Background Recurrent abdominal pain (RAP) in childhood is a common problem. The differential diagnosis is extensive, but rarely associated with organic disease. The Rome III paediatric criteria for functional gastrointestinal disorders (FGIDs) were developed as diagnostic tools on a symptom-based approach.
Objective Characterize the population of children referred to the Pediatric Gastroenterology consultation for RAP between 1996 and 2006.
Methods Retrospective analysis of patients’ medical records with review of clinical history, physical examination, diagnostic tests results, treatment and outcome. Patients with FGIDs were classified using the Rome III criteria.
Results Included 94 patients, 52% female, mean age 7.7 years. Clinically 23.4% had isolated abdominal pain, 41.5% had abdominal pain associated with an altered bowel pattern and 29.8% had dyspepsia and/or vomiting associated. The studies performed were: abdomen ultrasound (70.2%), blood chemistry (62.8%), parasites stool examination (43.6%), urinalysis (40.4%), immunological studies (17.0%), endoscopy (12.8%) and upper gastrointestinal series (5.3%). It was diagnosed an underlying organic disease in 8 patients (9.7%). Treatment was initiated in 45.7% of patients and included dietary measures, bowel softeners, analgesia, Helicobacter pylori eradication and psychotherapy. Patients were followed for a mean time of 11 months; 43.6% described symptomatic improvement, 33.0% resolution of symptoms, 7.4% showed no treatment response.
Conclusions RAP is usually due to functional disorders, even in a selected population of patients observed in a specialized consultation. The large number of diagnostic studies performed should (ideally) be reduced by using a symptom-based approach, however most times some normal basic evaluation is necessary to decrease families’ anxiety.