Recurrent abdominal pain in children.

Context: Recurrent abdominal pain is one of the commonest gastrointestinal complaints in children, affecting approximately 10% of school aged children and adolescents. There is no consensus with regards to etiology, investigation and management of this common problem. This review addresses some of the issues related to epidemiology, etiology, management and prognosis of recurrent abdominal pain. Evidence acquisition: We reviewed current literature on this broad subject, specially concentrating on epidemiology, etiology and, basic and advanced management strategies, from 1958 to date, using PubMed, Embase, Cochrane database and cross references. Results: The majority of the affected children have functional gastrointestinal diseases. The exact cause of pain remains obscure. New evidence suggests that emotional stress, visceral hypersensitivity and gastrointestinal motility disorders may play a vital part in its origin. Pharmacological treatments are commonly used in an effort to manage symptoms, despite the lack of data supporting their efficacy. Conclusions: Most children with recurrent abdominal pain have functional gastrointestinal diseases and a detailed history, examination and basic stool, urine and hematological investigations are sufficient to exclude organic pathology in them. Despite the magnitude of the problem, knowledge on the effective management options is poor.

Constipation and functional faecal retention in a group of school children in a district in Sri Lanka.

Objective To assess the prevalence of constipation and functional faecal retention among a group of school children in Gampaha district of Sri Lanka. Method This is a cross sectional survey. A validated, self-administered questionnaire was distributed to randomly selected children, aged 10- 16 years, in a semi-urban school in Gampaha District of Sri Lanka. Constipation was defined using Rome III criteria and Paris Consensus on Childhood Constipation Terminology (PACCT). Functional faecal retention was diagnosed using Rome II criteria. Results A total of 441 questionnaires were distributed and 429 (97.3%) responded (53.1% males, mean age 12.4 years, SD 1.5 years). According to Rome III criteria and PACCT, 46 (10.7%) had constipation. Prevalence of constipation was higher in males (14.5%) compared to females (6.5%) [OR 2.45, 95% CI 1.19-5.1, p=0.012]. Twenty three (5.4%) had functional faecal retention. Conclusions Chronic constipation is a significant problem, affecting approximately 10% of children in a semi-urban school in Gampaha district. It is commoner among males. Both Rome III criteria and PACCT are effective in diagnosing childhood constipation in epidemiological studies.

An intervention study to monitor weight gain in infants using a home based complementary food recipe and a hand blender.

OBJECTIVES: To assess the efficacy of a home made energy dense weaning food, containing 110-130 kcal (26-30kJ) per 100 ml on prevention of growth faltering during infancy. METHODOLOGY: Infants attending four child health welfare clinics in the Medical Officer of Health (Ragama) area were recruited at the age of 4 months. The intervention group received a specially designed hand blender, recipe and advice to prepare a weaning food. The control group received weaning foods without any intervention. They were followed up monthly up to the age of 12 months. RESULTS: 152 infants completed the study (83 from intervention group). The infants in the intervention group gained significantly more weight than the control group (intervention group 2.43 +/- 0.72 kg, control group 2.02 +/-0.62 kg, p = 0.0002). Both groups showed a drop in the Z score for mean weight for age during the study period but this was less marked in the intervention group. CONCLUSIONS: A high energy density home made complementary food was effective in improving the weight gain of infants during the weaning period.