Recurrent abdominal pain: an update
1Case Western Reserve University School of Medicine, Cleveland, OH, USA.
Insights
Recurrent abdominal pain (RAP) in children often indicates a functional gastrointestinal disorder. Diagnosis involves medical history, physical exams, and targeted tests to identify specific presentations like irritable bowel syndrome.
Area of Science:
- Pediatric Gastroenterology
- Functional Gastrointestinal Disorders
Background:
- Recurrent abdominal pain (RAP) is a common pediatric complaint.
- It describes a diverse group of children with episodic abdominal pain lasting over three months.
- The majority of RAP cases are linked to functional gastrointestinal disorders.
Observation:
- Functional abdominal pain is often triggered by gastrointestinal motility or sensory disturbances.
- These disturbances can be provoked by various physical and psychological stressors.
- Three primary clinical presentations are observed: periumbilical pain, dyspepsia, and irritable bowel syndrome.
Findings:
- Diagnosis of functional disorders in children is achieved through comprehensive evaluation.
- This includes detailed medical history and physical examination.
- Selected laboratory, radiologic, and endoscopic tests aid in positive diagnosis.
Implications:
- Accurate diagnosis of functional abdominal pain is crucial for effective management in children.
- Understanding the triggers and presentations aids in developing targeted treatment strategies.
- This approach helps differentiate functional disorders from organic diseases, improving patient care.
Abstract:
RAP is a broad descriptive term commonly used in pediatrics to define a heterogeneous group of patients who experience episodic attacks of abdominal pain over a period of at least 3 months. The majority of patients who seek medical attention for RAP have a functional disorder thought to be triggered by a motility or sensory disturbance of the GI tract provoked by a variety of physical and psychological stimuli. There are three distinct clinical presentations of functional abdominal pain in children and adolescents: periumbilical paroxysmal abdominal pain, dyspepsia, and irritable bowel. The medical history, physical examination, and selected laboratory, radiologic, and endoscopic evaluations allow a positive diagnosis of a functional disorder in each type of clinical presentation.
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