HOME HELP CONTACT US SUBSCRIPTIONS CME ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Take the CME quiz: Vol. 18 No. 9, September 1997 Rapid Responses: Submit a response Alert me when this article is cited Alert me when Rapid Responses are posted Alert me if a correction is posted Services E-mail this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to My File Cabinet Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Boyle, J. T. Search for Related Content PubMed PubMed Citation Articles by Boyle, J. T. Related Collections Gastrointestinal Disorders

(Pediatrics in Review. 1997;18:310-321.)
© 1997 American Academy of Pediatrics

Recurrent Abdominal Pain: An Update

	IMPORTANT POINTS

 

1. Recurrent abdominal pain (RAP) is not a diagnosis; it is defined as paroxysmal abdominal pain in children between the ages of 4 and 16 years that persists for more than 3 months and affects normal activity.
   
2. There are three clinical presentations of RAP: isolated paroxysmal abdominal pain, abdominal pain associated with dyspepsia, and abdominal pain associated with an altered bowel pattern.
   
3. Diagnostic evaluation depends on the clinical presentation of RAP and the presence of specific findings that suggest the possibility of an organic disorder.
   
4. The most common cause of all presentations of RAP in children is a functional bowel disorder.
   
5. A functional bowel disorder in children is a positive diagnosis.
   
6. Therapy of functional bowel abdominal pain is directed primarily toward environmental modification.
   

	Introduction

 
The definition of recurrent abdominal pain (RAP) derives from the seminal description by Apley of paroxysmal abdominal pain in children between the ages of 4 and 16 years that persists for more than 3 months and affects normal activity. RAP is not a diagnosis. It may be the predominant clinical manifestation of a large number of precisely defined organic disorders, but in the majority of cases, RAP is due to a functional bowel disorder. The modifier "functional" is used in gastroen-terology if no specific structural, infectious, inflammatory, or biochemical cause for the abdominal pain can be determined. It is the delicate interface between organic and functional forms of pediatric RAP that challenges the primary care pediatrician. Because the exact etiology and pathogenesis of the pain are unknown and because no specific diagnostic markers exist, a diagnosis of functional bowel disorder often is viewed as a diagnosis of exclusion. Yet, functional abdominal pain can and should be a diagnosis that meets specific criteria. The diagnosis is established by a constellation of criteria based on a careful history, physical examination, . . . [Full Text of this Article]

This article has been cited by other articles:

				H. M. Malaty, S. Abudayyeh, K. J. O'Malley, M. J. Wilsey, K. Fraley, M. A. Gilger, D. Hollier, D. Y. Graham, and L. Rabeneck Development of a Multidimensional Measure for Recurrent Abdominal Pain in Children: Population-Based Studies in Three Settings Pediatrics, February 1, 2005; 115(2): e210 - e215. [Abstract] [Full Text] [PDF]

				J. V. Campo, J. Bridge, M. Ehmann, S. Altman, A. Lucas, B. Birmaher, C. D. Lorenzo, S. Iyengar, and D. A. Brent Recurrent Abdominal Pain, Anxiety, and Depression in Primary Care Pediatrics, April 1, 2004; 113(4): 817 - 824. [Abstract] [Full Text] [PDF]

				E. Crushell, M. Rowland, M. Doherty, S. Gormally, S. Harty, B. Bourke, and B. Drumm Importance of Parental Conceptual Model of Illness in Severe Recurrent Abdominal Pain Pediatrics, December 1, 2003; 112(6): 1368 - 1372. [Abstract] [Full Text] [PDF]