Psychological aspects of recurrent abdominal pain

Recurrent abdominal pain with no apparent organic cause is common in children. An investigation should be made for both psychological and organic causes. The initial assessment should include a detailed history of pain, a developmental history, a detailed family pain history, and history of any school, family or marital stress. A diary recording the parents' and child's observations of the child's pain may indicate its causes, ideas for management, and indicate whether it is improving. Specific treatment for psychological pain focuses on the underlying cause, removing it if possible. However, only non-specific treatment is possible when neither organic nor psychological causes can be found. The physician should discuss the diagnosis with parents and child and reassure them the pain is benign and self-limiting. He should also acknowledge the child's pain is real and encourage him to cope by taking part in as many of his normal activities as possible.