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Recurrent abdominal pain and irritable bowel syndrome in children
Mark E McOmber1, Robert J Shulman
1Baylor College of Medicine, Texas Children's Hospital, Children's Nutrition Research Center, 1100 Bates Street, Houston, TX 77030, USA.
Insights
Recurrent abdominal pain in children involves physiological factors like visceral hypersensitivity. Parental and child psychological states significantly influence symptom severity, requiring a biopsychosocial approach for effective management.
Area of Science:
- Pediatric Gastroenterology
- Child Psychology
- Pain Management
Background:
- Recurrent abdominal pain (RAP) is a common pediatric condition with significant emotional and economic burdens.
- Understanding of RAP has evolved from a purely psychological to a biopsychosocial model, integrating biological, psychological, and social factors.
Purpose of the Study:
- To review current research on the etiologies, diagnostic methods, and treatment strategies for recurrent abdominal pain in children.
Main Methods:
- Review of current studies on recurrent abdominal pain in children.
- Analysis of diagnostic techniques and treatment options.
Main Results:
- Visceral hypersensitivity is a key factor in recurrent abdominal pain.
- Parental and child psychological states (anxiety, somatization, coping) modulate symptom expression.
- Diagnosis relies on history and physical examination; newer treatments include behavioral therapies and medications.
Conclusions:
- A comprehensive approach to pediatric recurrent abdominal pain must acknowledge physiological contributions.
- The psychological state of both the child and parents is crucial in modulating symptom severity and requires integrated management.
Purpose Of Review:
Recurrent abdominal pain continues to be one of the most ubiquitous conditions faced by the healthcare team, and has a significant emotional and economic impact. We have moved from considering it a psychological condition to recognizing the physiological and environmental contributions, and considering the condition in the framework of a biopsychosocial model where biology, psychology and social environment interact. Here, we review current studies addressing etiologies, diagnostic techniques and treatment options for recurrent abdominal pain in children.
Recent Findings:
Studies continue to highlight the role of visceral hypersensitivity in recurrent abdominal pain. The psychological state of the child and the parent (most often the mother) in terms of their anxiety, somatization and coping skills can, however, modulate the expression of symptoms. Diagnosis still is made by history and physical examination. Newer treatment options include relaxation and distraction therapies as well as medications. The role of probiotics in children remains to be defined.
Summary:
The approach to the child with recurrent abdominal pain must include the recognition of the physiological contributions, and this information must be relayed to the child and parents. Acknowledgement also must be paid to the role of psychological state in the parent as well as in the child in modulating the severity of symptoms.
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