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Protozoa as a cause of recurrent abdominal pain in children

Carolien F M Gijsbers1, Joachim J Schweizer, Hans A Büller

  • 1*Department of Paediatric Gastroenterology, Juliana Children's Hospital/Haga Teaching Hospital, The Hague †Department of Paediatric Gastroenterology, Willem-Alexander Children's Hospital/Leiden University Medical Centre, Leiden ‡Sophia Children's Hospital/Erasmus Medical Centre, Rotterdam, The Netherlands.

Journal of Pediatric Gastroenterology and Nutrition
|June 21, 2013
PubMed

Insights

Protozoa cause recurrent abdominal pain (RAP) in 6-11% of children. However, these protozoan infections lack a distinct clinical presentation, making them difficult to identify based on symptoms alone.

Area of Science:

  • Pediatric Gastroenterology
  • Infectious Diseases

Background:

  • Recurrent abdominal pain (RAP) is a common pediatric complaint.
  • The role of protozoa as a cause of RAP is not well-defined.
  • Identifying specific clinical presentations for protozoan infections is crucial for diagnosis.

Purpose of the Study:

  • To determine the prevalence of protozoa as a cause of RAP in children.
  • To investigate if protozoan infections present with a unique clinical picture.

Main Methods:

  • Prospective evaluation of 220 children (ages 4-16) with RAP for Giardia lamblia, Dientamoeba fragilis, and Blastocystis hominis.
  • Treatment of positive cases and follow-up to assess pain resolution and infection eradication.
  • Calculation of the predictive value of pain characteristics for protozoan infections.

Main Results:

  • Protozoa were identified in 34% of patients; 11% experienced pain relief after treatment.
  • Dientamoeba fragilis, Blastocystis hominis, and Giardia lamblia were the most common protozoa.
  • No significant differences in clinical presentation were observed between children with protozoa-causing RAP and those with other causes or asymptomatic infections.

Conclusions:

  • Protozoa are a significant cause of RAP in 6-11% of pediatric cases.
  • Protozoan infections causing RAP do not have a characteristic clinical presentation.
  • Diagnosis of protozoan-related RAP requires laboratory testing rather than solely clinical assessment.
Abstract

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