Children's Hospital, Dayton, OH.



For a large portion of youth, pain-associated functional gastrointestinal disorders (FGIDs) are associated with significant impairment over time. Clinically feasible methods to categorize youth with FGIDs at greatest risk for persistent pain-related impairment have not yet been identified.


Measures of functional disability, pain intensity, and anxiety were collected on 99 patients with FGIDs (ages 8-18) during a visit to a pediatric gastroenterology office to assess for the presence of risk. Follow-up data were obtained on a subset of this sample (n = 64) after 6 months, either in person or via mail. The present study examined whether a greater number of risk factors at baseline predicted greater pain-related disability at follow-up.


Patients were divided into 4 groups based on number of risk factors present at the initial assessment: 0 (18.2%), 1 (24.2%), 2 (26.3%), and 3 (31.3%). The presence of 2 or 3 risk factors significantly predicted greater disability at follow-up compared to those with 0 risk factors (R = 0.311) and those with just 1 risk factor (Cohen's d values of -1.07 and -1.44, respectively).


A simple approach to risk categorization can identify youth with FGIDs who are most likely to report increased levels of pain-related impairment over time. These findings have important clinical implications that support the utility of a brief screening process during medical care to inform referral for targeted treatment approaches to FGIDs.

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