Recurrent abdominal pain in children

Abstract

CONTEXT: Recurrent abdominal pain is one of the commonest gastrointestinal complaints in children, affecting approximately 10% of school aged children and adolescents. There is no consensus with regards to etiology, investigation and management of this common problem. This review addresses some of the issues related to epidemiology, etiology, management and prognosis of recurrent abdominal pain. EVIDENCE ACQUISITION: We reviewed current literature on this broad subject, specially concentrating on epidemiology, etiology and, basic and advanced management strategies, from 1958 to date, using PubMed, Embase, Cochrane database and cross references. RESULTS: The majority of the affected children have functional gastrointestinal diseases. The exact cause of pain remains obscure. New evidence suggests that emotional stress, visceral hypersensitivity and gastrointestinal motility disorders may play a vital part in its origin. Pharmacological treatments are commonly used in an effort to manage symptoms, despite the lack of data supporting their efficacy. CONCLUSIONS: Most children with recurrent abdominal pain have functional gastrointestinal diseases and a detailed history, examination and basic stool, urine and hematological investigations are sufficient to exclude organic pathology in them. Despite the magnitude of the problem, knowledge on the effective management options is poor.