Recurrent abdominal pain in 200 children: somatic causes and diagnostic criteria

Acta Paediatr. 2011 Nov;100(11):e208-14. doi: 10.1111/j.1651-2227.2011.02351.x. Epub 2011 Jun 1.


Aim: To establish to what extent somatic causes can be found in children referred to secondary care with recurrent abdominal pain.

Methods: For 2 years, all consecutive patients (age 4-16 years) fulfilling Apley criteria, referred to secondary care, were included. After a diagnostic work-up, stepwise therapeutic interventions were performed. A diagnosis was considered to be the cause of the pain when the patient became pain free following therapeutic intervention and remained so for at least 6 months.

Results: Two hundred and twenty children (128 F, 92 M; mean age 8.8 years) were enrolled, of which 20 were lost to follow-up. Spontaneous recovery was seen in 54 patients, (occult) constipation in 92 patients (of whom 18 also had a somatic cause), gastrointestinal infections in 40, food allergy in five, miscellaneous disorders in seven and uncertain diagnosis in 13. In five patients, stress most likely caused the pain. A total of 198 patients became pain free and remained so during follow-up (mean 18, range 6-60 months).

Conclusion: In 200 children with recurrent abdominal pain, somatic causes were found in 26%. Laxative therapy was successful in 46%, resulting in nearly all patients with functional abdominal pain to become pain free. Eventually, 99% became pain free using a therapeutic intervention protocol.

MeSH terms

  • Abdominal Pain / diagnosis
  • Abdominal Pain / etiology*
  • Abdominal Pain / therapy
  • Adolescent
  • Child
  • Child, Preschool
  • Constipation / complications*
  • Constipation / diagnosis
  • Constipation / therapy
  • Diet Therapy
  • Female
  • Food Hypersensitivity / complications*
  • Food Hypersensitivity / diagnosis
  • Food Hypersensitivity / therapy
  • Gastrointestinal Diseases / complications*
  • Gastrointestinal Diseases / diagnosis
  • Gastrointestinal Diseases / therapy
  • Humans
  • Laxatives / therapeutic use
  • Male
  • Recurrence


  • Laxatives