Recurrent abdominal pain in children: past, present, and future

The management of recurrent abdominal pain (RAP) in children remains a challenge for physicians. RAP describes a diverse array of clinical presentations. These presentations usually involve abdominal pain and other nonspecific symptomatology for which no organic cause can be found. Long-term recurrence of symptoms is fairly high. RAP was once thought to be a physical manifestation of psychological stressors in children. Past research has neither confirmed nor ruled out the possibility of an organic or psychological etiology. Current theory contends that the clinical presentation of RAP represents a complex interplay between psychosocial and organic factors. New diagnostic subgroups for functional gastrointestinal diseases have been proposed. These subgroups are based on symptoms, since functional disease is often accompanied by no evidence of organic dysfunction. Future research will provide further information on the diagnostic distinctions and different indications for treatment between these subgroups that make up the broader category of RAP.