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Articles: Paul N. Thiessen Recurrent Abdominal Pain Pediatrics in Review 2002; 23: 39-46 [Full text] [PDF]

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Celiac Disease/Gluten Intolerance

Nina A. Tomei   (10 September 2003)

functional abdominal pain

paul n thiessen   (5 April 2002)

"Functional" Disorders

Avrum L. Katcher   (5 April 2002)

Celiac Disease/Gluten Intolerance 10 September 2003
Nina A. Tomei, Pediatrician Huntington Hospital; North Shore University Hospital Send letter to journal: Re: Celiac Disease/Gluten Intolerance ntomei{at}optonline.net Nina A. Tomei	The possibility of celiac disease/gluten intolerance was not mentioned as a possible cause of abdominal pain in children, yet it may be very common but remain undiagnosed. CD can cause recurrent vague abdominal pain in children, as well as constipation, and should be screened for especially when lactose intolerance is diagnosed. CD can present not only as the classical case of a 6 to 18 month old infant who is failing to thrive, with diarrhea, abdominal pain and bloating, but can present at any age with recurrent abdominal pain, reflux, lactose intolerance, diarrhea, constipation, poor appetite/anorexia, even in apparently thriving, normally developing children. CD can be screened for relatively simply, by testing the blood for anti-gliadin IgG and IgA antibodies, as well as the tissue transglutaminase IgA antibody and total serum IgA (to rule out IgA deficiency). Thank you for your attention. Nina A. Tomei, MD
functional abdominal pain 5 April 2002
paul n thiessen, physician Send letter to journal: Re: functional abdominal pain sydney_sutherland{at}urmc.rochester.edu paul n thiessen	Dear Dr. Katcher: Thanks for your letter questioning the use of the word functional in my article on recurrent abdominal pain. The problem with only using "recurrent abdominal pain" is that it does not adequately differentiate the majority of cases where no organic cause can be found to explain the pain. The use of the word "functional" in the manner I have employed in my article is supported by the Oxford English dictionery--one of their five definitions of functional is "having no discernible cause." While acknowledging the imperfection of the word and even concept of functional, it seems to be the best we have to offer. I have found that the best way of making this understandable to families is to compare it to headaches in adults, where the vast majority defy any physical explanation but the pain is very real. Hope that's helpful. Paul Thiessen
"Functional" Disorders 5 April 2002
Avrum L. Katcher, retired pediatrician RWJ Medical School Send letter to journal: Re: "Functional" Disorders estelleavrumk{at}blast.net Avrum L. Katcher	Is it appropriate to use the word functional for any disorder? What health conditions exist without function? Abdominal pain, for example, caused by IBD is still a product of the function of the diseased bowel. Why not just live with Recurrent Abdominal Pain? When in practice I regularly explained the situation to patient and parents and in a majority of instances was able to engage them in a manner similar to that of the author. I hope I do not compliment myself too much, for this article is a brilliant report on a common complaint, written by a master of language both for the laity and the profession.