Studies of the symptom abdominal pain--a systematic review and meta-analysis
Open Access
- 1 July 2014
- journal article
- research article
- Published by Oxford University Press (OUP) in Family Practice
- Vol. 31 (5), 517-529
- https://doi.org/10.1093/fampra/cmu036
Abstract
Diagnostic reasoning in primary care patients with abdominal pain is a complex challenge for GPs. To ensure evidence-based decision making for this symptom, GPs need setting-specific knowledge about the prevalence, potential risks for diseases and chance of recovery or risk of undesirable courses of disease. We conducted a systematic review of symptom-evaluating studies on prevalence, aetiology or prognosis of abdominal pain. We included all studies evaluating the symptom ‘abdominal pain’ as a reason for consultation in primary care. We included all types of study designs except for qualitative studies. Studies focussed solely on children or settings other than primary care were also excluded. We identified 14 studies. Mean consultation prevalence is 2.8% for abdominal pain. In about one-third of patients the underlying cause of abdominal pain cannot be specified. The most common aetiologies are gastroenteritis (7.2–18.7%), irritable bowel disease (2.6–13.2%), urological cause (5.3%) and gastritis (5.2%). About 1 in 10 abdominal pain patients suffers from an acute disease like appendicitis (1.9%), diverticulitis (3.0%), biliary/pancreatic (4.0%) or neoplastic (1.0%) diseases needing immediate therapy. There is a high prevalence of patients consulting GPs for abdominal pain. The review identified a comparably high rate of acute underlying diseases in need of further investigation or therapy. At the same time, the underlying cause of the complaints often remains unexplained. Further symptom-evaluating studies are necessary, ideally using standardized methodology in order to gain sufficient evidence for developing much-needed guidelines and decision support tools.Keywords
This publication has 17 references indexed in Scilit:
- Assessing risk of bias in prevalence studies: modification of an existing tool and evidence of interrater agreementJournal of Clinical Epidemiology, 2012
- Predictors of persistent gastrointestinal symptoms among new presenters to primary careEuropean Journal of Gastroenterology & Hepatology, 2010
- Self-reported health complaints in a primary care population living under stressful conditions in the Gaza Strip, PalestineMedicine, Conflict and Survival, 2010
- Undue reliance on I-2 in assessing heterogeneity may misleadBMC Medical Research Methodology, 2008
- Unspecified abdominal pain in primary care: the role of gastrointestinal morbidityInternational Journal of Clinical Practice, 2007
- Pain as a reason to visit the doctor: a study in Finnish primary health carePain, 2001
- Abdominal pain and irritable bowel syndrome in adolescents: A community-based studyThe Journal of Pediatrics, 1996
- Abdominal Pain in General PracticeFamily Practice, 1993
- Common symptoms in ambulatory care: Incidence, evaluation, therapy, and outcomeAmerican Journal Of Medicine, 1989
- Symptoms of Patients and Escorts in a Primary Care Department in Saudi ArabiaFamily Practice, 1984