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Recurrent abdominal pain in 200 children: somatic causes and diagnostic criteria
Author(s) -
Gijsbers CFM,
Kneepkens CMF,
Schweizer JJ,
Benninga MA,
Büller HA
Publication year - 2011
Publication title -
acta paediatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/j.1651-2227.2011.02351.x
Subject(s) - medicine , abdominal pain , constipation , occult , intervention (counseling) , psychological intervention , surgery , pediatrics , physical therapy , alternative medicine , psychiatry , pathology
Aim: To establish to what extent somatic causes can be found in children referred to secondary care with recurrent abdominal pain. Methods: For 2 years, all consecutive patients (age 4–16 years) fulfilling Apley criteria, referred to secondary care, were included. After a diagnostic work‐up, stepwise therapeutic interventions were performed. A diagnosis was considered to be the cause of the pain when the patient became pain free following therapeutic intervention and remained so for at least 6 months. Results: Two hundred and twenty children (128 F, 92 M; mean age 8.8 years) were enrolled, of which 20 were lost to follow‐up. Spontaneous recovery was seen in 54 patients, (occult) constipation in 92 patients (of whom 18 also had a somatic cause), gastrointestinal infections in 40, food allergy in five, miscellaneous disorders in seven and uncertain diagnosis in 13. In five patients, stress most likely caused the pain. A total of 198 patients became pain free and remained so during follow‐up (mean 18, range 6–60 months). Conclusion: In 200 children with recurrent abdominal pain, somatic causes were found in 26%. Laxative therapy was successful in 46%, resulting in nearly all patients with functional abdominal pain to become pain free. Eventually, 99% became pain free using a therapeutic intervention protocol.