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Occult constipation: a common cause of recurrent abdominal pain in childhood

Tal Eidlitz-Markus1, Marc Mimouni, Avraham Zeharia

  • 1Day Care Unit, Schneider Children's Medical Center of Israel, Petah Tiqva, Israel. eidlitz@post.tau.ac.il

The Israel Medical Association Journal : IMAJ
|November 26, 2004
PubMed

Insights

Recurrent abdominal pain in children is often functional, but occult constipation may be the cause. Identifying and treating this hidden constipation significantly alleviates pain in most cases.

Area of Science:

  • Pediatric Gastroenterology
  • Childhood Functional Disorders

Background:

  • Recurrent abdominal pain affects 10% of children, often diagnosed as functional abdominal pain when no organic cause is identified.
  • Functional abdominal pain lacks a clear organic etiology, posing diagnostic challenges.

Purpose of the Study:

  • To investigate the potential role of occult constipation as a cause of recurrent abdominal pain in children.
  • To determine if undiagnosed constipation contributes to functional abdominal pain diagnoses.

Main Methods:

  • Occult constipation was defined as the absence of overt constipation symptoms during initial assessment.
  • Diagnosis of occult constipation was confirmed through rectal examination and/or plain abdominal X-ray.
  • Treatment involved paraffin oil and phosphate enemas.

Main Results:

  • Occult constipation was identified as the cause in 42.6% of children with recurrent abdominal pain.
  • Treatment led to significant pain reduction or resolution in 82.84% of cases within 2 weeks to 3 months.
  • Long-term follow-up (1-1.5 years) showed sustained improvement, with 96.5% reporting resolved pain and constipation.

Conclusions:

  • Occult constipation is a prevalent and treatable cause of recurrent abdominal pain in children previously diagnosed with functional abdominal pain.
  • Simple diagnostic methods and treatment can effectively manage this condition, improving outcomes for a significant number of pediatric patients.
Abstract

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