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Recurrent Abdominal Pain in Children

More than 10% of school-age children suffer from recurrent abdominal pain (recurrent).
It is most commonly found in children aged 8-10 years, are rarely found in children younger than four years and more frequently found in girls.

DEFINITION
Recurrent Abdominal Pain is a situation where abdominal pain occurred 3 times or more for at least 3 months.

CAUSE
In 5-10% of cases, abdominal pain caused by a physical illness:

    Intestinal abnormalities
    - Hiatus hernia
    - Hepatitis (liver inflammation)
    - Cholecystitis (inflammation of the gall bladder)
    - Pancreatitis (inflammation of the pancreas)
    - Peptic ulcer
    - Parasitic infestations (eg giardiasis)
    - Meckel’s diverticulum
    - Crohn’s Disease
    - Tuberculosis intestinal
    - Ulcerative colitis
    - Chronic Appendicitis
    Abnormalities of the urinary-genital
    - Congenital abnormalities
    - Urinary tract infections
    - Pelvic inflammatory disease (in girls)
    - Ovarian cysts (in girls)
    - Endometriosis (in girls)
    General
    - Lead poisoning
    - Purpura Henoch-Sch? Nlein
    - Sickle cell disease
    - Food allergy
    - Porphyria
    - Familial Mediterranean Anemia
    - Hereditary Angioedema
    - Migraines.

In 80-90% of cases, recurrent abdominal pain is caused more by psychological factors, usually triggered or aggravated in times of stress, anxiety or depression.

Sometimes recurrent abdominal pain is caused by abnormalities in the function of internal organs. Eg bowel dysfunction may occur if the child’s diet is not appropriate, especially if the child can not receive certain types of food, such as milk and dairy products.
Abnormalities of intestinal function can also be caused by constipation that occurs due to the reduced movement of the colon, which sometimes is a reaction to bowel training is not appropriate.
In young women, abdominal pain can be caused by muscle cramps in the uterus during menstruation (dysmenorrhea). Sometimes the release of eggs from the ovaries also cause abdominal pain.

SYMPTOMS
Symptoms vary, depending on the cause.
Abdominal pain due to physical illness usually does not disappear or occur in a cycle, often triggered by certain foods or activities. The pain tends to occur at a particular side of the abdomen, not felt around the navel and may radiate to the back.
Urinary tract infections can cause abdominal pain or lower pelvic pain. Pain may cause a child waking from sleep.

Other symptoms that may be found (depending on the cause):
- Decreased appetite
- Weight loss
- Recurrent or persistent fever
- Jaundice (jaundice)
- Shape and color of the feces changed
- Constipation or diarrhea
- There is blood in the stool
- Vomiting blood or food
- Abdominal swelling
- Pain or swelling of the joints.

Symptoms of recurrent abdominal pain due to abnormal organ function depends on the cause.
If the child has lactose intolerance, then the pain will occur within a few minutes to 2 hours after the child drink milk or consume dairy products.
If the child is suffering from gallbladder disease, abdominal pain occur immediately after eating fatty foods.

Pain due to psychological factors can occur every day or at any time. Sometimes children do not feel the pain for weeks or even months.
Pain is usually dull, often causing the child woke up from sleep at night, but children may be awakened earlier than usual.

Abdominal pain due to psychological factors most often felt around the navel. If the pain is felt further away from the navel, the more likely cause is a physical abnormality.
Psychic pain like a pain sometimes because of physical abnormalities, but pain is usually psychological in nature does not change or worsen.

DIAGNOSIS
Diagnosis based on the primary symptoms and accompanying symptoms, as well as the nature of abdominal pain that is felt.

Diagnosing abdominal pain associated with psychological factors may be somewhat difficult. Usually not found physical abnormalities. Children may be affected by stress in the family, financial problems or separation or loss of loved ones.

TREATMENT
Treatment depends on the cause.
If abdominal pain is triggered by a particular type of food, dietary changes should be made.
To reduce the pain caused by menstruation can be given ibuprofen.

Recurrent abdominal pain is the pain caused by psychological factors arising due to stress and tension. Parents can help by as much as possible to reduce stress and tension, helping children cope with stress and encourage children to enter school even though his stomach pains. Teachers can help by solving problems faced by children in school.
If after many efforts, children still feel abdominal pain (especially when children are depressed or dealing with parents’ marital problems at home), the child may need help from a psychiatrist.

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