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Query: UMLS:C0000737 (abdominal pain)
 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

H pylori infection is highly prevalent in asymptomatic children and it varies between countries and often within a country as well. Initial infection probably occurs at an early age and prevalence increases with age. Ethnic and racial factors, socio-economic status and living conditions affect the prevalence of infection. Long term population based studies are needed to identify the exact prevalence and clinical significance in Indian children. There is strong evidence for an association between H pylori infection and antral gastritis and duodenal ulcer disease in children, but it's association with recurrent abdominal pain needs further evaluation. Diagnostic tests for H pylori are based either on direct demonstration of the organism or indirectly by detecting a by-product (of the urease reaction) or by demonstrating antibodies. Histopathological identification of H pylori in [table: see text] antral biopsy specimen is by far the best method and is currently regarded as gold standard. Serological tests detecting IgG and IgA are possible tools for diagnosis but have many drawbacks. They may be useful for population surveys where invasive tests are not feasible. These tests should be standardized for the population for which they are going to be used. Urea breath test is a highly sensitive non-invasive test for H pylori infection and can be used even in a field setting. Urea Breath test needs to be standardized in tropical countries with high rates of dental colonization and duodenal microbial contamination. Newer diagnostic tests for H pylori infection are emerging but most have not been validated in various populations. Routine testing for H pylori is not indicated in children or adults. The decision to perform a diagnostic test has often to be linked with a therapeutic proposal. The only condition for which H pylori treatment is indicated is duodenal ulcer which is very uncommon in children. Treatment for RAP or even dyspepsia is not warranted on clinical grounds. There are several treatment regimens available, but it appears that at least three drugs including two antibiotics and a proton pump inhibitor are required for satisfactory eradication. In developing countries where the prevalence of infection is very high, well-planned double blind cross-over studies are needed before an evidence based answer can be provided for an optimal therapeutic strategy.
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PMID:Helicobacter pylori infection in children: a review. 1497 81

The term 'recurrent abdominal pain', or RAP, refers mainly to the duration of painful period and frequency of pain. The commonly accepted duration is at least three months in the preceding period, and over this three-month period, there are at least three episodes of pain that are severe enough to affect the daily activities of the affected patients. Over the years, with advances in medical technology and better understanding of the pathophysiology of abdominal pain, more and more organic causes have been identified. However, the most common cause of RAP in children is still functional in origin.
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PMID:Recurrent abdominal pain in children: a clinical approach. 2582 Aug 43

Introduction. Intermittent visceral distress syndrome is described as "at least three scenes of visceral distress, sufficiently severe to hinder their actions over a time longer than 3 months, continuing from the preceding year". Organic factors causing abdominal pain are rare, so most of the children with an intermittent visceral distress are designated to have a functional abdominal pain. This study was designed to evaluate psychological problems such as anxiety and distress in children with functional intestinal distress. Method. 120 children (50 boys and 70 girls) with an age range of 5-18 years, who complained of abdominal pain among other things, were included in this cross-sectional case-control study (forty with an organic etiology, 38 diagnosed as RAPS and 42 healthy controls). Revised Children's Manifest Anxiety Scale (RCMAS) questionnaire and Depression Self-Rated Scale (DSRS) questionnaire were used to determine the level of anxiety. A 28-question General Health Questionnaire (GHQ-28) was also used to investigate the general mental health of their mothers. Result. In the present study, organic and functional etiology of abdominal pain was significantly different with regard to the anxiety score. However, this was not seen as far as depression was concerned. The total GHQ score of mothers was not significantly different between the three groups. ANOVA was used to compare groups. Conclusion. As shown in the present study, that is consistent with most other studies, psychological factors were seen in RAP and need a more in depth investigation to be resolved.
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PMID:Psychological aspects of Recurrent Abdominal Pain Syndrome in children. 2831 7


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