
doi: 10.2223/jped.150
pmid: 14676920
OBJECTIVE: To present current concepts about the diagnosis of recurrent abdominal pain and to review the basis of the therapeutic approach for this disease in children and adolescents. METHODS: References were obtained from the Medline, from recent review articles, and from personal files. Books and dissertations were also analyzed. Only the most important articles were included in this review. RESULTS: Recurrent abdominal pain is the main cause of recurrent pain in children between 4 and 16 years of age. It is defined as the occurrence of three or more abdominal pain attacks within 3 months or less. These attacks are severe enough to interrupt routine activities, making the child remain asymptomatic between the episodes of pain. The diagnosis is based on a detailed clinical history, on an improved physical examination, and on a few laboratory tests. It can be manifested with isolated paroxysms of umbilical pain, abdominal pain with dyspeptic symptoms, and abdominal pain with digestive tract dysfunction. The treatment must emphasize the cognitive-behavioral factors of the recurrent pain. CONCLUSIONS: The treatment of recurrent abdominal pain using the strategy presented here represents an equilibrium in which time is neither wasted nor insufficient during the investigative process required for treating children and their families with this problem.
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