Recurrent abdominal pain in 200 children: somatic causes and diagnostic criteria
2011; Wiley; Volume: 100; Issue: 11 Linguagem: Inglês
10.1111/j.1651-2227.2011.02351.x
ISSN1651-2227
AutoresCFM Gijsbers, C. M. F. Kneepkens, JJ Schweizer, M. A. Benninga, HA Büller,
Tópico(s)Pediatric Pain Management Techniques
ResumoTo establish to what extent somatic causes can be found in children referred to secondary care with recurrent abdominal pain.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.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).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.
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