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. 2021 Sep;19(9):1864-1872.e5.
doi: 10.1016/j.cgh.2020.06.065. Epub 2020 Jul 3.

Prevalence and Characteristics of Abdominal Pain in the United States

Krutika Lakhoo  1 , Christopher V Almario  2 , Carine Khalil  3 , Brennan M R Spiegel  4
Affiliations

Prevalence and Characteristics of Abdominal Pain in the United States

Krutika Lakhoo et al. Clin Gastroenterol Hepatol. 2021 Sep.

Abstract

Background & aims: Abdominal pain is the most common gastrointestinal symptom reported in ambulatory clinics, but little is known about its prevalence and burden of illness in the general community. We conducted a population-based survey to determine the epidemiology, clinical characteristics, and healthcare-seeking behavior of persons with abdominal pain.

Methods: Using an online survey research firm, we recruited a representative sample of adults (18 years or older) with a history of abdominal pain. The survey included questions about abdominal pain severity as measured by GI PROMIS (a validated patient-reported outcome questionnaire), healthcare-seeking behaviors, and tests performed to evaluate symptoms. We used multivariable regression models to adjust for confounding.

Results: Overall, 24,929 individuals accessed the survey and 10,300 respondents reported experiencing abdominal pain and completed the questionnaire. Most participants (81.0%) were symptomatic in the past week, as measured by GI PROMIS. Of participants with prior pain, 61.5% sought medical care for their symptoms; non-Hispanic Blacks, Latinos, and participants with more education, insurance, a usual source of care, comorbidities, and more severe pain had increased odds for seeking care. Participants who sought care consulted with the following providers: primary care physicians (84.5%), gastroenterologists (39.2%), nurse practitioners or physician assistants (18.6%), obstetricians or gynecologists (8.3%), general surgeons (7.1%), or rheumatologists (3.2%). Moreover, 72.4% of healthcare seekers received tests to evaluate their pain: cross-sectional imaging (54.2%), colonoscopy (52.3%), upper endoscopy (40.8%), exploratory surgery (6.3%), or capsule endoscopy (5.0%).

Conclusions: The burden of illness and healthcare use associated with abdominal pain is high in the United States. However, 2 of 5 individuals did not seek care for their symptoms and many of them might have undiagnosed, treatable disorders.

Keywords: Abdominal Discomfort; Acute Hepatic Porphyria; Gastrointestinal; Healthcare Seeking; Patient-Reported Outcome.

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Figures

FIGURE 1.
FIGURE 1.
Qualitative content analysis of perceived causes of abdominal pain (n=9,062). Note: font size corresponds to prevalence.
See this image and copyright information in PMC

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