Chronic abdominal pain in children

Chronic abdominal pain is a common disorder in children and adolescents worldwide. It affects the child’s wellbeing, and the costs from missed school days and use of healthcare resources are high. Children with chronic abdominal pain represent a heterogeneous population comprising both organic and functional gastrointestinal disorders. Functional disorders are those that cannot be explained by structural or biochemical abnormalities. Differences in prevalence of organic disease are reported depending on the setting, ranging from 5% in the general population to 40% in a paediatric gastroenterologist practice.1 General practitioners feel confident in labelling chronic abdominal pain as an easy to manage functional disorder. After minimal further testing, these children and their parents can be reassured by explaining that the symptoms are common and rarely associated with disease. However, when diagnostic uncertainty increases, pain does not resolve over time, or parents are hard to reassure, extensive testing and referral easily set in. As a consequence paediatricians perceive chronic abdominal pain as a time consuming and therapy resistant disorder.

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