Recurrent abdominal pain in children - A retrospective study of outcome ina group referred to a pediatric gastroenterology practice

Recurrent abdominal pain (RAP) affects a significant number of children eac h year. We reviewed our experience over a 2-year period to determine the ou tcome of patients who were referred for pediatric gastroenterology consulta tion. We identified 356 patients, 149 (42%) male and 207 (58%) female. All patients underwent a thorough interview and complete physical examination. Patients suspected of having irritable bowel syndrome (IBS) were treated as such without further initial evaluation. Others underwent an initial blood and urine evaluation. When these initial screening studies were negative, additional studies were performed including abdominal ultrasonography, radi ography, and/or endoscopy of the upper gastrointestinal (GT) tract if the h istory suggested a possible diagnosis that could be excluded or confirmed b y such tests. There was no identifiable diagnosis in 43.5% of the patients studied. IBS was diagnosed in 25.8% of all patients, Constipation was diagn osed in 3.7%. Miscellaneous causes, including GI mucosal lesions, and renal and pancreatic disorders were found in an additional 27% of patients. In a follow-up survey, more than 70% of the treated respondents were improved ( i.e,, their RAP had resolved or was markedly improved). We conclude that mo st children with RAP have a functional disorder. Patients with an organic c ause for pain can he identified and treated in a cost-effective manner with carefully planned evaluation.