Bhaswati Acharyya1, Sanjeev Joshi2, Sanjay Wazir3, A.G. Karthikeyan4, Vyankatesh M. Chavan5, I. Shrikanth Rao6, Chaitanya Balloji7, Neha8, Seema Vikas Bhagat8, Krishna Chaitanya Veligandla8, Rahul Rathod8, Bhavesh Kotak8, Manipa Saha9, Monjori Mitra1*
1Institute of Child Health, Kolkata, West Bengal, India
2Chirayu Criticare and Joshi Bal Rugnalay, Yavatmal, Maharashtra, India
3Neonatology at Cloud Nine Hospital, Gurgaon, India
4Sai Mother and Child Health Care, Royapettah, Chennai, India
5Bhagwaan Mahaveer Jain Hospital, Vasanthanagar, Bangalore, India
6Chetana Hospital, Puttur, Udupi, India
7Chaitanya Balloji Clinic in Ramachandra Rao Pet, West Godavari, India
8Dr. Reddy's Laboratories Ltd., Hyderabad, India
9Medclin Research Pvt. Ltd., Kolkata, West Bengal, IndiaFulltext PDF
Background and Objectives: Functional Abdominal Pain (FAP) is prevalent among children; diagnosis and management are challenging due to poorly understood etiology and lack of guidelines. We investigated pediatricians’ current knowledge, attitude, and practice with respect to FAP.
Methods: A survey was conducted between December 2022 and March 2023 via a validated questionnaire, comprising 29 pertinent questions on general characteristics of pediatricians, and diagnosis and treatment of FAP, shared with ~2000 Indian pediatricians.
Results: Responses were received from 302 pediatricians, predominantly male (68.9%), aged 40-50 years (31.1%), from Tier-I (40.9%) places, practicing in private clinics (54.8%). Most respondents identified FAP definition (74.6%) and site of pain (78.1%). Confirmatory diagnosis was mostly done on the second or third visit (90.7%); vomiting was considered the predominant red flag (86.8%). FAP was believed to be a ‘diagnosis of exclusion’ (76%). Most respondents used ROME IV criteria (53%), ordered ultrasonography (USG) (74.3%), advised antispasmodics (75.6%), and agreed that investigations in upto 30% FAP cases were ordered due to parental pressure (79%). Most respondents expected ≤30% FAP patients to improve with non-pharmacological or pharmacological approaches, or with diet modification, and preferred combinatorial management strategy (60.1%). Probiotics were advised by 67.3% respondents in ≤20% patients, mostly using single strains (67.3%). Referral rate to cross-specialties was low (<10%). Most respondents considered reduction in intensity and pain frequency as therapeutic success (61.8%).
Conclusions: A general awareness about FAP exists among Indian pediatricians; however, a consensus in diagnosis and management is lacking. Most respondents stated that guidelines might be helpful.
Functional Abdominal Pain (FAP), Knowledge, Attitude, Practice, Pediatricians, India
Bhaswati Acharyya, Sanjeev Joshi, Sanjay Wazir, A.G. Karthikeyan, Vyankatesh M. Chavan, I. Shrikanth Rao, et al.Functional Abdominal Pain (FAP) in Children: Knowledge, Attitude, and Practice of Pediatricians in India. Int Jour Gastro Hepat. 2023;2(2):1-13.