Recurrent Abdominal Pain

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Recurrent abdominal pain is a common paediatric problem affecting 10-20% of school children. In children less than 2 years the pain is often associated with an organic cause. However in older children only 10% of cases have an organic cause. The symptom is frightening to the average parent and causes great discomfort to the child leading to absence from school and lack of involvement in play.

The physician must approach the diagnosis of chronic abdominal pain with confidence and never doubt that the child is in actual pain. He must build a trusting relationship with the parent and child.

A detailed comprehensive history may provide clues to the etiology. (Identification of a relationship between the pain and meals or bowel movement may provide a clue to the diagnosis of peptic diseases constipation or irritable bowel syndrome). IBS is familial and is characterized by abdominal pain and intermittent constipation and diarrhoea without an organic cause. Recurrent abdominal pain unassociated with other significant symptoms is usually functional.

A meticulous physical examination including growth parameters is important not only for detection of abnormal findings but also for reassurance. It coveys the physician interest in the patient and his complaints.

Etiology
The common causes of recurrent abdominal pain in children are (in order of frequency):


1. Functional
2. Lactose intolerance
3. Constipation
4. Musculoskeletal pain
5. Parasitic infection
6. Gastritis/reflux oesophagitis
7. Peptic ulcer disease
8. Inflammatory bowel disease
9. Pancreatitis and hepatobiliary disease
10. Urinary tract infection
11. Migraine

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r4988 

Dear Sir, I am suffering from stomach pain since september 2009 and i have taken a lots of medicine from locality doctors but I am still suffering from my pain. help me and suggest any type of medicine which is better for my stomach pain. Regards R.K. Sharma

Kash01 

very informative article. my child of age 6 is suffering from abdominal pain from last 1 week but no clue. We have made several trips to doctor but the doctor did not suggest all of the above diagnosis. Urine test and ultrasound were given. Still no clue why this is reoccurring with my child. When she complaints abdominal pain, it usually lasts for few hours. After a vomit, she is usually fine. This is still continuing......

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