Recurrent abdominal pain in children [Article in Croatian]

Abstract

Recurrent abdominal pain (RAP) is common in the paediatric population. Although most of the patients experiencing RAP do not have an underlying disease, it is important to recognize it. Organic, functional and psychogenic disorders may be associated with RAP. Functional disorders are the most common presenting as functional dyspepsia, irritable bowel syndrome, abdominal migraine, functional abdominal pain syndrome. They may appear as a single disorder or in combination. Should alarm symptoms or signs appear in patients, a detailed examination is necessary to exclude or confirm the organic etiology of the disease. These include loss of weight, deceleration of linear growth, significant vomiting, chronic severe diarrhoea, gastrointestinal bleeding, left upper and lower quadrant abdominal pain, unexplained fever, history of inflammatory bowel disease in the family and may be obtained from a history or upon examination. In such patients it is advisable to perform abdominal ultrasound, endoscopy with biopsy and oesophageal pH metry. There is no evidence that a stressful life style may cause RAP. Some investigators suggest that children (and their parents) with RAP suffer from anxiety and depression more often, and are prone to developing emotional or psychiatric disorders. The best therapeutic results are obtained through a course of adapted diet (no lactose and rich in fiber) combined with cognitive behavioral therapy.