Recurrent Abdominal Pain (RAP) in Children – More Than it Seems

European study found in RAP syndrome without any alarm features, 57% were found to have organic disease – and treatment of such lead to resolution of symptoms.

Things found included:

  • 19 (22.6%)  lactose intolerance.
  • 17 patients (20.2%)  celiac disease.
  • Two (2.4%) cow milk allergy.
  • 9 (10.7%) ureteral calculosis.
  • One (1.2%) was affected by teniasis = tapeworm

Minerva Pediatr. 2017 Aug;69(4):239-244. doi: 10.23736/S0026-4946.16.04247-X.
Recurrent abdominal pain in children: underlying pathologies in the absence of “alarm” symptoms.
Tolone C. et al
https://www.ncbi.nlm.nih.gov/pubmed/26745709

  • lactose inloterance from Hydrogen/methane gas testing I presume
  • Mild allergy  from elimination (easy with soy and almond milks) and reintroduction
  • celiac – now here is a problem – I am not convinced our testing is accurate as I have not had a positive even among known gluten sensitive cases. Biopsy may not be positive unless subject has consumed much gluten for months. Dumbed down versions might only show lymphocytes
    New Help for Some Fibromyalgia (FM) – Gluten Sensitivity Management
    http://painmuse.org/?p=4330
    – I had one pediatric gastroenterologist find increased lymphocyte cellularity in villi as not significant.
    eliminating gluten could take months to show full effects
    Anyone got an answer?
  • Ureteral stones – passing kidney stone – flank pain, blood in urine, vomiting, 40% family history of stones,  metabolic history discussed here:
    https://link.springer.com/article/10.1007/s00467-008-1073-x
  • Possibility of protozoal infection has been previously discussed:
    Some Recurrent Abdominal Pains (RAP) in Kids are Missed Protozoan Infection
    http://painmuse.org/?p=2831

Comment – these leaves much to be considered in young belly-aching children.

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