Pathogenesis and rationale of treatment of recurrent abdominal pain

Since the turn of the century, recurrent abdominal pain (RAP) has been a diagnostic dilemma. From the fifties, the work of Apley led to a shift in the thinking i.e., away from organic to psychosomatic causes for the pain. During the past decade, however, better gastroenterological studies have led to a return to a search for organic causes. Psychologically, this may prove salutory to the child with RAP. Based on the history, glucose tolerance and histopathological studies reported elsewhere by the authors, it is suggested that the pain in these children is due to intestinal angina. The angina may be consequent to the master switch of life operating as a glucose homeostatic mechanism in mild viral infections. The role of intravenous glucose in such situations is discussed.