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Recurrent abdominal pain in childhood: the functional element

A R Bremner1, B K Sandhu

  • 1Department of Paediatric Gastroenterology, Royal Bristol Childrens Hospital, Upper Maudlin Street, Bristol BS2 8BJ, UK.

Indian Pediatrics
|May 30, 2009
PubMed

Insights

Recurrent abdominal pain in children often stems from functional gut disorders, not organic causes. Psychological therapies show promise in managing symptoms and improving school attendance.

Area of Science:

  • Pediatrics
  • Gastroenterology

Background:

  • Chronic abdominal pain is common in children, impacting daily life and education.
  • Distinguishing functional abdominal pain from organic causes is crucial for appropriate management.
  • Organic causes like infections or celiac disease are less common than functional disorders in Western populations.

Purpose of the Study:

  • To review evidence for investigative and management strategies in pediatric functional abdominal pain.
  • To highlight the prevalence of functional gut disorders and their long-term implications.
  • To assess the efficacy of different therapeutic approaches.

Main Methods:

  • Review of epidemiological studies from European and American populations.
  • Analysis of available therapeutic trials, noting a lack of high-quality evidence.
  • Examination of psychological interventions and their impact on symptoms and school attendance.
  • Consideration of findings from Asian studies on gastrointestinal infections and functional pain.

Main Results:

  • Organic causes of recurrent abdominal pain in children are infrequent in Western studies.
  • Functional abdominal pain is a significant issue, potentially predicting adult functional gut disorders.
  • Psychological interventions, including cognitive behavioral and family therapy, demonstrate effectiveness.
  • High-quality trials for treatment are scarce, with no conclusive evidence for specific therapies.

Conclusions:

  • Functional abdominal pain is prevalent in children, necessitating a management approach focused on reassurance and return to normal activities.
  • Psychological therapies are effective for symptom control and improving school attendance in functional abdominal pain.
  • Further high-quality research is needed to establish definitive treatment guidelines for pediatric functional abdominal pain.

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