title: Clinical and laboratory findings in 220 children with recurrent abdominal pain.
abstract: OBJECTIVE
  To investigate the clinical and laboratory findings in children with recurrent abdominal pain (RAP).
  
  
  METHODS
  Consecutive patients with RAP (Apley criteria), age 4-16 years, referred to a secondary medical centre were evaluated by a standardized history, physical examination and laboratory tests. The tests encompassed Helicobacter pylori (Hp), gastrointestinal bacterial infections, protozoa, coeliac disease, carbohydrate malabsorption, food intolerance, abdominal ultrasound and plain abdominal X-ray. More investigations were obtained if indicated. Patient characteristics were compared with surgical patients without abdominal pain (control group).
  
  
  RESULTS
  A total of 220 consecutive patients were included (92 M, mean age 8.8 years [4.1-16.0 years]). In 88% of the patients, abnormalities were found that refer to possible causes. Especially, protozoa were present in 33% of the patients, mostly Dientamoeba fragilis, Yersinia enterocolitica in 12% and endoscopically proven infection with Hp in 11%. In 36%, a plain abdominal X-ray raised suspicion of constipation.
  
  
  CONCLUSIONS
  In 220 consecutive patients with RAP, referred to secondary care, a standardized work-up yielded abnormal results in a high percentage. The clinical significance of these findings remains to be established.
authors.affiliation: Department of Paediatric Gastroenterology, Juliana Children's Hospital/Haga Teaching Hospital, The Hague, The Netherlands. c.gijsbers@hagaziekenhuis.nl
authors.forename: C F M
authors.initials: CF
authors.lastname: Gijsbers
authors.forename: Ma
authors.initials: M
authors.lastname: Benninga
authors.forename: Ha
authors.initials: H
authors.lastname: Büller
mesh_terms: D015746:Abdominal Pain / Q000209:etiology* / Q000382:microbiology / Q000469:parasitology; D000293:Adolescent; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003248:Constipation / Q000150:complications*; D004029:Dientamoeba / Q000145:classification / Q000302:isolation & purification; D004030:Dientamoebiasis / Q000150:complications*; D016099:Endoscopy, Gastrointestinal; D005260:Female; D016481:Helicobacter Infections / Q000150:complications*; D016480:Helicobacter pylori / Q000302:isolation & purification; D006801:Humans; D008297:Male; D011446:Prospective Studies; D011860:Radiography, Abdominal; D012008:Recurrence; D012017:Referral and Consultation; D015009:Yersinia Infections / Q000150:complications*; D015008:Yersinia enterocolitica / Q000302:isolation & purification