Recurrent Abdominal Pain in Childhood
Giulio J. Barbero MD1
1 Department of Child Health, University of Missouri School of Medicine, Columbia, MO 65202
Recurrent abdominal pain (RAP) in childhood is a common complaint that may be difficult to diagnose and manage. Apley has reported that 10% of children have three or more episodes severe enough to impair activity and function over at least a three-month period. RAP appears less often in preschool children and, when present at earlier ages, it usually occurs in brief episodes rather than the more frequent and intense pattern that is characteristic of the school-aged child. RAP is more frequent in girls and is particularly prominent as a symptom in early adolescence. Occasional abdominal pain is a universal symptom in childhood and its significance is often difficult to assess. A practical approach is to determine the frequency, severity, and limitations produced by the pain before further exploration of its cause.
DIAGNOSIS
Recurrent abdominal pain in childhood can be divided into disturbances of gastrointestinal functions and a variety of pathologic disease or organic categories. A combination of the disturbance of function and other organic disease can also be present as the basis for the pain. Fewer than 10% to 15% of referred children reported in various studies have been found to have pain of organic origin. It is important to recognize that many patients and their parents are fearful of the pain as a symptom and are not easily able to incorporate a concept of disorder of a gastrointestinal function at the onset.
