RECURRENT ABDOMINAL PAIN IN CHILDREN

1. RECURRENT ABDOMINAL PAIN IN CHILDREN DR. KANUPRIYA CHATURVEDI 1

2. 1.TERMINOLOGY AND DEFINITION 2.EPIDEMILOGY & ETIOLOGY PATHOPHYSIOLOGY 3.EVALUATION AND DIAGNOSIS 4.MANAGEMENT 5.PROGNOSIS 6. SUMMARY 2 OUTLINE OF PRESEN TATION

3. Chronic and recurrent abdominal pain are common symptoms in children and adolescents . Chronic abdominal pain can be organic or nonorganic, depending on whether a specific etiology is identified. Nonorganic abdominal pain or functional abdominal pain refers to pain without evidence of anatomic, inflammatory, metabolic, or neoplastic abnormalities. Overlap between chronic and recurrent abdominal pain exists, and the terms are sometimes used synonymously. TERMINOLOGY 3 SOURCE: J.APLEY

4. Chronic abdominal pain — Chronic abdominal pain is defined by pain of at least three months' duration, although some clinicians consider pain of more than one to two months' duration to be chronic . Recurrent abdominal pain — Recurrent abdominal pain is one of the most common recurrent pain syndromes in childhood. The classic definition is based upon four criteria : History of at least three episodes of pain Pain sufficiently severe to affect activities Episodes occur over a period of three months No known organic cause DEFINITION 4 Source:Hyams et.al 1996. Chronic abdominal pain can be organic or nonorganic, depending on whether a specific etiology is identified. Nonorganic abdominal pain or functional abdominal pain refers to pain without evidence of anatomic, inflammatory, metabolic, or neoplastic abnormalities. In the original case series, recurrent abdominal pain of childhood was considered to be the diagnosis . However, using the term as a description rather than a diagnosis probably is more accurate . Clinical and laboratory observations suggest that recurrent abdominal pain in childhood is not a single entity, but a symptom complex with organic and functional etiologies that can be exacerbated by psychologic disorders. Source :Di Lorenzo et al 2001; Dufton L, et al 2009 Chronic abdominal pain can be organic or nonorganic, depending on whether a specific etiology is identified. Nonorganic abdominal pain or functional abdominal pain refers to pain without evidence of anatomic, inflammatory, metabolic, or neoplastic abnormalities. In the original case series, recurrent abdominal pain of childhood was considered to be the diagnosis . However, using the term as a description rather than a diagnosis probably is more accurate . Clinical and laboratory observations suggest that recurrent abdominal pain in childhood is not a single entity, but a symptom complex with organic and functional etiologies that can be exacerbated by psychologic disorders. Source :Di Lorenzo et al 2001; Dufton L, et al 2009

5. Chronic abdominal pain Long-lasting intermittent or constant abdominal pain that is functional or organic (disease based) Functional abdominal pain Abdominal pain without demonstrable evidence of pathologic condition, such as anatomic metabolic, infectious, inflammatory or neoplastic disorder. Functional abdominal pain can manifest with symptoms typical of functional dyspepsia, irritable bowel syndrome, abdominal migraine or functional abdominal pain syndrome. Functional dyspepsia Functional abdominal pain or discomfort in the upper abdomen Recommended Clinical Definitions 5

6. Irritable bowel syndrome Functional abdominal pain associated with alteration in bowel movements Abdominal migraine Functional abdominal pain with features of migraine (paroxysmal abdominal pain associated with anorexia, nausea, vomiting or pallor as well as maternal history of migraine headaches) Functional abdominal pain syndrome Functional abdominal pain without the characteristics of dyspepsia, irritable bowel syndrome, or abdominal migraine. Contd. 6