From the Guidelines
Abdominal pain affects more than 40% of the global population, with disorders of gut-brain interaction, such as irritable bowel syndrome, being a major contributor. The incidence and prevalence of abdominal pain vary across different populations, with studies showing that approximately 25-40% of individuals experience abdominal pain in any given year 1. The prevalence is higher in women than men, with women being 1.5-2 times more likely to report abdominal pain. Age also plays a significant role, with prevalence peaking in young to middle-aged adults (20-50 years) and often decreasing in older populations.
In terms of specific populations, children are also affected, with about 10-15% of school-aged children experiencing chronic abdominal pain, mostly due to functional abdominal pain. Geographically, developed countries tend to report higher rates of functional abdominal pain disorders like irritable bowel syndrome (10-15% prevalence), while developing regions show higher rates of infectious causes 1. Socioeconomic factors influence both reporting and actual incidence, with lower-income populations often having higher rates of infectious causes but potentially lower reported rates due to healthcare access limitations.
Some of the key factors contributing to the variation in prevalence include:
- Physiological factors, such as visceral stimuli
- Psychological factors, such as cognitive and affective factors
- Dietary factors, such as food intolerance
- Environmental factors, such as lifestyle and occupation
- Socioeconomic factors, such as income and access to healthcare
The management of abdominal pain is complex and influenced by a range of factors, including cognitive, affective, and behavioral factors. First-line dietary treatments, antidiarrheals, and laxatives are used frequently in irritable bowel syndrome but have limited evidence for efficacy for abdominal pain 1. Therefore, a comprehensive approach to management is necessary, taking into account the individual's specific needs and circumstances.
From the Research
Incidence and Prevalence of Abdominal Pain
- The incidence and prevalence of abdominal pain vary across different populations and age groups 2, 3, 4.
- A study conducted in Denmark found that abdominal pain occurred significantly more often among women (prevalence: 49%, incidence: 21%) compared to men (prevalence: 38%, incidence: 15%) 2.
- In the United States, a population-based survey found that 24,929 individuals reported experiencing abdominal pain, with most participants (81.0%) being symptomatic in the past week 4.
- The prevalence of abdominal pain also varies by age, with a study in Japan finding that longer hospital stays and higher in-hospital mortality were observed in patients aged ≥ 80 years 3.
Age-Related Differences in Abdominal Pain
- Age-related differences in outcomes and etiologies of acute abdominal pain have been observed, with intestinal infection or acute appendicitis being more frequent in younger patients (< 20 or 20-39 years) and ileus or cholelithiasis being more frequent in older patients (60-79 or ≥ 80 years) 3.
- A study in the United States found that non-Hispanic Blacks, Latinos, and participants with more education, insurance, a usual source of care, comorbidities, and more severe pain had increased odds of seeking medical care for abdominal pain 4.
Healthcare-Seeking Behavior and Diagnosis
- Many individuals with abdominal pain do not seek medical care, with a study in the United States finding that 2 out of 5 individuals did not seek care for their symptoms 4.
- Diagnostic tests such as cross-sectional imaging, colonoscopy, upper endoscopy, and exploratory surgery are commonly used to evaluate abdominal pain, with the choice of test depending on the location of pain and index of suspicion for specific etiologies 5.
- A systematic review found that the most common aetiologies of abdominal pain are gastroenteritis, irritable bowel disease, urological cause, and gastritis, with about 1 in 10 abdominal pain patients suffering from an acute disease needing immediate therapy 6.