Abdominal Pain

Key Points Functional abdominal pain disorders are the most common causes of recurrent abdominal pain in pediatrics.The Rome IV criteria in 2016 for functional abdominal pain have eliminated the requirement of "no evidence for organic disease"; it now is defined as > 2 months of pain, ≥ 4 times per month, and after appropriate medical evaluation the symptoms cannot be attributed to another medical condition.History and physical examination are the only evaluations required most of the time in a child with abdominal pain.

PEDIATRICS ◽  
1967 ◽  
Vol 40 (6) ◽  
pp. 1024-1026
Author(s):  
Donald G. Marshall

MUCH has been written in recent years about the importance of psychogenic disturbances as causes of abdominal pain in childhood. Yet, by no means all recurrent abdominal pain is so caused. A recent article in Pediatrics on nonorganic abdominal pain therefore promised this subsequent paper on pain of organic origin. I would like to caution the reader that his "surgeon's viewpoint" tends to exclude consideration of organic abdominal pain not surgically treated. Perhaps a third paper is indicated. Abdominal pain of whatever origin requires a planned approach to diagnosis. While it is only too easy for the clinician to submit a patient to innumerable investigations of varying degrees of unlikelihood of revealing disorders of differing degrees of rarity, a detailed history and searching interview with the parents, together with a complete physical examination, will go very far to reduce the number of cases submitted to any but quite simple tests. The diagnosis of psychogenic pain, no less than that of organic pain, must rest on positive findings. To make a diagnosis of psychogenic pain, there must be something more than the absence of demonstrable organic disease. There must be significant psychopathology. If there is evidence of neither this nor organic disease, one must resolve to be irresolute and decide to be undecided. One must not make a diagnosis of psychic disease simply because one can find no organic cause. One must also remember that psychic disturbance does not confer immunity from organic disease. A neurotic, psychotic, or brain-damaged child can have appendicitis.


2015 ◽  
Vol 35 (1) ◽  
pp. 57-58
Author(s):  
A Das ◽  
M Basu

Recurrent abdominal pain is a common problem among children. Since its first description by John Apley in 1958, the condition has remained poorly understood with a multitude of factors being implicated in causation. The symptoms tend to be vague and investigations seldom show organic disease. But the importance to evaluate each child with recurrent abdominal pain should be considered important nevertheless, particularly, in protracted cases. Here, we present a case who presented with history of recurrent abdominal pain for several years before being diagnosed as a case of hereditary pancreatitis. This stresses the importance of evaluating each case with a detailed and complete history, physical examination and selected investigations.J Nepal Paediatr Soc 2015;35(1):57-58


1982 ◽  
Vol 4 (1) ◽  
pp. 29-34
Author(s):  
Giulio J. Barbero

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.


Author(s):  
R. Mark Beattie ◽  
Anil Dhawan ◽  
John W.L. Puntis

Introduction 256Classification 257Personality type and family factors 259Common stresses in children with recurrent abdominal pain 259Therapeutic options 260Outcome 261Recommended clinical approach 261• Recurrent abdominal pain is common in school-aged children and is a frequent presenting complaint in general practice and general paediatric and paediatric gastroenterology clinics. Patients often have vague symptomatology and investigation usually results in a low yield of organic disease. Treatment strategies are varied and often subjective with very little evidence upon which to base them....


Author(s):  
Mark Tighe ◽  
Mark Beattie

Recurrent abdominal pain occurs in 10–15% of school-aged children and is a frequent presenting complaint in general practice and general paediatric and paediatric gastroenterology clinics. Patients often have vague symptoms and investigation usually results in a low yield of organic disease. Treatment strategies are varied and often subjective with limited evidence upon which to base them. This chapter includes a general overview, classification, discussion of the complex and multifactorial aetiology, therapeutic approach, and outcome. It discusses a recommended clinical approach for the management of complex cases.


2022 ◽  
Vol 99 (7-8) ◽  
pp. 465-468
Author(s):  
A. A. Sheptulin

The article discusses the algorithm for diagnosing of centrally mediated abdominal pain syndrome (CAPS), formerly called functional abdominal pain syndrome, contained in the Rome Criteria of the IV revision (2016). Recommendations for the diagnosis of CAPS, mainly based on the compliance of the signs available in patients with the developed diagnostic criteria with a minimum of additional laboratory tests, are criticized, since such an approach is fraught with possible errors. The author considers the diagnosis of CAPS as a “diagnosis of exclusion”, which can be made only after a thorough examination of patients using laboratory and instrumental research methods (including ultrasound and endoscopic), confi rming the absence of organic diseases in patients.


2017 ◽  
Vol 41 (1) ◽  
pp. 4-8
Author(s):  
Hossain Sahid Kamrul Alam ◽  
Mohammed Rizwanul Ahsan ◽  
Md Aynal Hoque ◽  
Abm Mahfuz Hassan Al Mamun ◽  
Syed Shafi Ahmed

Background: Abdominal pain is very common among children and adolescents. There are many causes of recurrent abdominal pain in children, but parents may find it surprising that it is very common for there to be no clear cause identified for childhood abdominal pain even though examinations and tests have been done.Objective: This study was carried out to identify the demographic profile, causes and outcomes of adolescents admitted with recurrent abdominal pain.Methods: This Retrospective descriptive study was carried out at the Adolescent Unit of Dhaka Shishu (Children) Hospital during the period from 1st October 2015 to 31st March 2017 among 102 adolescents with history of recurrent abdominal pain after following the inclusion and exclusion criteria. Collected data were statistically analyzed with the use of the Statistical Package for Social Science (SPSS) program version 15.Results: Out of 1080 total 102 (9.44%) adolescents were admitted with recurrent abdominal pain of which majority subjects were male (57%). Urban were 61.76% and rest were rural (38.24%). The specific diagnosis pattern revealed that majority had Functional abdominal pain (44.12%) followed by Urinary tract infection (UTI) (20.59%), Peptic ulcer diseases (13.73%), Gastroesophagial reflux diseases (GERD) (11.76%), Abdominal tuberculosis (5.88%), Pelvic inflammatory diseases (4.90%), Cholecystitis (1.96%) and Abdominal migraine (0.98%).Conclusion: Recurrent abdominal pain is common among adolescents. Functional abdominal pain is the most common cause of recurrent abdominal pain. An uniform management protocol should be developed for proper investigations to minimize the cost and for judicious use of drugs in order to help these adolescents with recurrent abdominal pain.Bangladesh J Child Health 2017; VOL 41 (1) :4-8


Author(s):  
Muzal Kadim

Diagnostic criteria for functional abdominal pain has developed in the last decade, from the Rome III criteria to the Rome IV criteria. The major change was in the phrase "abdominal pain related gastrointestinal disorders" to "functional abdominal pain disorders (FAPD)". According to Rome IV criteria, FAPD  are divided into functional dyspepsia (FD), irritable bowel syndrome (IBS), abdominal migraine, and functional abdominal pain-not otherwise specified (FAP-NOS). In order to diagnose FAPD, it is important to pay attention to alarm signs that can indicate organic abnormalities. The pathophysiology of FAPD was a complex interaction between psychosocial, genetic, environmental and life experiences of children through the gut brain axis. The risk factors for functional abdominal pain in children include psychological factors including anxiety and depression, stress conditions, negative experiences, and socioeconomic status.  


PEDIATRICS ◽  
1985 ◽  
Vol 76 (6) ◽  
pp. 934-937
Author(s):  
William J. Byrne ◽  
Watson C. Arnold ◽  
Michael W. Stannard ◽  
John F. Redman

Three cases of ureteropelvic junction obstruction are presented in which the only symptom was recurrent abdominal pain. Results of physical examination and urinalysis were normal. Ultrasound established the correct diagnosis in the two patients in whom it was performed. Because it is safe, involves no radiation exposure, and is useful in evaluating the gallbladder, pancreas, and liver, as well as both kidneys, abdominal ultrasound should be performed prior to contrast radiography in the evaluation of children with recurrent abdominal pain.


QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Ahmed Mohammed Hamdy Saber ◽  
Ahmed Tohamy Ahmed Ibrahim ◽  
Ola Adel Abdellah Mahdy

Abstract Background Abdominal pain defined as any type of pain or discomfort that occurs in any area from the lower chest to the groin. Abdominal pain is symptom of a wide variety of mild to serious diseases, disorders, conditions. Abdominal pain can result from infection, malignancy, inflammation, obstruction and other abnormal processes. Aim of the Work To define the causes of recurrent abdominal pain among a sample of school age children. Subjects and Methods This cross sectional study was carried out to evaluate those children who presented to the Pediatric Outpatient Clinic, Children Hospital, Ain Shams University because of recurrent abdominal pain they were diagnosed in the pediatric Gastroenterology unit between June 2016 and July 2017. History taking included full analysis of abdominal pain, associated gastrointestinal symptoms and associated systemic manifestations. Examination included anthropometric measurements, general and local abdominal examination. Routine investigations included complete blood counts, urine analysis and culture, microscopic stool examination and pelviabdominal US. Other specific investigations were selected according to clinical manifestations to reach an organic cause. After reaching the definitive diagnosis, patients were classified into 2 groups organic causes and functional abdominal pain. Results During the study period, 100 children presented with recurrent abdominal pain. Results revealed that only 28% of the recurrent abdominal pain causes were attributed to organic factors; the most commonly encountered organic causes of recurrent abdominal pain were urinary tract infection (12%) while 72% of children presented with functional recurrent abdominal pain. The most common causes of function recurrent abdominal pain in our study was irritable bowel syndrome. Conclusion Most of the cases of RAP among school age children are due to functional abdominal pain (72%).


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