Submitted to: Current Opinion in Pediatrics
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 8/1/2007
Publication Date: 10/1/2007
Citation: McOmber, M.E., Shulman, R.J. 2007. Recurrent abdominal pain and irritable bowel syndrome in children. Current Opinion in Pediatrics. 19(5):581-585. Interpretive Summary: This review discusses two of the most common conditions that affect children. Although the exact cause(s) are not known, we now understand some of the factors that contribute to these conditions. They include a gastrointestinal tract that is very sensitive to normal functions and an interaction between the psychological state of the parent, usually the mother, and the child. Newer treatments include improving coping skills as well as medications such as peppermint oil and probiotics ("good bacteria").
Technical Abstract: Recurrent abdominal pain continues to be one of the most ubiquitous conditions faced by the healthcare team, and has a significant emotional and economic impact. We have moved from considering it a psychological condition to recognizing the physiological and environmental contributions, and considering the condition in the framework of a biopsychosocial model where biology, psychology, and social environment interact. Here, we review current studies addressing etiologies, diagnostic techniques, and treatment options for recurrent abdominal pain in children. Studies continue to highlight the role of visceral hypersensitivity in recurrent abdominal pain. The psychological state of the child and the parent (most often the mother) in terms of their anxiety, somatization, and coping skills can, however, modulate the expression of symptoms. Diagnosis still is made by history and physical examination. Newer treatment options include relaxation and distraction therapies as well as medications. The role of probiotics in children remains to be defined. The approach to the child with recurrent abdominal pain must include the recognition of the physiological contributions, and this information must be relayed to the child and parents. Acknowledgement also must be paid to the role of psychological state in the parent as well as in the child in modulating the severity of symptoms.