A Study on Subclassification and Clinical Manifestations of Recurrent Abdominal Pain in Childhood According to Its Symptoms

ABSTRACT

PURPOSE: Recurrent abdominal pain(RAP) is a common problem in childhood, and has a reported prevalence of 10 to 20% in children. Functional abdominal pain is classified into nonulcer dyspepsia(NUD) and irritable bowel(IB) in adults. We designed this study to evaluate clinical manifestations of RAP according to its subclassification. METHODS: Patients who visited Samsung Medical Center from January to July 1998 due to recurrent abdominal pain were included. According to questionaire and history taking, RAP was classified into NUD, its subtypes, and IB. RESULTS: Among 118 children, 93 children were included. Fifteen patients were excluded because we knew the causes of RAP and 10 patients were excluded because they couldn't understand the questionaire. Thirty-five patients(37.6%) had symptoms of NUD, 11(11.8%) had symptoms of IB, and 47(50.5%) had both symptoms. Among the patients with NUD, 16(19.5%) were classified into dysmotility-like dyspepsia(NUDD), 18 patients(22%) into ulcer-like dyspepsia(NUDU) and 1 patient(1.2%) into reflux-like dyspepsia(NUDR). Twenty eight patients(34%) had both symptoms of NUDD and NUDU, 8 patients(9.8%) had both NUDD and NUDR, 3 patients(3.7%) had both NUDR and NUDU and 8 patients(9.8%) had all symptoms. Among patients with IB and NUD, symptom of NUDD(63.2%) was most prevailing. NUDR significantly correlated with autonomic nervous symptoms(P=0.006). However, the prevalence rate of H. pylori IgG antibody were not significantly different among subgroups. CONCLUSION: NUDD is the most common symptom that is manifestated in children and it is the same in adults. This study showed that the subclassification of RAP in children is feasible.