New approach to chronic recurrent abdominal pain in children

소아 만성 복통의 새로운 임상적 접근

  • Yang, Hye Ran (Department of Pediatrics, Seoul National University College of Medicine)
  • 양혜란 (서울대학교 의과대학 소아과학교실)
  • Received : 2005.12.22
  • Accepted : 2005.12.26
  • Published : 2006.02.15

Abstract

Chronic recurrent abdominal pain is a common manifestation in children. Functional abdominal pain is the most common cause of chronic abdominal pain and can be diagnosed properly by the physician without the requirement of specific evaluation when there are no alarm symptoms or signs. Functional abdominal pain is categorized as functional dyspepsia, irritable bowel syndrome, functional abdominal pain, abdominal migraine, and aerophagia, according to the Rome II criteria for pediatric functional gastrointestinal disorders. New concepts on the pathogenesis of functional abdominal pain include brain-gut interaction, visceral hypersensitivity, gastrointestinal dysmotility, inflammation, autonomic dysfunction, genetic predisposition, and triggering factors including psycho-social stress.

Keywords

References

  1. Apley J, Naish N. Recurrent abdominal pains : a field survey of 100 school children. Arch Dis Child 1958;50:429-36
  2. Faull C, Nicol AR. Abdominal pains in six-year olds : an epidemiological study in a new town. J Child Psychol Psychiatry 1986;27:251-60 https://doi.org/10.1111/j.1469-7610.1986.tb02287.x
  3. Hyams JS, Burke G, Davis PM, Rzepski B, Andrulonis PA. Abdominal pain and irritable bowel syndrome in adolescents : a community-based study. J Pediatr 1996;129:220-6 https://doi.org/10.1016/S0022-3476(96)70246-9
  4. Di Lorenzo C, Colletti RB, Lehmann HP, Boyle JT, Gerson WT, Hyams JS, et al. Chronic abdominal pain in children : a technical report of the American Academy of Pediatrics and the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition. J Pediatr Gastroenterol Nutr 2005;40:249-61 https://doi.org/10.1097/01.MPG.0000154661.39488.AC
  5. Rasquin-Weber A, Hyman PE, Cucchiara S, Fleisher DR, Hyams JS, Milla PJ, et al. Childhood functional gastrointestinal disorders. Gut 1999;45 Suppl 2:1160-8
  6. Kokkonen J, Haapalahti M, Tikkanen S, Karttunen R, Savilahti E. Gastrointestinal complaints and diagnosis in children : a population-based study. Acta Paediatr 2004;93:880- 6 https://doi.org/10.1080/08035250410024907
  7. Chitkara DK Rawat DJ, Talley NJ. The epidemiology of childhood recurrent abdominal pain in Western countries : a systematic review. Am J Gastroenterol 2005:100;1868-75 https://doi.org/10.1111/j.1572-0241.2005.41893.x
  8. Boyle JT. Abdominal pain. In : Walker WA, et al, editors. Pediatric Gastrointestinal disease. 4th ed. Ontario : BC Decker Inc., 2004:232-43
  9. Kohli R, Li BU. Differential diagnosis of recurrent abdominal pain: new considerations. Pediatr Ann 2004;33:113-22 https://doi.org/10.3928/0090-4481-20040201-10
  10. Drossman DA. The functional gastrointestinal disorders and the Rome II process. Gut 1999;45 Suppl 2:II1-5 https://doi.org/10.1136/gut.45.2008.ii1
  11. Walker LS, Lipani TA, Greene JW, Caines K, Stutts, Polk DB, et al. Recurrent abdominal pain : symptom subtupes based on the Rome II criteria for pediatric functional gastrointestinal disorders. J Pediatr Gastroenterol Nutr 2004;38: 187-91 https://doi.org/10.1097/00005176-200402000-00016
  12. Caplan A, Walker L, Rasquin A. Validation of the pediatric Rome II criteria for functional gastrointestinal disorders using the questionnaire on pediatric gastrointestinal symptoms. J Pediatr Gastroenterol Nutr 2005;41:305-16 https://doi.org/10.1097/01.mpg.0000172749.71726.13
  13. Hasler WL. Nausea, gastroparesis, and aerophagia. J Clin Gastroenterol 2005;39:S223-9 https://doi.org/10.1097/01.mcg.0000156111.69232.f2
  14. Di Lorenzo C, Colletti RB, Lehmann HP, Boyle JT, Gerson WT, Hyams JS, 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 : American Academy of Pediatrics Subcommittee on Chronic Abdominal Pain and NASPGHAN Committee on Abdominal Pain. J Pediatr Gastroenterol Nutr 2005;40:245-48 https://doi.org/10.1097/01.MPG.0000155367.44628.21
  15. Drossman D, Richter JE, Talley N. The functional gastrointestinal disorders : diagnosis, pathophysiology, and treatment : a multinational consensus. McLean : Degnon Associates; 2000
  16. Sperber AD, Drossman DA. Chronic functional abdominal pain. Curr Treat Options Gastroenterol 2000;3:315-28 https://doi.org/10.1007/s11938-000-0045-4
  17. Boey CC, Goh KL. Psychosocial factors and childhood recurrent abdominal pain. J Gastroenterol Hepatol 2002;17: 1250-3 https://doi.org/10.1046/j.1440-1746.2002.02884.x
  18. Gwee KA, Leong YL, Graham C, McKendrick MW, Collins SM, Walters SJ, et al. The role of psychological and biological factors in postinfective gut dysfunction. Gut 1999; 44:400-6 https://doi.org/10.1136/gut.44.3.400
  19. Di Lorenzo C, Youssef NN, Sigurdsson L, Scharff L, Griffiths J, Wald A. Visceral hyperalgesia in children with functional abdominal pain. J Pediatr 2001;139:838-43 https://doi.org/10.1067/mpd.2001.118883
  20. Van Ginkel R, Voskuijl WP, Benninga MA, Taminiau JA, Boeckxstaens GF. Alterations in rectal sensitivity and motility in childhood irritable bowel syndrome. Gastroenterology 2001;120:31-8 https://doi.org/10.1053/gast.2001.20898
  21. Dimson SB. Transit time related to clinical findings in children with recurrent abdominal pain. Pediatrics 1972;47:666- 74
  22. Kopel FB, Kim IC, Barbero GJ. Comparison of rectosigmoid motility in normal children, children with RAP, and children with ulcerative colitis. Pediatrics 1967;39:539-44
  23. Pineiro-Carrero VM, Andres JM, Davis RH, Mathias JR. Abnormal gastroduodenal motility in children and adolescents with recurrent functional abdominal pain. J Pediatr 1988;113:820-5 https://doi.org/10.1016/S0022-3476(88)80007-6
  24. Dunlop SP, Jenkins D, Spiller RC. Distinctive clinical, psychological, and histological features of postinfective irritable bowel syndrome. Am J Gastroenterol 2003;98:1578-83 https://doi.org/10.1111/j.1572-0241.2003.07542.x
  25. Chelimsky G, Boyle JT, Tusing L, Chelimsky TC. Autonomic abnormalities in children with functional abdominal pain : coincidence or etiology? J Pediatr Gastroenterol Nutr 2001;33:47-53 https://doi.org/10.1097/00005176-200107000-00008
  26. Walker LS, Garber J, Van Slyke DA, Greene JW. Longterm health outcomes in patients with recurrent abdominal pain. J Pediatr Psychol 1995;20:233-45 https://doi.org/10.1093/jpepsy/20.2.233
  27. Magni G, Pierri M, Donzelli F. Recurrent abdominal pain in children : a long term follow-up. Eur J Pediatr 1987;146:72- 4 https://doi.org/10.1007/BF00647291
  28. Campo JV, Di Lorenzo C, Chiappetta L, Bridge J, Colbom DK, Gartner JC Jr, et al. Adult outcomes of pediatric recurrent abdominal pain : do they just grow out of it- Pediatrics 2001;108:E1 https://doi.org/10.1542/peds.108.1.e1
  29. Apley J, Hale B. Children with recurrent abdominal pain : how do they grow up? BMJ 1973;3:7-9 https://doi.org/10.1136/bmj.3.5870.7