Aetiology of recurrent abdominal pain in a cohort of Sri Lankan children.
OBJECTIVE
Recurrent abdominal pain (RAP) has a multifactorial aetiology with many affected children having no evidence of organic pathology. This study assessed the functional and organic causes for RAP in a cohort of Sri Lankan children.


METHODS
Fifty-five Sri Lankan children (45.5% males, aged 5-15 years) having RAP were screened for organic diseases. RAP was defined using Apley criteria. Children without clinical or laboratory evidence of organic diseases were classified into functional gastrointestinal diseases (FGD) using Rome II and III criteria. Thirty-nine patients with functional RAP and 20 healthy children (50% males, age 5-15 years) from same area were tested for Helicobacter pylori using a stool antigen test.


RESULTS
Thirteen (23.6%) children had organic RAP. According to Rome II, 33 (60%), and according to Rome III, 39 (71%) (functional abdominal pain 19, irritable bowel syndrome nine, functional dyspepsia nine, abdominal migraine one, aerophagia one) children had FGD. Two (5.1%) patients and one (5%) control tested were positive for Helicobacter pylori (P > 0.05). Except for constipation, pain characteristics and associated symptoms were not significantly different between organic and functional RAP.


CONCLUSIONS
Organic pathology accounted for symptoms in less than a quarter of Sri Lankan children with RAP. The majority had functional bowel diseases, of which the commonest was functional abdominal pain. Rome III criteria were more effective than Rome II criteria in identifying FGD. Helicobacter pylori infection did not appear to be associated with RAP.
Devanarayana
Niranga M
NM
Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka. niranga1230@lycos.com
de Silva
D G Harendra
DG
de Silva
H Janaka
HJ
D015746:Abdominal Pain / Q000209:etiology*; D000293:Adolescent; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D003248:Constipation / Q000150:complications; D005243:Feces / Q000382:microbiology; D005260:Female; D005767:Gastrointestinal Diseases / Q000150:complications* / Q000175:diagnosis / Q000382:microbiology; D016481:Helicobacter Infections / Q000150:complications / Q000382:microbiology; D016480:Helicobacter pylori / Q000302:isolation & purification; D006801:Humans; D008297:Male; D013188:Sri Lanka