Recurrent Abdominal Pain In Children Research Articles

Helicobacter pylori, gastroduodenal disease, and recurrent abdominal pain in children

Helicobacter pylori, gastroduodenal disease, and recurrent abdominal pain in children

Helicobacter pylori, hypergastrinaemia, and recurrent abdominal pain in children

The association between Helicobacter pylori and recurrent abdominal pain (RAP) is controversial. In this cross-sectional study, the authors aim to determine whether hypergastrinaemia causes RAP in children with H pylori gastritis. In 439 children age 4 to 13 years (mean 7.3 years) attending for nongastrointestinal day-case surgery, anti-Helicobacter immunoglobulin G (IgG) was identified in serum by an enzyme-linked immunosorbent assay (ELISA) method validated in children and fasting plasma gastrin was measured. A history of RAP was sought. One hundred twenty-seven children (29%) tested seropositive for H pylori. Fiftyone seronegative children (16.3%) and 22 seropositive children (17.3%) gave a history of RAP. The mean fasting gastrin in seronegative children was 52 ng/L compared with 117 ng/L in seropositive children ( P < .001). The mean fasting gastrin in seropositive children with RAP (124 ng/L) was not significantly different from that of seropositive children without RAP (115 ng/L). The high prevalence of H pylori seropositivity in this study is at variance with other reported paediatric data from the developed world. No association between childhood H pylori gastritis, hypergastrinaemia, and RAP was found. In children with H pylori gastritis, the increase in circulating gastrin (mean 140% increase) is greater than that seen in adults (50% increase).

Recurrent abdominal pain in childhood

Acta PaediatricaVolume 83, Issue 7 p. 775-776 Recurrent abdominal pain in childhood Tor Lindberg, Corresponding Author Tor Lindberg Department of Pediatrics. University of Umeå. Umeå, SwedenT Lindberg, Department of Pediatrics, University of Urned, S-90185 Umeå, SwedenSearch for more papers by this author Tor Lindberg, Corresponding Author Tor Lindberg Department of Pediatrics. University of Umeå. Umeå, SwedenT Lindberg, Department of Pediatrics, University of Urned, S-90185 Umeå, SwedenSearch for more papers by this author First published: July 1994 https://doi.org/10.1111/j.1651-2227.1994.tb13137.xCitations: 9AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article.Citing Literature Volume83, Issue7July 1994Pages 775-776 RelatedInformation

Non organic recurrent abdominal pain — A practical and integrated approach to the assessment and management of recurrent abdominal pain in children

Recurrent abdominal pain (RAP) is a common childhood complaint which may provoke a ‘heart sink’ reaction for the paediatrician or general practitioner. It tests the clinician’s diagnostic skill and self confidence since the differential diagnosis is broad, investigations are usually unhelpful and treatment is thought to be difficult. The management of children and their families in cases of non organic RAP needs confidence in seeking and treating pathology in the child’s emotional and personal functioning. An organic cause underlying RAP is only revealed in a small proportion of cases probably less than 5%.’

Motilin in children with recurrent abdominal pain: a controlled study.

The aim of this study was to compare serum motilin levels in children with and without recurrent abdominal pain, based on the assumption that recurrent abdominal pain in children is a gut motility disorder. In this controlled study, 19 children between 6 and 15 years of age with recurrent non-organic abdominal pain and 20 control children between 6 and 15 years of age without abdominal pain or other functional somatic complaints were evaluated. No statistical significant difference was found in serum motilin levels between children with and without abdominal pain. Median difference between the groups was 11 pmol/l (95% confidence limits of median difference -9 to +33). This investigation could not support the assumption that motilin might be a pathogenic factor in children with recurrent abdominal pain. It is suggested, however, that future research should compare serum motilin levels during and between attacks of pain.

The treatment of recurrent abdominal pain in children: A controlled comparison of cognitive-behavioral family intervention and standard pediatric care.

The treatment of recurrent abdominal pain in children: A controlled comparison of cognitive-behavioral family intervention and standard pediatric care.

Recurrent abdominal pain in children in developing countries frequently has an organic basis : H. Wardhan, P. Ojha, and R. Kulshrestha. Pediatr Surg Int 8:20–22, (January), 1993

Recurrent abdominal pain in children in developing countries frequently has an organic basis : H. Wardhan, P. Ojha, and R. Kulshrestha. Pediatr Surg Int 8:20–22, (January), 1993

Upper Gastrointestinal Endoscopy in Recurrent Abdominal Pain of Childhood

SummaryOver a 2.5‐year period, 82 consecutive children complaining of recurrent abdominal pain underwent upper gastrointestinal endoscopy. Gastroscopy confirmed pathology in 48 of the children (58.5%). Four of the children, who also had undergone gastroscopy, had other diagnoses (lactose malabsorption, hydronephrosis, yersinosis), and 30 of the children (36.6%) retained the initial diagnosis of recurrent abdominal pain syndrome. Gastritis was found in 48 of the children, 18 of whom (37.5%) had positive test results for Helicobacter pylori, based on histology and/or culture. Of 16 H. pylori‐positive children tested, 12 (75%) also had an elevated concentration of IgG‐class antibodies to H. pylori in their sera. Three of the children had duodenal ulcer disease, all of whom were H. pylori positive. Esophagitis was found in eight of the children with gastritis, all of whom were found to have gastroesophageal reflux. Our data suggest that among the children with recurrent abdominal pain syndrome, organic pathology is more common than was previously thought. Altogether 22% of the children with recurrent abdominal pain syndrome were infected with H. pylori.

Upper Gastrointestinal Endoscopy in Recurrent Abdominal Pain of Childhood

Over a 2.5-year period, 82 consecutive children complaining of recurrent abdominal pain underwent upper gastrointestinal endoscopy. Gastroscopy confirmed pathology in 48 of the children (58.5%). Four of the children, who also had undergone gastroscopy, had other diagnoses (lactose malabsorption, hydronephrosis, yersiniosis), and 30 of the children (36.6%) retained the initial diagnosis of recurrent abdominal pain syndrome. Gastritis was found in 48 of the children, 18 of whom (37.5%) had positive test results for Helicobacter pylori, based on histology and/or culture. Of 16 H. pylori-positive children tested, 12 (75%) also had an elevated concentration of IgG-class antibodies to H. pylori in their sera. Three of the children had duodenal ulcer disease, all of whom were H. pylori positive. Esophagitis was found in eight of the children with gastritis, all of whom were found to have gastroesophageal reflux. Our data suggest that among the children with recurrent abdominal pain syndrome, organic pathology is more common than was previously thought. Altogether 22% of the children with recurrent abdominal pain syndrome were infected with H. pylori.

Preliminary findings on increased muscle tension and tenderness, and recurrent abdominal pain in children. A clinical study.

Recurrent abdominal pain of "non-organic origin" is a common pediatric problem. In most instances it is related to psychological factors. The origin of the pain itself, however, is still unknown. In this study, we question whether or not the complaint could have a muscular origin. In this clinical study of recurrent abdominal pain of probable "psychosomatic origin", all 27 children had tense and tender abdominal muscles, which was not the case in a control group. The children with recurrent abdominal pain also had a typical pattern of muscular tension and tenderness in other muscles. These children often have tension headache, "tension" chest pains and also more general symptoms such as loss of appetite and disturbed bowel function.

Recurrent abdominal pain in children in developing countries frequently has an organic basis

A total of 1,602 children with recurrent abdominal pain (RAP) were admitted to the Department of Paediatric Surgery at Safdarjang Hospital, New Delhi, India during the period August 1974 – December 1990. The children included in the study had had three or more episodes of pain persisting for more than 3 weeks. Major causes were worm infestation, abdominal tuberculosis, giardiasis, amoebic colitis, and urinary tract lesions (67.1%). Organic lesions were identified in 89.5% of patients, and only in 18 cases was RAP attributed to psychogenic factors.

Gastroesophageal reflux in children with recurrent abdominal pain.

In this study we investigated the presence of gastroesophageal reflux in children with recurrent abdominal pain and its possible relationship to food intolerance-associated duodenal inflammation. Twenty-four-hour intra-esophageal pH monitoring, an endoscopic duodenal biopsy and a small bowel 51Cr-EDTA permeability test were performed in 25 children with recurrent abdominal pain. In 14 cases (56%) the pH monitoring was abnormal, pointing to the presence of pathological gastroesophageal reflux. Treatment of gastroesophageal reflux in the latter patients resulted in resolution or improvement of abdominal pain in 10 cases (71%). Gastroesophageal reflux did not appear to be associated with either intestinal permeability to 51Cr-EDTA or duodenal biopsy findings. We conclude that pathological gastroesophageal reflex is a frequent finding in children with recurrent abdominal pain, that it is unrelated to duodenal inflammation and that there might be a causal relationship between pathological gastroesophageal reflux and recurrent abdominal pain in children.

Recurrent Abdominal Pain in Children with Lymphoid Hyperplasia of the Appendix

Recurrent Abdominal Pain in Children with Lymphoid Hyperplasia of the Appendix

Matching treatment with recurrent abdominal pain symptoms: An evaluation of dietary fiber and relaxation treatments

We evaluated whether symptoms of recurrent abdominal pain in children provide a basis for treatment selection. Subjects were assigned to dietary fiber or relaxation treatments based upon whether they presented with symptoms of constipation. Elven subjects were treated in a combined multiple baseline and A-B or A-B-C design. As a control, some subjects recived the alternative treatment first. All four subjects with symptoms of constipation showed reductions in the number of stomachaches during the dietary fiber treatment. Of the seven subjects without symptoms of constipation, one showed reductions in stomachaches during the relaxation treatment, three showed some minimal reduction that was difficult to attribute to the relaxation treatment, two responded to the dietary fiber treatment, and one spontaneously improved during baseline. Results support the effectiveness of a dietary fiber treatment for children with symptoms of constipation. Minimal support was obtained for the effectiveness of a relaxation treatment for children without symptoms of constipation. Implications, limitations, and directions for future research are discussed.

Diagnostic value of ultrasound in children with recurrent abdominal pain

In order to investigate the diagnostic value of ultrasound in children with recurrent abdominal pain and to estimate the clinical relevance of rare organic causes of abdominal pain in these patients, we prospectively examined 93 children aged between 5.5 and 12 years by means of abdominal ultrasound. In 3 patients (3.2%) an anatomic abnormality was detected, which could not account for the abdominal pain. We conclude that many organic abnormalities, that could be diagnosed by ultrasound, are clinically irrelevant as a cause of recurrent abdominal pain in children and therefore ultrasound does not significantly contribute to the diagnosis. However, ultrasound can still play a role in the work-up of children with recurrent abdominal pain in avoiding unnecessary radiologic X-ray procedures.

Ultrasonographic Studies in the Management of Recurrent Abdominal Pain

The medical records of 65 children and adolescents who had abdominal ultrasonography for the evaluation of recurrent abdominal pain were reviewed. Fifty-three subjects (81%) had normal results; in 12 cases (19%) an abnormality was detected. In no case could the pain be attributed to the abnormal finding. Furthermore, in 3 subjects, disclosure of the abnormal findings could have caused more harm than good. The role of the abdominal ultrasonographic study in the management of recurrent abdominal pain in children and adolescents is discussed.

Recurrent Abdominal Pain in Children: Psychiatric Diagnoses and Parental Psychopathology

Approximately 12% of children report recurrent episodes of abdominal pain. In only about 10% of these cases, however, can an organic etiology be identified, and therefore it often is assumed that these children have emotional problems. To test this hypothesis, children with recurrent abdominal pain (RAP) with no identifiable organic cause were compared to children with an organic diagnosis for their abdominal pain, children with psychiatric disorders, and healthy controls. Both groups of children with abdominal pain had significantly more psychiatric disorders (predominantly anxiety and depression) than did the healthy group. Both RAP and psychiatric children had significantly higher Child Behavior Checklist internalizing scores; psychiatric children were rated as significantly more maladjusted on the Children's Global Assessment Scale. Mothers of RAP children were significantly more anxious than mothers of organic pain and healthy children. Psychiatric children were significantly more likely than the other three groups to underreport their psychiatric symptoms relative to their mothers.

Pelviureteric junction obstruction and recurrent abdominal pain in childhood : H.C. Ward, and R.J. Brereton. Br J Surg 76:818–819, (August), 1989

Pelviureteric junction obstruction and recurrent abdominal pain in childhood : H.C. Ward, and R.J. Brereton. Br J Surg 76:818–819, (August), 1989

Behavioural Treatment of Childhood Recurrent Abdominal Pain: Relationships Between Pain, Children's Psychological Characteristics and Family Functioning

This study examined the impact and side effects of a cognitive behavioural program for the treatment of recurrent abdominal pain (R.A.P.) on children's behavioural adjustment and family functioning. It assessed the extent to which changes in children's pain symptoms covaried with family processes thought to be etiologically significant in cases of R.A.P. Results showed that pain symptoms of both experimental and control children improved significantly six months after initial assessment. Treatment achieved its objectives more quickly with a higher proportion of completely pain-free children. None of the measures of child adjustment or family conflict, expressiveness, independence or achievement orientation were associated with changes in pain intensity ratings or parent observational measures of pain behaviour. There was no evidence that treatment was associated with any negative side effects.

Understanding Recurrent Abdominal Pain of Childhood

Recurrent abdominal pain is a distressing childhood phenomenon. It is a benign pain syndrome, with no definitive cause, affecting more than 10% of all school-aged children. It is important for gastrointestinal nurses to recognize the symptoms of recurrent abdominal pain and provide individualized management for the child and family.