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[Recurrent abdominal pain at the Pediatric Gastroenterology Outpatient Clinic]
C A Lunardi1, L A Azevedo, L C Azevedo
1Serviço de Pediatria Clínica, Hospital do Servidor Público Estadual Francisco Morato de Oliveira, IAMSPE, SP.
Insights
Recurrent abdominal pain in children often has an organic cause, with chronic constipation being the most frequent diagnosis. Pediatricians should consider multifactorial origins for these symptoms.
Area of Science:
- Pediatric Gastroenterology
- Clinical Medicine
Context:
- Recurrent abdominal pain (RAP) is a common pediatric complaint.
- Identifying the underlying cause of RAP is crucial for effective management.
Purpose:
- To analyze features of pediatric patients with recurrent abdominal pain.
- To identify common etiologic diagnoses and their clinical/laboratorial differences.
Summary:
- A study of 167 children with RAP found chronic intestinal constipation (58.6%), intestinal parasitosis (22.8%), and peptic disease (20.4%) as primary diagnoses.
- Significant differences in age, consultations, pain characteristics, and stool features were observed among diagnostic groups.
- Organic diseases were found to be more common than anticipated in pediatric RAP.
Impact:
- Highlights the importance of thorough investigation for organic causes in pediatric RAP.
- Suggests considering multifactorial origins for persistent abdominal pain in children.
Objective:
To analyze the features of pediatric patients with recurrent abdominal pain, identify the main ethiologic diagnoses and their clinical and laboratorial differences.
Patients And Methods:
We studied the medical records from 167 children attended at a pediatric gastroenterology outpatient clinic. After analysis of the entire sample, the patients were divided in groups according to their diagnosis. Those patients with more than one diagnosis were arranged into a subgroup named multiple diagnosis. Statistical analysis was performed with Kruskall-Wallis test for numeric variables and chi-square test for non-numeric variables.
Results:
The patients age ranged from 3 to 17 years (median 9), the number of consultations ranged from 1 to 16 (median 2) and the period of attendance ranged from 1 to 37 months (median 4). The pain was mainly periumbilical (35.8%) and crampy-like (76.1%). The main diagnoses found were chronic intestinal constipation (58.6%), intestinal parasitosis (22.8%), and peptic disease (20.4%). In 34 patients (20.3%) we were not able to establish the diagnosis. Among the groups, there was statistically significant difference in age (p=0.00003), number of consultations (p=0.00004), period of attendance (p=0.00001), kind of pain (p=0.0003), intestinal habit (p=0.0002), stool features (p=0.0001), and evolution (p=0.0006).
Conclusions:
The authors conclude that finding organic disease in patients with recurrent abdominal pain is much more common than it was expected. The pediatrician always has to consider the possibility of multifactorial origin for these patients' complaints.
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