[Chronic abdominal pain in children]

Abstract

Recurrent abdominal pain has been reported to occur in 10 to 15% of children between the ages of 5 and 15 years, and is considered to be one of the most encountered symptoms in childhood. It is important to avoid a shotgun approach to rule out all potential infectious, inflammatory, structural, and biochemical causes, that leads to an excess of diagnostic tests, as well as to avoid considering every abdominal pain as functional, which leads to a risk of misdiagnosing the rare organic causes of chronic abdominal pain. Careful history and clinical examination, completed if necessary by minimal laboratory investigation, allow either finding clues to the diagnosis of organic causes [represented most often by gastrointestinal diseases (constipation, gastroesophageal reflux) or nephro-urologic diseases] or suggesting that chronic abdominal pain may be of functional origin. Distinguishing between psychosomatic and functional chronic abdominal pain can be sometimes difficult.