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Clinical and laboratory findings in 220 children with recurrent abdominal pain

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Abstract Aim: 

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. Conclusion: 

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.
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Keywords: Abdominal pain; Child; Helicobacter pylori; Infantile colic; Parasites

Document Type: Research Article

Affiliations: 1: Department of Paediatric Gastroenterology, Juliana Children’s Hospital/Haga Teaching Hospital, The Hague, The Netherlands 2: Department of Paediatric Gastroenterology Academic Medical Centre, Amsterdam, The Netherlands 3: Erasmus Medical Centre, Rotterdam, The Netherlands

Publication date: 2011-07-01

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