Clinical and laboratory findings in 220 children with recurrent abdominal pain

• Published in: Acta Paediatrica Vol. 100; no. 7; pp. 1028 - 1032
• Main Authors: Gijsbers, CFM, Benninga, MA, Büller, HA
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.07.2011; Blackwell; Wiley Subscription Services, Inc
• Subjects: Abdomen; Abdominal pain; Abdominal Pain - etiology; Abdominal Pain - microbiology; Abdominal Pain - parasitology; Adolescent; Bacterial diseases; Bacterial diseases of the digestive system and abdomen; Biological and medical sciences; Case-Control Studies; Child; Child, Preschool; Constipation - complications; Dientamoeba - classification; Dientamoeba - isolation & purification; Dientamoebiasis - complications; Endoscopy, Gastrointestinal; Female; General aspects; Helicobacter Infections - complications; Helicobacter pylori; Helicobacter pylori - isolation & purification; Human bacterial diseases; Humans; Infantile colic; Infectious diseases; Male; Medical sciences; Medical treatment; Pain; Parasites; Parasitic diseases; Prospective Studies; Radiography, Abdominal; Recurrence; Referral and Consultation; Yersinia enterocolitica - isolation & purification; Yersinia Infections - complications; Human; Infantile colic; Pediatrics; Relapse; Spirillales; Digestive system; Gut; Spirillaceae; Parasite; Infant; Parasitosis; Recurrent; Parasites; Abdomen; Infection; Symptomatology; Pain; Helicobacter pylori; Clinical biology; Bacteriosis; Abdominal pain; Bacteria; Colon; Child
• ISSN: 0803-5253; 1651-2227
• DOI: 10.1111/j.1651-2227.2011.02179.x

Aim:  To investigate the clinical and laboratory findings in children with recurrent abdominal pain (RAP). Methods:  Consecutive patients with RAP (Apley criteria), age 4–16 years, referred to a secondary medical centre were evaluated by a standardized history, physical examination and laboratory tests. The tests encompassed Helicobacter pylori (Hp), gastrointestinal bacterial infections, protozoa, coeliac disease, carbohydrate malabsorption, food intolerance, abdominal ultrasound and plain abdominal X‐ray. More investigations were obtained if indicated. Patient characteristics were compared with surgical patients without abdominal pain (control group). Results:  A total of 220 consecutive patients were included (92 M, mean age 8.8 years [4.1–16.0 years]). In 88% of the patients, abnormalities were found that refer to possible causes. Especially, protozoa were present in 33% of the patients, mostly Dientamoeba fragilis, Yersinia enterocolitica in 12% and endoscopically proven infection with Hp in 11%. In 36%, a plain abdominal X‐ray raised suspicion of constipation. Conclusion:  In 220 consecutive patients with RAP, referred to secondary care, a standardized work‐up yielded abnormal results in a high percentage. The clinical significance of these findings remains to be established.