Christopher Chiong Meng Boey

The significance of life-events as contributing factors in childhood recurrent abdominal pain in an urban community in Malaysia

This study aimed to look at the link between childhood recurrent abdominal pain (RAP) and the presence of recent life-events in an urban community in Malaysia. School children aged from 9 to 15 years in the city of Petaling Jaya were randomly selected to fill in a questionnaire and to be interviewed. The prevalence of RAP among 1488 school children studied was 9.6% (95% confidence interval (CI), 8.18-11.25). Higher prevalences of RAP were found in children who had experienced the following life-events in the previous year: loss of a family member through death (P<.001), hospitalisation of a family member (P<.001), the childs own hospitalisation (P=.001), change of address (P<.001), change in occupation of an immediate family member (P<.001), failure in a major school examination (P<.001), bullying at school (P=.001). Following logistic regression analysis, five life-events remain significant: hospitalisation of a family member (P=.038), the childs own hospitalisation (P=.034), change in occupation of an immediate family member (P=.049), examination failure (P=.001) and bullying at school (P=.028). This study strongly suggests that recent stressful life-events are important risk-factors for RAP.

The prevalence of recurrent abdominal pain in 11- to 16-year-old Malaysian schoolchildren.

Objective: To determine the prevalence of recurrent abdominal pain (RAP) among Malaysian school children aged from 11 to 16 years.

Correlation among academic performance, recurrent abdominal pain and other factors in Year-6 urban primary-school children in Malaysia

Objective:  The present study aimed to investigate the extent to which recurrent abdominal pain and other factors were associated with academic achievement among Year‐6 (12 years of age) schoolchildren.

Asia Pacific Consensus Statements on Crohn's Disease Part 1: definition, diagnosis and epidemiology (Asia Pacific Crohn’s Disease Consensus Part 1)

Inflammatory bowel disease (IBD) was previously thought to be rare in Asia, but emerging data indicate rising incidence and prevalence of IBD in the region. The Asia Pacific Working Group on Inflammatory Bowel Disease was established in Cebu, Philippines, at the Asia Pacific Digestive Week conference in 2006 under the auspices of the Asian Pacific Association of Gastroenterology with the goal of developing best management practices, coordinating research, and raising awareness of IBD in the region. The consensus group previously published recommendations for the diagnosis and management of ulcerative colitis with specific relevance to the Asia‐Pacific region. The present consensus statements were developed following a similar process to address the epidemiology, diagnosis, and management of Crohns disease. The goals of these statements are to pool the pertinent literature specifically highlighting relevant data and conditions in the Asia‐Pacific region relating to the economy, health systems, background infectious diseases, differential diagnoses, and treatment availability. It does not intend to be all comprehensive and future revisions are likely to be required in this ever‐changing field.

Stressful life events and recurrent abdominal pain in children in a rural district in Malaysia.

Objective The purpose of this study was to look at the correlation between recurrent abdominal pain and the presence of recent stressful life events among schoolchildren in a rural district in Malaysia. Method This is a cross-sectional study of schoolchildren aged 9–15 years based in Kuala Langat, a rural district located in the south-west of the Malaysian state of Selangor. Schoolchildren were selected randomly and given questionnaires to fill in. This was followed by interview with the children on the same day by one of the authors (CCMB) to ensure consistency of response. Recurrent abdominal pain was defined as ‘at least three episodes of abdominal pain, severe enough to affect their activities over a period longer than three months’[1]. The children were also asked to answer either ‘yes’ or ‘no’ to whether they had experienced various life events in the previous year. Results A sample of 1462 schoolchildren (722 boys and 740 girls) aged between 9 and 15 years were included in the study. There were 768 Malays, 393 Chinese and 301 Indians. Of these 1462 children, 161 (11.0%) had recurrent abdominal pain. On performing multiple logistic regression analysis, two life events were significantly associated with recurrent abdominal pain: death of a family member (P = 0.008; odds ratio 0.61, 95% CI 0.43–0.88) and a change in occupation of an immediate family member (P = 0.003; odds ratio 0.53, 95% CI 0.35–0.81). Conclusion This study suggests that recurrent abdominal pain in children is associated with recent stressful life events in the childrens lives.

Predictors of health-care consultation for recurrent abdominal pain among urban schoolchildren in Malaysia.

Aim: To look at the predictors of health‐care consultation for recurrent abdominal pain among urban schoolchildren in Malaysia.

Recurrent abdominal pain and consulting behaviour among children in a rural community in Malaysia.

AIM To look at predictors of consulting behaviour among children with recurrent abdominal pain in a rural community in Malaysia. SUBJECTS AND METHODS A sample of 1462 school-children aged between 9 and 15 years were randomly selected from all schools in Kuala Langat, a rural district in Malaysia. Those with recurrent abdominal pain, defined according to Apleys criteria, were recruited and divided into consulters and non-consulters. A consulter was defined as a child who had sought the help of a medical practitioner at least once in the past year for recurrent abdominal pain. A detailed clinical, social and family history was obtained in all recruited children. RESULTS A total of 161 children were recruited: 78 (48.4%) consulters, 83 (51.6%) non-consulters. Of the consulters, 40 were boys, 38 were girls (male:female ratio = 1.1:1). The two sexes did not show a significant difference in prevalence of consulters [p=0.189). Of the ethnic groups, only Indians had a significantly higher likelihood to consult a doctor (Indians, p=0.006; Malays, p=0.742; Chinese, p=0.050]. Younger children (under 12 years) had a significantly higher chance of having been brought to see a medical practitioner (p=0.014). Children in whom age of onset of abdominal pain was below ten years were also more likely to have been seen by a doctor (p=0.012). Children who had consulted a doctor were more likely to be missing school because of abdominal pain (p<0.001). Pain severity was not a significant factor (p=0.429). Multiple logistic regression analysis revealed that the only variable that remained significantly associated with health-care consultation was school absence (p<0.001). CONCLUSIONS Children who saw their doctors for recurrent abdominal pain were also more likely to be those who missed school on account of abdominal pain. Following multiple regression analysis, other factors were no longer significant.

Predictors of recurrent abdominal pain among 9 to 15-year-old urban school-children in Malaysia

A cross‐sectional survey of school‐children aged from 9 to 15 y was performed in the city of Petaling Jaya to look for predictors of recurrent abdominal pain. A sample of 1488 children was randomly chosen, of whom 143 (9.6%) had recurrent abdominal pain according to Apleys criteria.

Seroprevalence of Helicobacter pylori infection in Malaysian children: Evidence for ethnic differences in childhood

Objectives: To determine the prevalence of Helicobacter pylor (H. pylori) in healthy Malaysian children and to discover whether differences exist among children of different races.

Psychosocial factors and childhood recurrent abdominal pain

Abstract   Recurrent abdominal pain in children is not a single condition but a description of a wide spectrum of clinical manifestations, some of which fit into a definite pattern, such as the irritable bowel syndrome, while others do not. Organic disorders may be present, but in the majority of children they cannot be detected. Although children with recurrent abdominal pain do not generally have psychological or psychiatric illness, there is a growing body of evidence to suggest that psychosocial stress plays an important role in this condition. This review will look into some of this evidence. The precise pathophysiology that results in abdominal pain is still not clearly understood, but the current belief is that visceral hypersensitivity or hyperalgesia and changes in the brain–gut axis linking the central and enteric nervous systems are important mechanisms.