Recurrent abdominal pain and irritable bowel syndrome in children.
OBJECTIVE
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.


RESULTS
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.


CONCLUSIONS
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.
McOmber
Mark E
ME
Baylor College of Medicine, Texas Children's Hospital, Children's Nutrition Research Center, 1100 Bates Street, Houston, TX 77030, USA.
Shulman
Robert J
RJ
D015746:Abdominal Pain / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D002648:Child; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D009035:Mothers / Q000523:psychology; D012008:Recurrence