Epidemiology of Pediatric Functional Abdominal Pain Disorders: A Meta-Analysis

Functional abdominal pain disorders (FAPDs) are debilitating disorders with unknown current prevalence. To estimate global prevalence rates of FAPDs, their entities, and variations by diagnostic criteria, geography, gender, and age. Medline, Embase, CINAHL, PsycInfo, and Cochrane Library were searched through October 14, 2024. Epidemiological studies of birth cohorts, school based, and from general population samples reporting FAPD prevalence in children (aged 4-18 years) using the Rome criteria. Two researchers independently performed screening, data extraction, and quality assessment. A total of 66 studies, encompassing 201 134 participants from 29 countries, were included. The estimated global pooled prevalence of FAPDs was 11.7% (95% CI, 10.5%-13.1%). The most prevalent type was irritable bowel syndrome (5.8%; 95% CI, 4.5-7.4%), while functional abdominal pain-not otherwise specified was least prevalent (1.2%; 95% CI, 0.7%-2.1%)). Prevalence was highest using Rome III (13.2%; 95% CI, 11.3%-15.3%) and lowest under Rome IV criteria (9.0%; 95% CI, 6.7%-12.0%; P = .05). Girls had higher prevalence (14.4%; 95% CI, 12.5%-16.6%) than boys (9.4%; 95% CI, 7.8%-11.4%; P < .01). FAPDs were nonsignificantly more prevalent in Asia (13.0%; 95% CI, 10.4%-16.3%) compared to Europe (8.3%; 95% CI, 6.4%-10.7%) and North America (7.7%; 95% CI, 4.3-13.6; P = .09). No differences by age (P = .14) were recorded. Contributing factors include anxiety, depression, stress, negative life events, and poor sleep. Language restrictions, significant interstudy heterogeneity, and underrepresentation from Africa. FAPDs affect over 1 in 9 children worldwide, with higher prevalence in girls and those with psychological stressors.