Krutika Lakhoo1, Christopher V Almario2, Carine Khalil3, Brennan M R Spiegel4. 1. Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California. 2. Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California; Division of Digestive and Liver Diseases, Cedars-Sinai Medical Center, Los Angeles, California; Cedars-Sinai Center for Outcomes Research and Education, Cedars-Sinai Medical Center, Los Angeles, California; Division of Health Services Research, Cedars-Sinai Medical Center, Los Angeles, California; Division of Informatics, Cedars-Sinai Medical Center, Los Angeles, California. 3. Cedars-Sinai Center for Outcomes Research and Education, Cedars-Sinai Medical Center, Los Angeles, California. 4. Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California; Division of Digestive and Liver Diseases, Cedars-Sinai Medical Center, Los Angeles, California; Cedars-Sinai Center for Outcomes Research and Education, Cedars-Sinai Medical Center, Los Angeles, California; Division of Health Services Research, Cedars-Sinai Medical Center, Los Angeles, California; Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, California. Electronic address: brennan.spiegel@cshs.org.
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.
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.
Authors: Dayna S Early; Tamir Ben-Menachem; G Anton Decker; John A Evans; Robert D Fanelli; Deborah A Fisher; Norio Fukami; Joo Ha Hwang; Rajeev Jain; Terry L Jue; Khalid M Khan; Phyllis M Malpas; John T Maple; Ravi S Sharaf; Jason A Dominitz; Brooks D Cash Journal: Gastrointest Endosc Date: 2012-06 Impact factor: 9.427
Authors: Brennan M R Spiegel; Dinesh Khanna; Roger Bolus; Nikhil Agarwal; Puja Khanna; Lin Chang Journal: Am J Gastroenterol Date: 2011-03 Impact factor: 10.864
Authors: Jeffrey M Lackner; Gregory D Gudleski; Laurie Keefer; Susan S Krasner; Cathrine Powell; Leonard A Katz Journal: Clin Gastroenterol Hepatol Date: 2010-02-17 Impact factor: 11.382
Authors: Christopher V Almario; Megana L Ballal; William D Chey; Carl Nordstrom; Dinesh Khanna; Brennan M R Spiegel Journal: Am J Gastroenterol Date: 2018-10-15 Impact factor: 10.864
Authors: Herbert L Bonkovsky; Vinaya C Maddukuri; Cemal Yazici; Karl E Anderson; D Montgomery Bissell; Joseph R Bloomer; John D Phillips; Hetanshi Naik; Inga Peter; Gwen Baillargeon; Krista Bossi; Laura Gandolfo; Carrie Light; David Bishop; Robert J Desnick Journal: Am J Med Date: 2014-07-10 Impact factor: 4.965