Recurrent Abdominal Pain in Children: Etiological Spectrum and Utility of Baseline Investigations – A Prospective Study in a Tertiary Care Hospital.
Keywords:
Recurrent abdominal pain, functional abdominal pain, irritable bowel syndrome, organic causes..Abstract
Background: Recurrent abdominal pain (RAP) is a common complaint in children. This study was conducted to determine the etiological spectrum and evaluate the utility of baseline investigations in children with RAP. Methods: This prospective observational study was carried out in the Department of Pediatrics of a tertiary care hospital from 1 May 2016 to 31 July 2016. A total of 124 children aged 5–15 years satisfying the modified Apley’s criteria were enrolled. Detailed history, clinical examination, and baseline investigations (complete blood count, ESR, urine routine and microscopy, stool examination for ova/cysts, and abdominal ultrasonography) were performed in all cases. Rome III criteria were used to classify functional gastrointestinal disorders. Results: Organic causes were identified in 38 children (30.6%), while 86 children (69.4%) had functional abdominal pain disorders. The common organic etiologies were urinary tract infection (9.7%), mesenteric lymphadenitis (7.3%), chronic constipation (6.5%), and renal calculi/hydronephrosis (4.0%). Parasitic infestation was seen in only 3.2% of cases. Baseline investigations (particularly urine analysis and ultrasonography) detected 89.5% of organic cases. Conclusion: Functional abdominal pain disorders constitute the majority of RAP cases in children. Simple baseline investigations have high diagnostic yield and should be used as the initial work-up in tertiary care settings. This approach helps in identifying treatable organic causes while avoiding unnecessary invasive tests....
Downloads
References
Quak SH. Recurrent abdominal pain in children: a clinical approach. Singapore Med J. 2015;56(3):125-128.
2. Plunkett A, Beattie RM. Recurrent abdominal pain in childhood. J R Soc Med. 2005;98(3):101-106.
3. Apley J, Naish N. Recurrent abdominal pains: a field survey of 1,000 school children. Arch Dis Child. 1958;33(168):165-170.
4. Di Lorenzo C, et al. Chronic abdominal pain in children: a clinical report of the American Academy of Pediatrics and the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition. J Pediatr Gastroenterol Nutr. 2005;40(3):245-248.
5. Reddy M, Kamale V, Sharma P, Shamim A, Thamke R, Mohanty N. Etiological Spectrum and Base-line Investigations in Recurrent Pain Abdomen Among Children.
6. Devanarayana NM, Rajindrajith S, De Silva HJ. Recurrent abdominal pain in children. Indian Pediatr. 2009;46(5):389-399.
7. Alfvén G. One hundred cases of recurrent abdominal pain in children: diagnostic procedures and criteria for a psychosomatic diagnosis. Acta Paediatr. 2003;92(1):43-9. doi: 10.1111/j.1651-2227.2003.tb00467.x. Erratum in: Acta Paediatr. 2003 May;92(5):641. PMID: 12650298.
8. Bufler P, Gross M, Uhlig HH. Recurrent abdominal pain in childhood. Dtsch Arztebl Int. 2011 Apr;108(17):295-304. doi: 10.3238/arztebl.2011.0295. Epub 2011 Apr 29. PMID: 21629513; PMCID: PMC3103980.
9. Kulshreshtha R, George V. Pain in abdomen: a clinical study. Indian Pediatr. 1976;13:1855.
10. Gupta S, Agarwal HC, Bhardwaj OP, Gupta JP. Recurrent abdominal pain in children. Indian Pediatr. 1974;11:115.
11. Galler JR, Neustein S, Walker WA. Clinical aspects of recurrent abdominal pain in children. Adv Pediatr. 1980;27:31-53.
12. Gadiyar BN, Taneja PN, Ghai OP. Recurrent pain in abdomen in children. Indian J Child Health. 1963;12:289-295.
13. American Academy of Pediatrics Subcommittee on Chronic Abdominal Pain. Chronic abdominal pain in children. Pediatrics. 2005;115:812-815.
14. Celia VH, Asaolu SG, Crompton DWF. The epidemiology of Ascaris lumbricoides and other soil-transmitted helminths in primary school children from Ile-Ife, Nigeria. Parasitology. 1989;99:275-285.
15. Saxena SN, Varghese A, Ghosh Ray B. A comparison of salt-floatation and formol-ether techniques in demonstrating helminthic ova in faeces. Indian J Med Res. 1969;57(7):1213-1219.
16. Chawla S, Gadekar NG, Ghai OP, Walia BN. Barium meal analysis of 202 children. J Assoc Physicians India. 1964;12:29-36.
17. Reddy YR, Reddy D. Recurrent abdominal pain. Indian Pediatr. 1969;6(5):272-277.
18. Pushpa V, Venkatappa Rao A, Krishnamurthy KA. Psychogenic abdominal pain in childhood. Indian Pediatr. 1969;26:277.
19. Manchanda SS, Paul R, Lal H. Recurrent abdominal pain. Indian Pediatr. 1970;7(11):612-618.
20. Das PM, Sulochana L. Pain in abdomen in children: a study of 200 cases. Indian Pediatr. 1977;14(11):891-893.
21. Mackeith R, O’Neil D. Recurrent abdominal pain in children. Lancet. 1951;2(6677):278-282.
22. Wood JL, Hardy LM, White H. Chronic vague abdominal pain in children. Pediatr Clin North Am. 1955;2:465-481.
23. Aziz Q, Thompson DG. Brain-gut axis in health and disease. Gastroenterology. 1998;114:559-578.
.
Downloads
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution 4.0 International License.
You are free to:
- Share — copy and redistribute the material in any medium or format
- Adapt — remix, transform, and build upon the material for any purpose, even commercially.
Terms:
- Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
