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Rivista di Pediatria, Neonatologia, Medicina dell’Adolescenza
e Neuropsichiatria Infantile

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Minerva Pediatrica 2016 Jan 08


lingua: Inglese

Recurrent abdominal pain in children: underlying pathologies in absence of alarm symptoms and signs in a tertiary center.

Carlo TOLONE 1, Valeria PELLINO 1, Margherita PICCIRILLO 1, Mariarosaria LETIZIA 1, Ivano BELFIORE 1, Salvatore TOLONE 2

Department of Pediatric, Second University of Naples, Naples, Italy; 2 Department of General Surgery, Second University of Naples, Naples, Italy


BACKGROUND: Recurrent abdominal pain (RAP) is a common disorder in childhood. However it is not clear what the incidence of organic disease is if there is absence of alarm symptoms or signs. Aim of this study was to clarify if the performance of diagnostic tests can be useful in revealing underlying organic disorders.
METHODS: Participants were 4 to 16 years old children, who were referred to our tertiary care pediatric center. We selected 98 children (48 males, 50 females) with RAP but without any alarm symptoms or signs. In the 98 selected children the performance of diagnostic tests for suspected organic diseases was recommended.
RESULTS: Fourteen children refused diagnostic tests. A total of 48/84 children with RAP without any alarm symptoms and signs received a diagnosis of organic disease. Nineteen (22.6%) patients resulted positive for lactose intolerance. Seventeen patients (20.2%) were affected by celiac disease. Two (2.4%) patients were positive for cow milk allergy. Nine (10.7%) patients resulted positive for ureteral calculosis. One (1.2%) was affected by teniasis. Thirty-three children of the 38 children tested positive for lactose intolerance, celiac disease or cow-milk allergy were completely symptom-free at the 6 months follow-up and the remaining five patients reported a significant lower mean level of pain severity overall. Seven of 9 children with calculosis improved symptomatology. At the next follow-up six children were again suffering from RAP.
CONCLUSION: Children with RAP should be referred to pediatric gastroenterologists if symptoms persist; testing should be performed even in the absence of alarm signs because of the high prevalence of underlying organic pathologies.

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