Chronic and Recurrent Abdominal Pain.

نویسنده

  • Paul E Hyman
چکیده

By definition, chronic or recurrent abdominal pain must occur at least 4 times each month for at least 2 months. Abdominal pain complaints begin as soon as a child can provide an accurate pain history, usually around age 7 years but occasionally younger. Before that age, children have difficulty separating emotional distress from physical pain. The differential diagnosis of child and adolescent abdominal pain is unrelated to age. One in 10 children visits a clinician because of chronic or recurrent abdominal pain. (1) How can a clinician screen quickly for disease? The first consideration is the duration of each episode. If the pain lasts less than 5 minutes, even if it occurs many times daily, the pain is unlikely to be worrisome. Abdominal pains lasting just a few minutes may be abdominal wall muscle cramps or high-amplitudepropagating colon contractions. High-amplitude-propagating contractions are waves of muscle contraction starting in the ascending colon, with pressures greater than 60 mm Hg, that move colonic contents through the colon to the rectum. (2) High-amplitude-propagating colon contractions are normal, but they cause an urge to defecate for about 2 minutes several times daily. Children who AUTHOR DISCLOSURE Dr Hyman has disclosed no financial relationships relevant to this article. This commentary does contain a discussion of an unapproved/investigative use of a commercial product/device.

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عنوان ژورنال:
  • Pediatrics in review

دوره 37 9  شماره 

صفحات  -

تاریخ انتشار 2016