Mahmood Iqbal, Bashir Ahmed Malik, Aqeel Safdar.
Recurrent abdominal pain in children.
J Coll Physicians Surg Pak Jan ;14(4):254-5.
This study was conducted at Combined Military Hospital, Lahore, Kharian and Quetta. Children aged 5 to 12 years suffering from RAP of more than three months duration were enrolled after parental consent. They were administered a structured questionnaire, deciphering demographic data, details of abdominal pain, family and school environment. After the detailed history and physical examination, the following tests were carried out: complete blood count, urinalysis, stool analysis (3 times) serum ALT, urea and abdominal ultrasound. Special investigations including upper GI endoscopy were also carried out where indicated. RESULTS: Sixty-five patients were enrolled in the study. Of these 29 (44.6%) satisfied the inclusion criteria and were found to be suffering from organic RAP. The remaining 36 patients had non-organic RAP. Of the 29 patients with organic RAP, chronic constipation was identified in 44.8% (n=13), followed by Helicobacter gastritis (20.6%)(n=6), giardiasis (10.3%)(n=3), urinary tract infection(6.8%)(n=2) and one had urolithiasis. Three patients had excessive intake of carbohydrates (sweets, candies, carbonated beverages and juices etc.) and one had abdominal migraine. Most of the patients with non-organic RAP had psychological or emotional problems i.e. difficulty with peer group, tension at home and school, maladjustment and overprotection by parents. However, there was not much difference in school performance between the two groups (p=>0.05). Interference of sleep was more common in organic RAP group (p=<0.05). A large number of children presenting with RAP have no obvious cause ie 55.4%.
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