School attendance in children with functional abdominal pain and inflammatory bowel diseases

Objective: Inflammatory bowel disease (IBD) and functional abdominal pain (FAP) are associated with debilitating symptoms and frequent medical visits that may disrupt school functioning. The aim of this study was to assess school-related quality of life and school absenteeism in children with IBD, compared with FAP and healthy controls. Methods: School absenteeism and participation in school and after-school activities data were obtained for 43 children with Crohn disease (CD), 31 children with ulcerative colitis (UC), 42 children with FAP, and 30 agematched healthy controls for the 2013-2014 school year. We used a semistructured questionnaire for both children and parents. For diminishing recall bias, absenteeism data were cross-matched with the patient's school annual report cards. Results: Children with FAP, CD, and UC missed significantly more school days than age-matched healthy controls (17.6 [8.75-30], 24 [14-30], and 21 [12-25] vs 5.1 [3.75-6.25], respectively, P<0.001). Compared with children with FAP, absenteeism because of medical appointments and hospitalization was significantly greater in children with CD and UC (8.8 [4-14] and 7.1 [3-10] vs 4.4 [2-6.25], P=0.001). Participation of children with FAP and IBD in various school and after-school activities was significantly reduced compared with healthy controls. There was no difference in school attendance and functioning between children with IBD and FAP. Conclusions: FAP has a significant impact on school attendance and functioning similar to IBD. These findings show that significant psychosocial and academic difficulties are faced not only by children with chronic diseases like IBD but also by children with FAP.