Recurrent abdominal pain in childhood

Singapore Med J. 2013 Apr;54(4):195-9; quiz 200. doi: 10.11622/smedj.2013072.

Abstract

Recurrent abdominal pain in childhood is common, and continues to be a diagnostic and therapeutic challenge. It is usually attributed to a functional gastrointestinal disorder rather than an organic disease. In most cases, a comprehensive history and physical examination should enable one to make a positive diagnosis of functional disorder. The presence of alarm symptoms and signs, such as weight loss, gastrointestinal bleeding and chronic severe diarrhoea, warrants further investigations and referral to a paediatric gastrointestinal specialist. The mainstay of therapy in functional abdominal pain is education, reassurance and avoidance of triggering factors. While symptom-based pharmacological therapy may be helpful in patients who do not respond to simple management, it is best used on a time-limited basis due to the lack of good evidence of its efficacy. The primary goal of therapy is a return to normal daily activities rather than complete elimination of pain. In recalcitrant cases, psychological interventions such as cognitive behaviour therapy and relaxation training have proven to be efficacious.

MeSH terms

  • Abdominal Pain / diagnosis*
  • Abdominal Pain / psychology
  • Abdominal Pain / therapy*
  • Child
  • Female
  • Gastrointestinal Diseases / diagnosis
  • Gastrointestinal Diseases / psychology
  • Gastrointestinal Diseases / therapy
  • Humans
  • Pain Threshold
  • Pediatrics / methods*
  • Recurrence
  • Treatment Outcome