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Unexplained Gastrointestinal Symptoms in Abused Children

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The medical community is aware of the occurrence of unexplained gastrointestinal symptoms in adults who recall being abused as children. Adult survivors of abuse are more likely to suffer from disabling and chronic gastrointestinal symptoms than adults who did not experience abuse. Sexually abused women experience a high incidence of unexplained gastrointestinal problems. However, there is limited data documenting the association of childhood maltreatment and early unexplained gastrointestinal symptoms. A group of researchers led by Miranda A. L. van Tillburg, PhD, conducted a study to investigate this correlation. Their findings are reported in the current issue of the Annals of Family Medicine.

Data was gathered from the Longitudinal Study of Child Abuse and Neglect, which is a collection of five studies on child maltreatment. A group of 845 children were observed from ages 4 through 12 years. Allegations of maltreatment were obtained from the records of the Child Protective Services. At two year intervals, information on gastrointestinal symptoms was obtained from the parents. At twelve years of age, the children reported on gastrointestinal symptoms, maltreatment experiences, and psychological distress. The criteria for maltreatment included emotional maltreatment, lack of supervision, failure to provide food, hygiene, clothing, shelter or medical care, sexual abuse, and physical abuse.

Review of the data indicated that maltreated children were more likely to experience unexplained gastrointestinal symptoms and psychological distress. On self-reports, increased abdominal pain, nausea, and vomiting were associated with all forms of abuse. In comparison to boys, girls were less likely to be reported for physical abuse, more likely to be reported for sexual abuse, self-reported more psychological maltreatment, and suffered more abdominal pain. Sexually abused youths reported experiencing abdominal pain 8.8% before sexual abuse, 46% at the time of abuse, and 45.2% at a later time after the abuse.

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