WHAT IS RECURRENT ABDOMINAL PAIN (RAP)
Recurrent Abdominal Pain (RAP) is one of the commonest gastrointestinal complaints from children and adolescents and can be defined as the abdominal pain that occurs at least four times a month over a period of two months or more. The abdominal pain severe enough to keep a child from doing everyday activities.
Recurrent Abdominal Pain (RAP) is believed to be a Functional Gastrointestinal Disorder or Functional Gut-brain Interaction Disorder (FGID) that is caused by altered feedback mechanisms between the gut and the central pain pathways. This brain-gut dysfunction relates to the disharmony in the way the brain and the gastrointestinal system communicate. This impaired communication can lead to increased pain and bowel difficulties.
WHAT CAUSES RAP?
The recurrent abdominal pain, is quite often due to a number of gastrointestinal (GI) issues such as infection of the GI tract, dietary indiscretion, urinary tract infection and sometimes other sinister surgical conditions like appendicitis.
Some possible causes of recurrent abdominal pain include:
- Indigestion
- Constipation
- Irritable Bowel Syndrome (IBS)
- Stomach ulcers
- Liver or gallbladder issues
- Food sensitivities, for e.g. lactose intolerance
- Heartburn (gastroesophageal reflux)
- Abdominal migraines
- Anxiety or depression
- Gas
- Ovulation in girls
- Inflammatory Bowel Disease (IBD) of family history of IBD, such as Crohn’s disease or ulcerative colitis
- Recurrent urinary tract infections
WHEN SHOULD YOU CONSULT A PEDIATRIC GASTROENTEROLOGIST?
The symptoms of RAP, in fact, differ from person to person. The pain actually starts without a warning, and in some cases, it could be ongoing. Some children describe the pain as a dull ache in their belly some children experience sharp cramps. Apart from pain, there could be some other symptoms like diarrhea or vomiting.
Most children who complain of recurrent abdominal pain because of an underlying organic pathology you should immediately contact your child’s doctor if your child has any of the following:
- Weight loss
- Failure to gain weight or slowed growth
- Persistent pain on the right side of the abdomen
- Fever
- Significant vomiting
- Chronic diarrhea
- Pain that wakes up the child night
- Pain or bleeding with urination or feeling the urgency to urinate
- Changes in stool pattern - either more frequently or less frequently than what was the usual for the child
- Abnormal physical signs, such as pallor or jaundice
There is a possibility that your child might not show any of these symptoms in spite of an existing recurrent abdominal pain. In such cases, mother should record the details in a diary – when the pain happened, how long did it last and were there any clear triggers. Share these with your child’s pediatrician.
OUR APPROACH TO TREATMENT:
When you visit us with your child shows the above symptoms, Dr. Deepak Goyal and his team’s approach is to first understand more about the symptoms and family history. They will enquire about when the pain starts and what makes the child feel better or worse. This will be followed by a thorough physical examination.
The team of doctors at PedsGastroDelhi.com aim to follow a course of action that empowers the mothers to be an active part of the process and importantly avoid unnecessary investigations. However, some routine investigations cannot be avoided and need to be done and in some cases, some elaborate investigations are asked for.
The results of these tests help your doctor to decide the treatment process that will help your child the most. In some cases, a specific health issue may be the rout cause of abdominal pain, in such cases your doctor would suggest the treatment accordingly.
