CHARACTERIZATION OF SYMPTOMS IN CHILDREN WITH RECURRENT ABDOMINAL-PAIN - RESEMBLANCE TO IRRITABLE-BOWEL-SYNDROME

We sought to prospectively characterize and compare the symptoms of ch ildren greater than or equal to 5 years of age with recurrent abdomina l pain to previously established criteria for irritable bowel syndrome (IBS) in adults. For all eligible subjects, a detailed questionnaire concerning characteristics of abdominal pain and defecatory pattern wa s completed at presentation. In addition, a battery of screening tests was performed and additional evaluation was done at the discretion of their physician. In all, 227 subjects fulfilled the entrance criteria , but 56 were subsequently excluded because of diagnoses of inflammato ry bowel disease (nine cases), lactase malabsorption (46 cases), or ce liac disease (one case). Of the remaining 171 patients, 117 had IBS sy mptoms. In the IBS subjects, lower abdominal discomfort (p < 0.001), c ramping pain (p < 0.0009), and increased flatus (p < 0.0003) were more common, whereas dyspeptic symptoms such as epigastric discomfort (p < 0.003), pain radiating to the chest (p < 0.009), and regurgitation (p < 0.02) were more common in the non-IBS subjects. Our study not only confirms the clinical heterogeneity of children with recurrent abdomin al pain but also concomitantly demonstrates that most children with th is disorder have symptoms that fulfill the standardized criteria for I BS in adults. The identification of subgroups of children with recurre nt abdominal pain can provide a framework far the diagnosis of functio nal bowel disease as well as establish the need for invasive and expen sive tests.